Long-term surgical and hardware-related complications of deep brain stimulation.

Abstract

OBJECTIVE:

To evaluate the incidence of surgical and hardware-associated complications of deep brain stimulation (DBS) for a range of movement disorders.

METHODS:

The study design is a retrospective analysis and review of surgical and hardware complications of DBS performed by a single surgeon from 1999 to 2009. A total of 153 cases of DBS (298 electrodes) for various movement disorders and a minimum follow-up of 1 year have been included. Two patients could not be implanted. A further 54 patients who underwent change of the implantable pulse generator (IPG) have been included for analysis of hardware-related complications.

RESULTS:

The mean follow-up was 64 ± 36.15 (range = 12-129) months for the DBS group. Twenty-four (15.6%) patients developed complications. Confusion occurred in 3.9%, vasovagal attack in 1.9%, lead migration/misplaced lead in 2.5%, erosion and infection in 4.5% and IPG malfunction occurred in 1.4% of the patients. When calculated with respect to the number of electrodes and IPG replacements, the complication rate was lower (11.9%). Three patients had their system explanted, two of them being patients with dystonia who had inadvertently damaged their operative site.

CONCLUSION:

DBS surgery is a relatively safe surgery, with most of the complications being minor, without long-term morbidity. The complication rate in elderly (age ≥65 years) is comparable to that in younger patients. However, confusion is more frequent in this age group, and patients and relatives can be prepared to accept this as a transient morbidity.

• Authors: Paresh K Doshi
• Journal: Stereotactic and functional neurosurgery (Stereotact Funct Neurosurg) Vol. 89 Issue 2 Pg. 89-95 ( 2011) ISSN: 1423-0372 [Electronic] Switzerland
• PMID: 21293168 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Confusion (epidemiology)
• Deep Brain Stimulation (adverse effects, instrumentation, methods)
• Equipment Failure
• Female
• Foreign-Body Migration (epidemiology)
• Humans
• Implantable Neurostimulators (adverse effects)
• Incidence
• Intraoperative Complications (epidemiology)
• Male
• Middle Aged
• Movement Disorders (therapy)
• Neurosurgical Procedures (adverse effects, instrumentation, methods)
• Retrospective Studies
• Surgical Wound Infection (epidemiology)
• Time Factors
• Young Adult