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mening/encefalitis
NSTB
Jan 31, 2023 13:37
1 yr ago
34 viewers *
Spanish term

Decúbito

Spanish to English Medical Medical (general) Neurology - Parkinson's/DBS
The following appear in an E.R. report for a patient with Parkinson's disease and DBS system.

Motivo de Consulta:
Decúbito cable extensión ECP.
...

Evolución y comentarios:
Paciente con antecedentes de EPI tratada mediante ECP NSTB en 2021. Derivada a SURG desde consulta de NRL por decúbito de cable de sistema de ECP NSTD de mas de tres meses de evolución.
Su familia refiere traumatismo en dicha región desde hace 3 meses y posteriormente aparición de decúbito con exposición de electrodo derecho en convexidad craneal, antes de conexión con extensión del sistema.
...

Expl: exposición de cable de ECP a nivel de electrodo intracraneal en vertex antes de conexión.
...

Diagnostico principal:
Decúbito electrodo intracraneal.

Please can anyone suggest the intended meaning of "decúbito" in this context ("decubitus" clearly does not appear to fit)?
Thanks.
Proposed translations (English)
3 lead extrusion
4 electrode migration/displacement
3 skin erosion
References
comment

Discussion

Lisa Rosengard Jan 31, 2023:
decubitus Here's a definition of decubitus, which is a posture adopted when lying down. It's a reclining position with an arrangement of the limbs.
https://www.thefreedictionary.com/decubitus
Douglas Davies (asker) Jan 31, 2023:
Hi again Maria. I tend to agree with the received that NSTB probably indicates "bilateral subthalamic nucleus". Then NSTD would probably indicate "right subthalamic nucleus". I wonder if "decúbito" is possibly intended to indicate "downward migration"?
María M. Hernández S. Jan 31, 2023:
I cannot image what else could mean decúbito here -take in account that physicians have a very particular way to redact their reports.
The article above deals with the effects of bilateral stimulation of STN (NSTB?) and placement in the dorsal (NSTD?) or ventral portion of STN
https://academic.oup.com/cercor/article/22/5/1124/280350
Douglas Davies (asker) Jan 31, 2023:
Hi Maria and thanks for your suggestion. I did consider the same but there would appear to be some text missing in that case. I wondered if it may be intended to indicate that it has become detached or fallen out. I'm really not sure. NST = "subthalamic nucleus" but I'm not sure what the "D" and "B" are intended to indicate.
María M. Hernández S. Jan 31, 2023:
Lo único que se me ocurre es que la paciente podría presentar exposición del cable estimulación cerebral profunda estando en posición decúbito. No encuentro nada acerca de NSTB/NSTD, excepto algunas referencias en inglés sobre NSTD > nonspecific tic disorder

Proposed translations

1 day 12 hrs
Spanish term (edited): Decúbito cable/electrodo
Selected

lead extrusion

Creo que decúbito se refiere específicamente a la extrusión en este caso de un cable del dispositivo implantado que se produce como consecuencia de la erosión progresiva del tejido que rodea inicialmente a la porción extruida.

Ver por ejemplo aquí:
Decúbito del marcapasos: Consiste en la erosión mecánica del bolsillo subcutáneo donde se aloja el generador o del trayecto subcutáneo de los cables, con la exposición parcial del dispositivo.
https://www.google.com/url?sa=t&source=web&rct=j&url=https:/...

Así, una cosa sería la erosión aislada, otra el desplazamiento -pej. de la punta del electrodo (de manera que deja de estimular la zona o el núcleo que debe ser estimulado) y otra la extrusión (tras erosión previa del tejido circundante).

Curiosamente -lo dejo a título de anécdota- ocasionalmente también aparece en inglés con el mismo sentido:

pacemaker decubitus
https://www.google.com/url?sa=t&source=web&rct=j&url=https:/...

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-8159....
Note from asker:
Thanks for the suggestion and information Chema. I wasn't familiar with this term, but it does appear to be the closest match.
Something went wrong...
4 KudoZ points awarded for this answer. Comment: "Many thanks. Lead extrusion seems to me to be the best match in this context."
4 hrs

skin erosion


Skin erosion around the DBS extension cable.

También se habla de decúbito en marcapasos.

Definición de decúbito

Considerando decúbito el adelgazamiento de la capa cutánea sobre el generador con adherencia del mismo, con o sin signos inflamatorios locales.

https://www.researchgate.net/publication/263511149_Evolucion...

In addition, DBS may cause skin erosion and infection because of the subcutaneous placement of a bulky foreign body called an internal pulse generator (IPG) and a long extension.

https://www.frontiersin.org/articles/10.3389/fnagi.2022.8197...

Skin erosion and infection are common but serious problems in deep brain stimulation (DBS).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208212/

Skin erosion is a common complication after deep brain stimulator procedures.

Skin erosion is the loss of epidermis over the implants (leads, internal pulse generator, wires, or extensions), exposing hardware and predisposing to local infections.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326058/

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Note added at 4 hrs (2023-01-31 18:27:10 GMT)
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For example, due to intracranial electrode insertion, DBS can cause intracerebral hemorrhage (ICH). In addition, DBS may cause skin erosion and infection because of the subcutaneous placement of a bulky foreign body called an internal pulse generator (IPG) and a long extension.

https://www.frontiersin.org/articles/10.3389/fnagi.2022.8197...
Note from asker:
Hi both. Many thanks for the suggestion. This seems to be a good fit. I was thinking of "exposure" of the lead.
Something went wrong...
14 hrs

electrode migration/displacement

Due to displacement of the electrode after trauma.
Ref:
Despite the best efforts to ensure stereotactic precision, deep brain stimulation (DBS) electrodes can wander from their intended position after implantation. In many cases, the migration occurs before closure of the operative wound and is likely due to an inadvertent movement of the electrode during the procedure. However, several centers reported late migration of electrodes occurring months or years after the initial surgery. Most of these displacements are in the upward direction and are thought to be related to a tenuous attachment of the electrode to the skull that allows the electrode to slide as the head and neck are turned. However, Susatia et al. (12) described a patient with cervical dystonia in which the displacement was in the downward direction and hypothesized that the electrode was driven deeper into the brain by the vigorous dystonic movements. We report a patient with Parkinson disease discovered to have downward electrode migration 10 years after successful implantation.
https://www.sciencedirect.com/science/article/abs/pii/S18788...
Something went wrong...

Reference comments

3 hrs
Reference:

comment

only finding:

Electrical stimulation for treating pressure ulcers - Arora, M
Cochrane Library ·
https://www.cochranelibrary.com › full
by M Arora · 2020 · Cited by 30 — Pressure ulcers (also known as pressure sores, decubitus ulcers or bedsores) are localised injuries to the skin or underlying tissue, ...


ie.

electrode-related decubitus ulcer/pressure ulcer


you say the patient has had this for three months?


cEEG electrode-related pressure ulcers in acutely hospitalized ...
Neurology ·
https://cp.neurology.org › content
by LMVR Moura · 2017 · Cited by 10 — Methods: We performed an observational investigation of cEEG-electrode-related pressure ulcers (EERPU) among acutely ill patients over a ...

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Note added at 3 heures (2023-01-31 16:47:45 GMT)
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Electrodes can injure skin through direct pressure, chemical dermatitis, and local heating when exposed to electromagnetic fields. cEEG-electrode-related pressure ulcers (EERPU) are preventable lesions that increase patient discomfort and risk for infections.
Note from asker:
High Liz. That's what the family appear to report. I think the best option could be "skin erosion", as suggested, with the lead being exposed. An associated report uses the term "externalizacion" instead of "decúbito".
Peer comments on this reference comment:
agree neilmac
1 hr
Something went wrong...
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