title: A tremulous twiddler.
abstract: Twiddler's syndrome describes the intentional external manipulation or spontaneous rotation of implanted devices such as cardiac pacemakers. Here we report the same phenomenon occurring in a patient with an implanted deep brain stimulator generator. The clinical syndrome is described and potential technical nuances to prevent its occurrence are suggested.
authors.affiliation: Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel. israelz@hadassah.org.il
authors.forename: Zvi
authors.initials: Z
authors.lastname: Israel
authors.forename: Alexander
authors.initials: A
authors.lastname: Spivak
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004868:Equipment Failure; D020329:Essential Tremor / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D011859:Radiography; D012008:Recurrence; D012399:Rotation