Drowning hazard with deep brain stimulation: case report

Abstract

The caudal zona incerta target within the posterior subthalamic area is an investigational site for deep brain stimulation (DBS) in Parkinson disease (PD) and tremor. The authors report on a patient with tremor-predominant PD who, despite excellent tremor control and an otherwise normal neurological examination, exhibited profound difficulty swimming during stimulation. Over the last 20 years, anecdotal reports have been received of 3 other patients with PD who underwent thalamic or pallidal lesioning or DBS surgery performed at the authors' center and subsequently drowned. It may be that DBS puts patients at risk for drowning by specifically impairing their ability to swim. Until this finding can be further examined in larger cohorts, patients should be warned to swim under close supervision soon after DBS surgery.

Beware of deep water after subthalamic deep brain stimulation

“…The observation that several patients lost their ability to swim was therefore unexpected, particularly since the surgical procedure was considered successful given the improvement in motor symptoms and quality of life. However, the findings are consistent with a previous case report 5 . One reasonable explanation may be that DBS affects the supplementary motor area (SMA) differently than levodopa.…”

DBS for dystonia: Should we take our patients to the swimming pool?

“…In this paper, we address the presence of serious swimming problems in dystonia patients receiving DBS-GPi. In several recent reports impaired swimming skills in patients with PD were described after subthalamic, thalamic and pallidal DBS [3][4][5]. We hypothesized that a similar mechanism could be present in dystonia.…”

Tiefe Hirnstimulation beim idiopathischen Parkinson-Syndrom

“…Die THS kann bestimmte koordinative Fähigkeiten verschlechtern, z. B. die Fähigkeit zu schwimmen mit entsprechendem Risiko des Ertrinkens [39]. Im Rahmen der Nachbetreuung darf der rechtzeitige Wechsel des Stimulationsaggregats (Batterieerschöpfung bzw.…”