One stormy afternoon in Ljubljana, the capital of Slovenia, thunder rolled, a bolt of lightning streaked across the sky, and therefore the television and air conditioning went dark within the apartment of a lady with electrodes implanted in her brain.
Lightning had struck the building. But the appliances weren't the sole things affected.
After about an hour, the woman, who had had the electrodes put in five years before to assist with debilitating muscle spasms in her neck, noticed her symptoms returning.
When she visited to see her doctor's subsequent day, they found that the pacemaker-like stimulator that powered the electrodes had switched itself off in response to the lightning strike.
In a study describing these events published Tuesday within the Journal of In neurosurgery, her doctors suggest that physicians and medical device companies add lightning strikes to the list of things patients with electrodes implanted in their brains should be cared for.
It may sound futuristic, but deep brain stimulation, or D.B.S., features a fairly long history.
Surgeons operating on epileptic patients within the 1930s and 1940s found that removing small portions of the brain could quiet seizures.
Later, researchers found that stimulating certain brain areas, rather than cutting them out could quell the involuntary movements characteristic of Parkinson’s and other disorders.
Today some patients with diagnoses like epilepsy, obsessive-compulsive disorder, and painful muscle spasms who don’t answer other treatments have surgery to implant electrodes on either side of the brain.
The electrodes are attached to wires running right down to a stimulator implanted within the chest or torso.
The stimulator provides electrical impulses to stay symptoms in restraint, employing a battery that in some models is often topped up with an antenna-equipped electrical converter that’s charged with a wall socket.
Just like people with pacemakers, those with D.B.S. implants must take care of getting diagnostic MRIs and spending time around devices that generate electromagnetic fields.
These could found out a current within the implants and cause injury or other issues, said Dusan Flisar, a neurologist in Slovenia who is an author of the paper.
For instance, one study reported a case where a patient sustained permanent neurological damage when an MRI scan heated a D.B.S. electrode.
“There also are environmental causes which will affect the right functioning of this the device,” Dr. Flisar said — namely, it appears, lightning strikes.
The woman who came to ascertain Dr. Flisar after the storm was lucky: She had not been charging her implanted battery at the time, nor had she had the charger pack plugged into the wall.
If either had been in use, the device and its accessories could have met an equivalent fate as her TV and air conditioning.
“The the charger would be destroyed like other appliances and therefore the patient injured if she was charging the stimulator during the event,” said Dr. Flisar.
Dr. Flisar and his colleagues recommend in their paper that patients plug their chargers into surge protectors, which can help protect them, and suggest that doctors tell patients to avoid charging during storms.
Fortunately, when he and his colleagues checked the woman’s implant, they found that it had not been damaged.
A safety function designed by the manufacturer had taken its cue from the sudden current running through the house and caused the device to modify itself off, pre-empting any interference from the lightning.
The programming was intact; the battery still had many charges.
When they fired up the device, it worked perfectly, none the more severe for the storm.