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An 84-year-old man underwent deep brain stimulation (DBS) for mixed rest-action tremors. One year later, he developed a keratoma where the DBS wire emerged from the insertion cap. It was suspected to be a foreign body reaction and removed by a dermatologist but returned and grew conically over the next 4 years, reaching a height of 4 cm (figure). The surrounding skin began to break down with protrusion of the adjacent extension wire. We recommended removal of the lead but due to continued efficacy and advanced age, he decided to continue with the stimulator in place under observation.
Footnotes
Author contributions: Michael Pourfar: manuscript preparation. Alon Mogilner: coauthor, manuscript review and editing. Antonios Mammis: photography, manuscript review. Robert Goodman: coauthor, manuscript review and editing.
Study funding: No targeted funding reported.
Disclosure: M. Pourfar has received consulting fees from Medtronic. A. Mogilner has received consulting fees from Medtronic. A. Mammis and R. Goodman report no disclosures. Go to Neurology.org for full disclosures.
Correspondence to Dr. Pourfar: Michael.Pourfar{at}NYUMC.org
- © 2013 American Academy of Neurology
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