COVID-19 AND MOVEMENT DISORDERS
Most medical centres are postponing elective procedures and deferring non-urgent clinic visits to conserve hospital resources and prevent spread of COVID-19. The pandemic crisis presents some unique challenges for patients currently being treated with deep brain stimulation (DBS). Patients with movement disorders (Parkinson’s disease, essential tremor, dystonia), neuropsychiatric disorders (obsessive compulsive disorder, Tourette syndrome, depression), and epilepsy can develop varying degrees of worsening symptoms from interruption of therapy due to their neurostimulator battery reaching end of life, device malfunction or infection. Urgent intervention to maintain or restore stimulation may be required for patients with Parkinson’s disease who can develop a rare but potentially life-threatening complication known as DBS-withdrawal syndrome. Similarly, patients with generalized dystonia can develop status dystonicus, patients with obsessive compulsive disorder can become suicidal, and epilepsy patients can experience potentially life-threatening worsening of seizures as a result of cessation of therapy. DBS system infection can require urgent, and rarely emergency, surgery. In this paper, Miocinovic et al., provide general recommendations and a workflow algorithm for DBS device management during the COVID-19 outbreak.
by Marialuisa Zedde and Francesco Cavallieri