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Beware of deep brain stimulation devices during neurophysiology
  1. Alexander St John Edward Barker1,
  2. Marios Hadjivassiliou2,
  3. Aijaz Ali Khan2,
  4. Dasappaiah Ganesh Rao1
  1. 1Department of Clinical Neurophysiology, Sheffield Teaching Hospitals NHS Trust (Royal Hallamshire Hospital), Sheffield, UK
  2. 2Department of Neurology, Sheffield Teaching Hospitals NHS Trust (Royal Hallamshire Hospital), Sheffield, UK
  1. Correspondence to Dr Dasappaiah Ganesh Rao, Department of Clinical Neurophysiology, N floor, Sheffield Teaching Hospitals NHS Trust (Royal Hallamshire Hospital), Glossop Road, Sheffield S10 2JF, UK; ganesh.rao{at}sth.nhs.uk

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Electromyography (EMG) and nerve-conduction studies (NCS) are subject to artefacts. In the context of these investigations, an artefact is defined as any electrical signal not originating from nerve or muscle.1 Erroneous interpretation of results may occur in electrodiagnostic studies if artefacts distort or obliterate the genuine response.1 Common causes of artefact include power lines (50 Hz UK, 60 Hz USA), radiofrequency interference, defective needle insulation and stimulus artefact. Artefact can also be caused by any intracorporeal or intracranial device which produces a potential difference (voltage) significant enough to be recorded during NCS or EMG studies. Artefacts caused by devices such as cardiac pacemakers2 and vagus nerve stimulators3 are well documented in the literature.

More recent advances in the treatment of conditions such as Parkinson's disease, benign essential tremor, cerebellar tremor and other movement disorders have led to an increasing number of patients having deep brain stimulation (DBS) devices implanted. These devices can produce …

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