gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Deep brain stimulation: Custom-made silicone-coated pulse generator implantation after allergic reaction to generator compounds

Meeting Abstract

  • Andreas Herbst - Klinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Max Lange - Klinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Alexander Brawanski - Klinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Juergen Schlaier - Klinik für Neurochirurgie, Universitätsklinikum Regensburg

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 046

doi: 10.3205/13dgnc463, urn:nbn:de:0183-13dgnc4639

Published: May 21, 2013

© 2013 Herbst et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: We present a rare case of allergic reaction to components of the pulse generator for deep brain stimulation and the treatment with a custom made silicone-coated pulse generator.

Method: A 53-year-old man underwent generator and stereotactic electrode implantation for Parkinson’s disease. The patient suffered repeated admissions for iterative sterile wound necrosis, leading to three repositionings and one exchange of the pulse generator. The latter was covered with a Dacron pouch. On the fourth admission the patient presented with a bacterial wound infection and the generator as well as the extensions of the electrodes had to be removed. 7 months later a silicone-coated pulse generator, custom-made for this case and two regular extensions were implanted.

Results: Dermatologic investigations using the manufacturer’s allergy kit and standard epicutaneous tests revealed an allergic reaction against gold only, which is no component of the generator casing. Histopathological findings showed lymphoplasmacytic infiltrations and eosinophilic granulocytes indicating an allergic contact dermatitis. After the implantation of the silicon-coated generator there has been no recurrence of wound complications.

Conclusions: Despite negative skin patch testing an allergic reaction to generator components is a possible cause for wound healing disorders. In such cases a custom-made silicone coated model is an effective treatment option.