Got DBS? Watch Out for Thunderstorms!

A recent report in the NY Times warns that people with electrodes implanted in their brain should be especially careful during thunderstorms, because if lightning strikes your building, you may not only only blow an electrical fuse and/or damage your computer and TV if they’re not plugged into a surge protector.  The electrical field created by the lightning may also shut down the electronic stimulator implanted in your chest.

Here’s the opening anecdote from the article, in italics:

One stormy afternoon in Ljubljana, the capital of Slovenia, thunder rolled, a bolt of lightning streaked across the sky, and the television and air conditioner went dark in the apartment of a woman with electrodes implanted in her brain.

Lightning had struck the building.

But the appliances were not the only things affected. After about an hour, the woman, who had had the electrodes put in five years before to help with debilitating muscle spasms in her neck, noticed her symptoms coming back. When she went to see her doctors the next day, they found that the pacemaker-like stimulator that powered the electrodes had switched itself off in response to the lightning strike.

The article mentions that people with Parkinson’s disease who have had DBS are in the same boat as the Slovenian woman.  There is a list of things people who have had DBS need to be cautious around or avoid completely – such as MRI scans, ham radio antennas, and walking through metal detectors and similar security devices at airports (and probably, going forward, at train stations, football stadiums, malls, libraries, high schools, rock concerts…).

The Journal of Neurosurgery has a recent article discussing the same issue.  And reports on the same anecdote as the Times:

The authors present the case of a 66-year-old woman who was being treated with a rechargeable DBS system for neck dystonia when her apartment was struck by lightning. Domestic electronic devices that were operating during the event were burned and destroyed. The woman’s IPG switched off but remained undamaged, and she suffered no neurological consequences.

So the woman was OK, but the whole situation sounds scary.

The Journal of Neurosurgery article lists all the precautions someone with DBS needs to follow.  I’ll paste the final paragraph here, in its entirety:

Patients treated with DBS must always be instructed to immediately check the functioning of their IPGs [implantable pulse generators] if they detect deterioration in their symptoms, especially after encountering a strong external EMF [electromagnetic field]. We also recommend that the IPG charger be plugged into a surge protector, which is an inexpensive electronic device, especially if there is a concern for high-voltage spikes. In addition, many modern buildings have whole-house surge protection, which might additionally help prevent significant voltage changes. If not, a surge protector installed directly between the electrical outlet and the electronic device could prevent damage to the device in such a situation. As a further precaution for patients with a Medtronic Activa RC, it is reasonable to recommend that the recharger be charged first and disconnected from the electrical outlet before being used to charge the IPG. We also advise all clinicians to regularly warn DBS patients to strictly follow the manufacturer’s safety recommendations and not to charge the recharger and IPG simultaneously during a thunderstorm. Last, we propose that in the future DBS manufacturers’ safety recommendations should specifically mention the possibility of hazards from naturally generated electromagnetic interference, such as during thunderstorms.