When brain devices go wrong: a patient with a malfunctioning deep brain stimulator (DBS) presents to the emergency department.
Isabel StrawCharlotte AshworthNicola RadfordPublished in: BMJ case reports (2022)
A man in his 50s attended the emergency department with an acute deterioration in his Parkinson's symptoms, presenting with limb rigidity, widespread tremor, choreiform dyskinesia, dysarthria, intense sadness and a severe occipital headache. After excluding common differentials for sudden-onset parkinsonism (eg, infection, medication change), an error on the patient's deep brain stimulator was noted. The patient's symptoms only resolved once he was transferred to the specialist centre so that the programmer could reset the device settings. Due to COVID-19-related bed pressures on the ward, there was a delay in the patient receiving specialist attention-highlighting the need for non-specialist training in the emergency management of device errors.
Keyphrases
- emergency department
- case report
- palliative care
- white matter
- resting state
- healthcare
- public health
- adverse drug
- parkinson disease
- deep brain stimulation
- sars cov
- drug induced
- coronavirus disease
- working memory
- liver failure
- early onset
- blood brain barrier
- extracorporeal membrane oxygenation
- brain injury
- subarachnoid hemorrhage
- acute respiratory distress syndrome
- mechanical ventilation