Drowning hazard with deep brain stimulation: case report

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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.

ABBREVIATIONScZI = caudal zona incerta; DBS = deep brain stimulation; MDS-UPDRS-III = Movement Disorder Society-Unified Parkinson’s Disease Rating Scale Part III (motor section); PD = Parkinson disease; PSA = posterior subthalamic area; STN = subthalamic nucleus.
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Contributor Notes

Correspondence Christopher Lind, Neurosurgical Service of Western Australia, 1st Fl., G Block, Sir Charles Gairdner Hospital, Hospital Ave., Nedlands WA 6009, Australia. email: christopher.lind@health.wa.gov.au.INCLUDE WHEN CITING Published online November 13, 2015; DOI: 10.3171/2015.5.JNS15589.Disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.

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