One
stormy afternoon in Ljubljana, the capital of Slovenia, thunder rolled, a bolt
of lightning streaked across the sky, and therefore the television and air
conditioning went dark within the apartment of a lady with electrodes implanted
in her brain.
Lightning
had struck the building. But
the appliances weren't the sole things affected.
After
about an hour, the woman, who had had the electrodes put in five years before
to assist with debilitating muscle spasms in her neck, noticed her symptoms
returning.
When
she visited to see her doctor's subsequent day, they found that the
pacemaker-like stimulator that powered the electrodes had switched itself off
in response to the lightning strike.
In
a study describing these events published Tuesday within the Journal of In neurosurgery, her doctors suggest that physicians and medical device companies
add lightning strikes to the list of things patients with electrodes implanted
in their brains should be cared for.
It
may sound futuristic, but deep brain stimulation, or D.B.S., features a fairly
long history.
Surgeons
operating on epileptic patients within the 1930s and 1940s found that removing
small portions of the brain could quiet seizures.
Later,
researchers found that stimulating certain brain areas, rather than cutting
them out could quell the involuntary movements characteristic of Parkinson’s
and other disorders.
Today
some patients with diagnoses like epilepsy, obsessive-compulsive disorder, and
painful muscle spasms who don’t answer other treatments have surgery to implant
electrodes on either side of the brain.
The
electrodes are attached to wires running right down to a stimulator implanted
within the chest or torso.
The
stimulator provides electrical impulses to stay symptoms in restraint,
employing a battery that in some models is often topped up with an antenna-equipped electrical converter that’s charged with a wall socket.
Just
like people with pacemakers, those with D.B.S. implants must take care of
getting diagnostic MRIs and spending time around devices that generate
electromagnetic fields.
These
could found out a current within the implants and cause injury or other issues,
said Dusan Flisar, a neurologist in Slovenia who is an author of the paper.
For instance, one study reported a case where a patient sustained permanent
neurological damage when an MRI scan heated a D.B.S. electrode.
“There
also are environmental causes which will affect the right functioning of this the device,” Dr. Flisar said — namely, it appears, lightning strikes.
The woman who came to ascertain Dr. Flisar after the storm was lucky: She had not
been charging her implanted battery at the time, nor had she had the charger
pack plugged into the wall.
If
either had been in use, the device and its accessories could have met an
equivalent fate as her TV and air conditioning.
“The the charger would be destroyed like other appliances and therefore the patient
injured if she was charging the stimulator during the event,” said Dr. Flisar.
Dr.
Flisar and his colleagues recommend in their paper that patients plug their
chargers into surge protectors, which can help protect them, and suggest that
doctors tell patients to avoid charging during storms.
Fortunately,
when he and his colleagues checked the woman’s implant, they found that it had
not been damaged.
A
safety function designed by the manufacturer had taken its cue from the sudden
current running through the house and caused the device to modify itself off,
pre-empting any interference from the lightning.
The
programming was intact; the battery still had many charges.
When
they fired up the device, it worked perfectly, none the more severe for the
storm.
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