{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:53:35Z","timestamp":1791244415453,"version":"4.1.0"},"reference-count":19,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,9]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>A man in his 50s attended the emergency department with an acute deterioration in his Parkinson\u2019s symptoms, presenting with limb rigidity, widespread tremor, choreiform dyskinesia, dysarthria, intense sadness and a severe occipital headache. After excluding common differentials for sudden-onset parkinsonism (eg, infection, medication change), an error on the patient\u2019s deep brain stimulator was noted. The patient\u2019s symptoms only resolved once he was transferred to the specialist centre so that the programmer could reset the device settings. Due to COVID-19-related bed pressures on the ward, there was a delay in the patient receiving specialist attention\u2014highlighting the need for non-specialist training in the emergency management of device errors.<\/jats:p>","DOI":"10.1136\/bcr-2022-252305","type":"journal-article","created":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T10:30:11Z","timestamp":1672050611000},"page":"e252305","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["When brain devices go wrong: a patient with a malfunctioning deep brain stimulator (DBS) presents to the emergency department"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0003-3550","authenticated-orcid":false,"given":"Isabel","family":"Straw","sequence":"first","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ashworth","sequence":"additional","affiliation":[{"name":"Accident and Emergency Department, Homerton University Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Radford","sequence":"additional","affiliation":[{"name":"Accident and Emergency Department, Homerton University Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"2025082709324449000_15.12.e252305.1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jemermed.2018.10.029","article-title":"Clinical Cybersecurity training through novel high-fidelity simulations","volume":"56","author":"Dameff","year":"2019","journal-title":"J Emerg Med"},{"key":"2025082709324449000_15.12.e252305.2","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3171\/2015.7.JNS142599","article-title":"A decade of emerging indications: deep brain stimulation in the United States","volume":"125","author":"Youngerman","year":"2016","journal-title":"J Neurosurg"},{"key":"2025082709324449000_15.12.e252305.3","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.wneu.2016.05.010","article-title":"Brainjacking: implant security issues in invasive neuromodulation","volume":"92","author":"Pycroft","year":"2016","journal-title":"World Neurosurg"},{"key":"2025082709324449000_15.12.e252305.4","doi-asserted-by":"publisher","DOI":"10.3171\/2013.10.JNS131225"},{"key":"2025082709324449000_15.12.e252305.5","doi-asserted-by":"crossref","unstructured":"Shils JL . \u2018Deep Brain Stimulation Fault Testing\u2019. In: Tarsy D , ed. Deep brain stimulation in neurological and psychiatric disorders. Humana Press, 2008: 473\u201394.","DOI":"10.1007\/978-1-59745-360-8_23"},{"key":"2025082709324449000_15.12.e252305.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.clineuro.2021.106577","article-title":"Deep brain stimulation and electromagnetic interference","volume":"203","author":"Rahimpour","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"2025082709324449000_15.12.e252305.7","doi-asserted-by":"crossref","unstructured":"Beavers JL . \u2018Hacking NHS Pacemakers: A Feasibility Study\u2019. 2019 IEEE 12th International Conference on Global Security, Safety and Sustainability (ICGS3). IEEE Xplore, 2019:206\u201312.","DOI":"10.1109\/ICGS3.2019.8688214"},{"key":"2025082709324449000_15.12.e252305.8","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jbi.2015.04.007","article-title":"Security and privacy issues in implantable medical devices: a comprehensive survey","volume":"55","author":"Camara","year":"2015","journal-title":"J Biomed Inform"},{"key":"2025082709324449000_15.12.e252305.9","unstructured":"Li C . \u2018Hijacking an Insulin Pump: Security Attacks and Defenses for a Diabetes Therapy System\u2019. 2011 IEEE 13th International Conference on E-Health Networking. Applications and Services 2011:150\u20136."},{"key":"2025082709324449000_15.12.e252305.10","doi-asserted-by":"publisher","DOI":"10.1038\/507290a"},{"key":"2025082709324449000_15.12.e252305.11","doi-asserted-by":"crossref","unstructured":"Maria MW . \u2018Brain Computer Interfaces and Human Rights: Brave New Rights for a Brave New World\u2019. 2022 ACM Conference on Fairness, Accountability, and Transparency, Association for Computing Machinery, 2022:1154\u201361.","DOI":"10.1145\/3531146.3533176"},{"key":"2025082709324449000_15.12.e252305.12","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-229122","article-title":"Malignant deep brain stimulator withdrawal syndrome","volume":"12","author":"Azar","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082709324449000_15.12.e252305.13","doi-asserted-by":"crossref","DOI":"10.1080\/02688697.2016.1229748","article-title":"Unusual complication after insertion of deep brain stimulator electrode","volume":"31","author":"Hussain","year":"2017","journal-title":"Br J Neurosurg"},{"key":"2025082709324449000_15.12.e252305.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2008.01.001"},{"key":"2025082709324449000_15.12.e252305.15","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21551"},{"key":"2025082709324449000_15.12.e252305.16","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.1111\/j.1528-1167.2012.03489.x","article-title":"Twiddler's syndrome in a patient with epilepsy treated with deep brain stimulation","volume":"53","author":"Penn","year":"2012","journal-title":"Epilepsia"},{"key":"2025082709324449000_15.12.e252305.17","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1002\/mds.20354","article-title":"\u2018Sudden Failure of Dual Channel Pulse Generators: Failure of Dual Channel Pulse Generators\u2019","volume":"20","author":"Alesch","year":"2005","journal-title":"Movement Disorders"},{"key":"2025082709324449000_15.12.e252305.18","unstructured":"Deep brain stimulation devices market size report, 2030. Available: https:\/\/www.grandviewresearch.com\/industry-analysis\/deep-brain-stimulators-dbs-market [Accessed 11 Jul 2022]."},{"key":"2025082709324449000_15.12.e252305.19","doi-asserted-by":"publisher","DOI":"10.3171\/2009.5.FOCUS0938"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-252305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:32:57Z","timestamp":1756312377000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-252305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":19,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,26]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bcr-2022-252305"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-252305","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}