Complications of Deep Brain Stimulation Surgery

Abstract

Although technological advances have reduced device-related complications, DBS surgery still carries a significant risk of transient and permanent complications. We report our experience in 86 patients and 149 DBS implants. Patients with Parkinson’s disease, essential tremor and dystonia were treated. There were 8 perioperative, 8 postoperative, 9 hardware-related complications and 4 stimulation-induced side effects. Only 5 patients (6%) sustained some persistent neurological sequelae, however, 26 of the 86 patients undergoing 149 DBS implants in this series experienced some untoward event with the procedure. Although there were no fatalities or permanent severe disabilities encountered, it is important to extend the informed consent to include all potential complications.

Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study

“…The calculated incidence of complications associated with laparoscopic bariatric surgery, obtained from the case series, 4,8,10,17,28,38,44,45,52,74,77,82,83,91,120 is summarized in Table 1; complications associated with DBS studies are shown in Table 2. 6,7,9,12,16,20,26,27,31,37,39,47,[55][56][57][58][59][60][61]64,[67][68][69]71,78,80,81,84,[86][87][88][89][96][97]…”

“…Despite reports of the safety and efficacy of DBS for movement disorders, 33,113 this surgery is not without adverse events, which may relate to the surgical procedure, implanted hardware, or the stimulation itself. 7 More recently, pilot studies and small clinical trials have demonstrated the efficacy and safety of DBS of the NAc in neuropsychiatric diseases such as obsessive-compulsive disorder 32 and major depression that are refractory to treatment. 95 To date, however, no clinical trials have been performed for morbid obesity.…”

Increasing Stimulation Parameters Relieves Acquired Eyelid Apraxia after Deep Brain Stimulation of the Subthalamic Nucleus

“…Eye lid apraxia is a non-paralytic motor abnormality characterized by difficulty in initiating opening of the eyelids [7,8]. Premotor control of lid-eye coordination by extrapyramidal and mesencephalic circuitries has been suggested and dopaminergic involvement was further substantiated by analysis of blinking rates in patients with PD [9].…”

“…Optimal hardware programming can be challenging in some cases, as side effects may interfere with stimulation parameters required for sufficient control of motor symptoms [3,4]. Eyelid Apraxia, defined as inability to voluntarily initiate opening of eyelids [5], is one of limiting adverse effects which has been reported in 1.8 to 30% of the patients after STN DBS and management of the eyelid apraxia event was mainly relied on medical treatment [6][7][8].…”

Anesthetic Considerations for Deep Brain Stimulation

“…They described perioperative complications in eight patients (hemorrhages, confusion, and seizures) and longterm postoperative complications in eight patients (delayed hematoma, behavioral changes, confusion, apraxia of eyelid opening, and peripheral nerve injury). Hardware-related issues were studied in nine patients (DBS electrode failure, extension wire failure, pulse generator malfunction, and pain over pulse generator) and stimulation-induced side effects were diagnosed in four patients (dysarthria, facial contraction, and confusion) [9].…”