Deep brain stimulator complications

Background

  • FDA-approved for medication-refractory movement disorders (e.g. Parkinson's disease, dystonia, essential tremor) and OCD
  • Single lead systems implanted into the thalamus
  • Complication rates range from 7-65%[1]

Clinical Features/Complication Types

  • Infection
    • Usually early after placement
    • Infection rates ~3-10%[2]
  • Cerebral hemorrhage
  • Lead fracture or migration
  • Failure of device to improve tremor/motor symptoms
  • Paresthesias (temporary or permanent)
  • Dysarthria, decreased verbal fluency
  • Disequilibrium
  • Affective changes (depression, apathy), impaired executive function, impulsivity

Differential Diagnosis

Evaluation

DBS-probes shown in X-ray of the skull.
  • May need to observe with device in "off" position to distinguish between device malfunction and other acute neurologic deficit

Management

  • Consult neurosurgery

Disposition

See Also

External Links

References

  1. ↑ Tabbal SD, Revilla FJ, Mink JW, et al. Safety and efficacy of subthalamic nucleus deep brain stimulation performed with limited intraoperative mapping for treatment of Parkinson's disease. Neurosurgery. 2007;61(3 Suppl):119-27.
  2. ↑ Tabbal SD, Revilla FJ, Mink JW, et al. Safety and efficacy of subthalamic nucleus deep brain stimulation performed with limited intraoperative mapping for treatment of Parkinson's disease. Neurosurgery. 2007;61(3 Suppl):119-27.
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