• Domenico Gerardo Iacopino, Rosario Maugeri, Antonella Giugno, and Cole A Giller.
• Department of Experimental Medicine and Clinical Neurosciences, Neurosurgical Section, University of Palermo, Palermo, Italy. Electronic address: gerardo.iacopino@unipa.it.
• World Neurosurg. 2015 Aug 1;84(2):591.e1-5.

BackgroundDespite the best efforts to ensure stereotactic precision, deep brain stimulation (DBS) electrodes can wander from their intended position after implantation. We report a case of downward electrode migration 10 years following successful implantation in a patient with Parkinson disease.MethodsA 53-year-old man with Parkinson disease underwent bilateral implantation of DBS electrodes connected to a subclavicular 2-channel pulse generator. The generator was replaced 7 years later, and a computed tomography (CT) scan confirmed the correct position of both leads. The patient developed a gradual worsening affecting his right side 3 years later, 10 years after the original implantation. A CT scan revealed displacement of the left electrode inferiorly into the pons. The new CT scans and the CT scans obtained immediately after the implantation were merged within a stereotactic planning workstation (Brainlab).ResultsComparing the CT scans, the distal end of the electrode was in the same position, the proximal tip being significantly more inferior. The size and configuration of the coiled portions of the electrode had not changed. At implantation, the length was 27.7 cm; after 10 years, the length was 30.6 cm.ConclusionsThese data suggests that the electrode had been stretched into its new position rather than pushed. Clinicians evaluating patients with a delayed worsening should be aware of this rare event.Copyright © 2015 Elsevier Inc. All rights reserved.

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