Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease

Karol Piwowarski; Michał Sobstyl; Karol Karamon

doi:10.5114/ppn.2025.151784

eISSN: 2720-5371
ISSN: 1230-2813

Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii

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2/2025
vol. 34

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Opis przypadku

Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease

Karol Piwowarski

¹

,

Michał Sobstyl

¹

,

Karol Karamon

²

Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw, Poland
Department of Radiology, Institute of Psychiatry and Neurology, Warsaw, Poland

Adv Psychiatry Neurol 2025; 34 (2): 124-129

DOI: https://doi.org/10.5114/ppn.2025.151784

Data publikacji online: 2025/06/24

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AMA

Piwowarski K, Sobstyl M, Karamon K. Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii. 2025;34(2):124-129. doi:10.5114/ppn.2025.151784.

APA

Piwowarski, K., Sobstyl, M.,  & Karamon, K. (2025). Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, 34(2), 124-129. https://doi.org/10.5114/ppn.2025.151784

Chicago

Piwowarski, Karol, Michał Sobstyl,  and Karol Karamon. 2025. "Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease". Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii 34 (2): 124-129. doi:10.5114/ppn.2025.151784.

Harvard

Piwowarski, K., Sobstyl, M.,  and Karamon, K. (2025). Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, 34(2), pp.124-129. https://doi.org/10.5114/ppn.2025.151784

MLA

Piwowarski, Karol et al. "Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease." Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, vol. 34, no. 2, 2025, pp. 124-129. doi:10.5114/ppn.2025.151784.

Vancouver

Piwowarski K, Sobstyl M, Karamon K. Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii. 2025;34(2):124-129. doi:10.5114/ppn.2025.151784.

Metryki PlumX:

Purpose
Deep brain stimulation for Parkinson’s disease (PD) is an established treatment modality for disabling Parkinsonian motor symptoms in off medication condition and levodopa-induced dyskinesia in on medication condition.

Case description
We report on the case of a 70-year-old woman with a 22-year history of PD diagnosis who had been treated with dopaminergic medication over this period. At age of 59, she underwent a staged bilateral implantation of deep brain stimulation (DBS) leads targeting the subthalamic nucleus (STN) with good control of Parkinsonian motor symptoms and the reduction of her daily levodopa dose by 50% after bilateral STN DBS. The patient damaged her DBS system after the standard replacement of a depleted left implantable pulse generator, which resulted in the removal of the entire deep brain stimulation system on the left side.

Comment
To our knowledge, this is the first report of probably self-injurious behavior in the context of a deep brain stimulation system related to the longstanding dopaminergic treatment of PD. Patients in advanced stages of PD require special care for the follow- up maintenance of sophisticated treatment modalities like DBS.

Damage to the entire deep brain stimulation system after the standard replacement of an implantable pulse generator, probably due to self-injurious behavior in a patient with advanced Parkinson’s disease

Karol Piwowarski 1 , Michał Sobstyl 1 , Karol Karamon 2

Karol Piwowarski

¹

,

Michał Sobstyl

¹

,

Karol Karamon

²