Malignant deep brain stimulation withdrawal syndrome following elective implantable pulse generator replacement. A case report

IF 0.4 Q4 CLINICAL NEUROLOGY Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2024-01-07 DOI:10.1016/j.inat.2023.101943

Paweł R. Zdunek , Victor Mandat , Henryk M. Koziara , Tomasz S. Mandat

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Abstract

Malignant deep brain stimulation (DBS) withdrawal syndrome constitutes a rare neurological emergency among advanced Parkinson's disease (PD) patients treated with the subthalamic nucleus (STN) Deep Brain Stimulation. Its clinical course mimics Neuroleptic Malignant Syndrome and when left untreated might lead to death.

We present a case of a 61 year old woman treated with STN DBS because of PD, who underwent under local anesthesia implantable pulse generator (IPG) replacement. The IPG stopped functioning several days before the replacement. Due to increased motor symptoms the patient was unable to intake medications several days prior to surgical intervention. Within immediate post-operative period she developed malignant DBS withdrawal syndrome. The successful treatment consisted of supportive care, dopaminergic medication and immediate restoration of the IPG.

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择期更换植入式脉冲发生器后的恶性脑深部刺激戒断综合征。病例报告

恶性脑深部刺激（DBS）戒断综合征是接受眼下核（STN）脑深部刺激治疗的晚期帕金森病（PD）患者中一种罕见的神经系统急症。我们报告了一例因帕金森病接受 STN DBS 治疗的 61 岁女性患者，她在局部麻醉下接受了植入式脉冲发生器（IPG）更换手术。IPG 在更换前几天停止工作。由于运动症状加重，患者在手术前几天无法服用药物。术后不久，她就患上了恶性 DBS 戒断综合征。成功的治疗包括支持性护理、多巴胺能药物治疗和立即恢复 IPG。

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