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When brain devices go wrong: a patient with a malfunctioning deep brain stimulator (DBS) presents to the emergency department
  1. Isabel Straw1,
  2. Charlotte Ashworth2 and
  3. Nicola Radford2
  1. 1Institute of Health Informatics, University College London, London, UK
  2. 2Accident and Emergency Department, Homerton University Hospital, London, UK
  1. Correspondence to Dr Isabel Straw; isabelstraw{at}doctors.org.uk

Abstract

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.

  • Emergency medicine
  • Ethics
  • Neurology
  • Neurology (drugs and medicines)
  • Health informatics

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Footnotes

  • Twitter @IsabelStrawMD

  • Contributors IS came up with the idea, performed the background research and developed the original draft of the manuscript, CA and NR contributed to edits of the manuscript and final revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.