Manipulating an internal pulse generator until twiddler’s syndrome in a patient treated with deep brain stimulation for obsessive-compulsive disorder

Andrea Franzini, Rebecca Ranieri, Orsola Gambini, Giuseppe Messina

Research output: Contribution to journalArticle


Background: Twiddler’s syndrome consists of rotation or manipulation of an implantable pulse generator (IPG) in its subcutaneous pocket by a patient, thus causing hardware malfunction. Methods: This syndrome is being reported more frequently in patients treated with deep brain stimulation (DBS). Results: We report the case of a woman who had received bed nucleus of stria terminalis (BNST) electrodes for obsessive-compulsive disorder (OCD) and developed twiddler’s syndrome a few months after surgery, causing hardware malfunction due to obsessive manipulation of the IPG. Conclusion: The patient did not have compulsions related to touching objects at admission, thus making it difficult to foresee and prevent TS.

Original languageEnglish
Pages (from-to)389-392
Number of pages4
JournalActa Neurochirurgica
Issue number2
Publication statusPublished - Feb 1 2018



  • Deep brain stimulation
  • Obsessive-compulsive disorder
  • Twiddler’s syndrome

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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