Neurosurgeons told to watch for signs of "twiddler's syndrome"

doi:10.1136/bmj.39279.395787.BE

BMJ 2007;335:114-115 (21 July), doi:10.1136/bmj.39279.395787.BE

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Neurosurgeons told to watch for signs of "twiddler's syndrome"

Roger Dobson

Abergavenny

The first 150 words of the full text of this article appear below.

Neurosurgeons need to watch out for signs of "twiddler's syndrome"in their patients, a new report warns.

With the increasing use of implanted stimulation devices, therehave been a number of reports where patients have consciously,subconsciously, or unintentionally moved wires attached to thedevice.

"With the advent of implanted pulse generators in the treatmentof epilepsy, Parkinson's disease, essential tremor, and painthose caring for patients with such a device should be awareof this potential complication," says the report in SurgicalNeurology (doi: 10.1016/j.surneu.2006.10.062).

It says, "Experience with similar placement of cardiac pacemakersand defibrillators had revealed the possibility of generatormigration and subsequent lead fracture either spontaneouslyor, more often, through a patient's conscious or subconsciousmanipulation of the device through the skin. This phenomenonhas been termed twiddler's syndrome."

Power for such stimulation devices comes from an implanted pulsegenerator, usually located in a pocket . . . [Full text of this article]

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