Objective: To report two cases of deep brain stimulation (DBS) withdrawal syndrome in Parkinson’s disease (PD), including one without typical risk factors.

Background: DBS withdrawal syndrome is a rare but potentially fatal complication in PD. It presents as akinetic crisis with severe rigidity, fever, autonomic instability, altered mental status, and elevated creatinine kinase (CK) levels. Reported cases are typically associated with older age, long PD duration (>15 years), and long DBS therapy (>5 years), with most patients having at least two of these risk factors. However, all available evidence comes from a limited number of case reports.

Method: We describe two patients who developed DBS withdrawal syndrome following battery depletion, outlining clinical features, disease and therapy duration, management, and outcomes.

Results: The first patient, in their late fifties with young‑onset PD, had bilateral STN‑DBS with good benefit but required high stimulation amplitude (4.1 V bilaterally). The first patient developed an akinetic crisis after battery depletion at PD duration of 11 years and DBS duration of 4 years. IPG replacement was performed 14 days later, resulting in permanent disability and, eventually, death.

The second patient, in their mid sixties with longstanding PD and 14 years of DBS therapy, presented with severe akinetic crisis and markedly elevated CK levels after battery depletion. IPG replacement within 2 days resulted in full recovery.

Conclusion: DBS withdrawal syndrome can occur without the typical risk profile, and high stimulation amplitude may represent an additional risk factor. Early recognition and immediate DBS therapy restoration are critical to prevent severe, potentially fatal outcomes.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/dbs-withdrawal-syndrome-in-parkinsons-disease-clinical-features-and-outcomes-of-two-new-cases/