Position-Dependent Dysfunction of Deep Brain Stimulation in Tourette Syndrome: Diagnostic Clues

  • Marc E. Wolf
  • Olaf Majewski
  • Kirsten R. Müller-Vahl
  • Christian Blahak
  • Dirk Michael Schulte
  • Joachim K. Krauss

Abstract

Background: Detection of defective deep brain stimulation (DBS) contacts/electrodes is sometimes challenging.

Case Report: We report a patient with Tourette syndrome (TS), who presented with abrupt tic increase and mild generalized headache 9 years after DBS implantation. On the suspicion of a hardware defect, a fracture of the DBS electrode and extension lead was ruled out by radiography and standard implantable pulse generator readouts. Further investigation revealed position-dependent modifiable therapeutic impedances, suggesting an impaired contact of the extension lead/adaptor. After replacement normal impedances were recorded, and the patient fully recovered.

Discussion: In DBS dysfunction with inconspicuous hardware check, position-dependent defects might be suspected.

Keywords: Deep brain stimulation, hardware complications, headache, impedance, Tourette syndrome

Citation: Wolf ME, Majewski O, Müller-Vahl KR, Blahak C, Schulte D-M, Krauss JK. Position-dependent dysfunction of deep brain stimulation in Tourette syndrome: Diagnostic clues. Tremor Other Hyperkinet Mov. 2019; 9. doi: 10.7916/tohm.v0.713