Deep brain stimulator

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Poorly controlled long-standing Parkinson's disease.

Patient Data

Age: 60 years
Gender: Male
ct

Bilateral deep brain stimulation devices are seen in place with the tip of electrodes extending to the region of the subthalamic nuclei.  Focal hypo densities are noted in the bilateral frontal lobe white matter around the electrodes which likely represent gliosis. Changes of age-related cerebral atrophy are noted. 

x-ray

Frontal radiograph of the chest shows bilateral pulse generators (black arrows) with
bilateral leads extending cranially (black arrows). Frontal & lateral views of the skull/neck show bilateral leads (black arrows) connecting to the electrodes that extend intracranially into the region of bilateral subthalamic nuclei (as seen on the CT brain shown above).

Case Discussion

Electronic stimulation devices are used as an alternative treatment option in different diseases which are refractory to the conventional medical management. These devices do not cure the underlying primary disease; however, help in the symptomatic management. Deep brain stimulation (DBS) is an example of one of such electronic devices which is used in the management of Parkinson disease and other movement disorders.

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