Drowning hazard with deep brain stimulation: case report

Omar K. Bangash School of Surgery, University of Western Australia;
Neurosurgical Service of Western Australia, Sir Charles Gairdner Hospital;

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Megan Thorburn Neurosurgical Service of Western Australia, Sir Charles Gairdner Hospital;

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Jimena Garcia-Vega School of Surgery, University of Western Australia;
Department of Physiotherapy, Sir Charles Gairdner Hospital;

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 BAppSc (Physio)
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Susan Walters Western Australian Neuroscience Research Institute;

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 BAppSc (Physio)
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Rick Stell Western Australian Neuroscience Research Institute;
Department of Neurology, Sir Charles Gairdner Hospital; and

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Sergio E. Starkstein Neuropsychiatry Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia

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 MD, PhD
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Christopher R. P. Lind School of Surgery, University of Western Australia;
Neurosurgical Service of Western Australia, Sir Charles Gairdner Hospital;

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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.

ABBREVIATIONS

cZI = 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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  • 1

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