Permanent neurological deficit related to magnetic resonance imaging in a patient with implanted deep brain stimulation electrodes for Parkinson's disease: case report.
OBJECTIVE
Deep brain stimulation (DBS) is an accepted treatment for patients with Parkinson's disease refractory to medication. The efficacy of this therapy has led to increasing numbers of patients receiving DBS implants. Importantly, physicians caring for patients with implantable neurostimulators must be aware of treatment guidelines for these patients, including the use of therapeutic ultrasound, diathermy, and imaging studies such as magnetic resonance imaging (MRI).


METHODS
We describe a case of serious, permanent neurological injury secondary to a radiofrequency lesion produced by heating of a DBS electrode associated with MRI of the lumbar spine in a patient with Parkinson's disease.


METHODS
MRI may be performed safely in patients with DBS devices only by following the specific guidelines of the manufacturer. The generalization of these conditions to other neurostimulation system positioning schemes, other scanners, and other imaging scenarios can lead to significant patient injuries.


CONCLUSIONS
To prevent catastrophic incidents, the manufacturer's guidelines should be followed carefully because they are known to result in the safe performance of MRI examinations of patients with neurostimulation systems used for DBS.
Henderson
Jaimie M
JM
Department of Neurosurgery, Stanford University, Stanford, California, USA.
Tkach
Jean
J
Phillips
Michael
M
Baker
Kenneth
K
Shellock
Frank G
FG
Rezai
Ali R
AR
D001930:Brain Injuries / Q000209:etiology* / Q000473:pathology*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004567:Electrodes, Implanted; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000601:surgery; D013131:Spine / Q000473:pathology; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed / Q000379:methods