Reversible Neurological Symptoms Caused by Diathermy in a Patient With Deep Brain Stimulators

Roark, Christopher; Whicher, Steven; Abosch, Aviva

doi:10.1227/01.neu.0000311085.73519.b4

Cited by 37 publications

(18 citation statements)

References 19 publications

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“…One agreed and lifethreatening risk of MW is its use in proximity to indwelling stimulators or electronic equipment. 2,61,62 The use of US away from such sites is erroneously also often contraindicated because its biophysical properties are misunderstood. 61 Both MW and US can cause superficial burning under certain conditions.…”

Section: Discussionmentioning

confidence: 99%

“…2,61,62 The use of US away from such sites is erroneously also often contraindicated because its biophysical properties are misunderstood. 61 Both MW and US can cause superficial burning under certain conditions. However, most adverse incidents reported with MW are secondary to its use in warming hot packs or damp cloths for superficial heating.…”

Section: Discussionmentioning

confidence: 99%

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Electrophysical agents and research: from instinct to evidence

Robertson¹

2008

Physical Therapy Reviews

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Objectives: Anecdotally the focus on evidence-based practice in many health sciences is not reflected in the availability and usage patterns of electrophysical agents. This proposition is examined in relation to therapeutic ultrasound (US) and microwave (MW). Methods: Research published in English between 1998 and 2008 and using MW or US to treat musculoskeletal conditions was identified and reviewed. Usage and availability of each modality was also examined and compared with evidence of clinical effectiveness identified in the literature review.Results: While MW is rarely available or used, recent research suggests positive outcomes in treating different musculoskeletal conditions, particularly with a frequency of 434 MHz. By contrast, US is often available and used but the research on this remains equivocal. Discussion: The known effectiveness of MW and US in treating musculoskeletal problems is not reflected in usage patterns. Usage appears to be based on other than evidence of the clinical utility of these two modalities. How much it derives from patients' expectations and issues clinicians may have in using research not targeted at practitioners is unknown. There are implications for educators, clinicians, researchers and journal editors. These may include the need for more syntheses of research findings and books that focus on clinical conditions rather than research per se. These ideas need further exploration. Conclusion: The choice of MW or US is apparently based on other than evidence of effectiveness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Electrophysical agents and research: from instinct to evidence

Robertson¹

2008

Physical Therapy Reviews

View full text Add to dashboard Cite

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“…Any environmental sources of electromagnetic interference such as cardiac pacemakers, implantable or external cardiac defibrillators, magnetic resonance imaging (MRI), and security checkpoints pose a potential risk of causing the DBS to change settings or turn off, according to the manufacturer's online manual . Cases of adventitious current or heat at the electrode site induced by MRI, diathermy, and cardioversion leading to severe neurologic injury have been reported . If MRI is to be used for a DBS patient, only scanners that are equipped with 1.5 Tesla horizontal bores, transmit–receive head coils, average head‐specific absorption rates below 0.1 watts/kg, and dB/dt gradients of 20 Tesla/sec or less are permitted according to manufacturer's warnings .…”

Section: Introductionmentioning

confidence: 99%

Differential Diagnosis of Psychiatric Symptoms After Deep Brain Stimulation for Movement Disorders

Quinn

Deligtisch

Rees

et al. 2014

Neuromodulation: Technology at the Neural Interface

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“…In the European Union, however, St. Jude Medical has received Conformité Européenne (CE) approval for its DBS device [3] , and Boston Scientific is conducting a clinical trial on its Vercise System [4] , aimed at obtaining CE approval. In the USA, the efficacy of DBS for both treatment-resistant depression and for epilepsy is currently under investigation, raising the possibility that an even greater proportion of patients will soon be implanted with DBS devices [5] .…”

Section: Introductionmentioning

confidence: 99%

MRI-Related Heating near Deep Brain Stimulation Electrodes: More Data Are Needed

Gupte

Shrivastava

Spaniol

et al. 2011

Stereotact Funct Neurosurg

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Magnetic resonance imaging (MRI) of patients with implanted deep brain stimulation (DBS) devices poses a challenge for healthcare providers. As a consequence of safety concerns about magnetic field interactions with the device, induced electrical currents and thermal damage due to radiofrequency heating, a number of stringent guidelines have been proposed by the device manufacturer. Very few detailed investigations of these safety issues have been published to date, and the stringent manufacturer guidelines have gone unchallenged, leading some hospitals and imaging centers around the world to ban or restrict the use of MRI in DBS patients. The purpose of this review is to stimulate research towards defining appropriate guidelines for the use of MRI in patients with DBS. Additionally, this review is intended to help healthcare providers and researchers make sound clinical judgments about the use of MRI in the setting of implanted DBS devices.

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Reversible Neurological Symptoms Caused by Diathermy in a Patient With Deep Brain Stimulators

Abstract: This is the first reported case of reversible injury from diathermy in a patient with DBS implants. Neurosurgeons must continue to emphasize to their patients and to other practitioners treating this population that diathermy is contraindicated for those with DBS implants.

Cited by 37 publications

References 19 publications

Electrophysical agents and research: from instinct to evidence

Electrophysical agents and research: from instinct to evidence

Differential Diagnosis of Psychiatric Symptoms After Deep Brain Stimulation for Movement Disorders

MRI-Related Heating near Deep Brain Stimulation Electrodes: More Data Are Needed

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