Twiddler syndrome occurs when a patient intentionally or unintentionally 
manipulates an implantable generator (usually a pacemaker) and dislodges the 
pacing leads, causing malfunction of the device. Though the syndrome has been 
described in patients with pacemakers, to our knowledge only one spontaneous 
case has been described in patients undergoing deep brain stimulation for 
movement disorders. We report the clinical cases of two patients with 
Parkinson's disease who had subthalamic bilateral electrodes implanted and 
presented the twiddler syndrome 2 and 3 years after surgery. We analysed the 
possible mechanisms of this syndrome and note that twiddler syndrome should be 
suspected in patients undergoing deep brain stimulation and showing hardware 
dysfunction.