Permanent Neurological Deficit Related to Magnetic Resonance Imaging in a Patient with Implanted Deep Brain Stimulation Electrodes for Parkinson's Disease: Case Report

Abstract

OBJECTIVE AND IMPORTANCE: 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). CLINICAL PRESENTATION: 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. INTERVENTION: 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. CONCLUSION: 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.