Surgical management of “Twiddler syndrome” in patients with deep brain stimulation: a technical note and review of the literature

Abstract

Background: The Twiddler syndrome (TS) describes a situation in which the implanted impulse generator (IPG) rotates several times around its own axis in the subcutaneous pocket. This can lead to severe mechanical damage of the leads and extensions and to dislocations. Method: Hereby, we report on a technique for revision surgery in patients diagnosed with Twiddler syndrome after undergoing previous deep brain stimulation (DBS) surgery. For revision surgery, the TYRX ™ Absorbable Antibacterial Envelope was used. Conclusion: The TS can be treated well with the envelope TYRX ™ Absorbable Antibacterial Envelope TYRX ™.