Acta Neurochirurgica

, Volume 152, Issue 2, pp 195–200

Skin complications in deep brain stimulation for Parkinson’s disease: frequency, time course, and risk factors

Authors

    • Paracelsus-Elena-KlinikCenter of Parkinsonism and Movement Disorders
  • Claudia Trenkwalder
    • Paracelsus-Elena-KlinikCenter of Parkinsonism and Movement Disorders
  • Christoph Kappus
    • Neurochirurgie der Philipps-Universität
  • Dieter Hellwig
    • Neurochirurgie der Philipps-Universität
Clinical Article

DOI: 10.1007/s00701-009-0490-3

Cite this article as:
Sixel-Döring, F., Trenkwalder, C., Kappus, C. et al. Acta Neurochir (2010) 152: 195. doi:10.1007/s00701-009-0490-3

Abstract

Purpose

Deep brain stimulation (DBS) has been recognized as an efficacious treatment for movement disorders. Its beneficial effects however may be lost due to skin complications such as erosions or infections over the implanted foreign material. We sought to document skin complications in the entire Parkinson’s disease patient population who received a DBS system at the Marburg/Kassel implantation centre since the start of our DBS program in January 2002 to analyze frequency, time course, and possible risk factors.

Methods

We investigated 85 consecutive patients with Parkinson’s disease (PD) from a single center/single surgeon DBS series for the occurrence of skin complications and analyzed localization, time course, and possible risk factors. Mean follow-up was 3 years (range 1-7 years).

Results

In total, 21/85 patients (24.7%) suffered a total of 30 single skin complications. Sixty percent of all incidents occurred within the first post-operative year. Forty percent of all incidents occurred later than the first year following primary implantation. Complications involved the burr hole cap in 37%, the course of the cables in 33%, and the impulse generator (IPG) site in 30%. Six of 21 patients suffered recurring skin complications. Eight patients permanently lost their DBS system. Factor analysis for age, gender, disease duration, disease severity, the incidence of hypertension or diabetes as well as a 2-day period with externalized electrodes for continuous test stimulation did not have any statistically significant impact on skin complications.

Conclusions

We conclude that (1) PD patients have a risk for skin complications after DBS as long as the system remains in situ and (2) there are at present no identifiable risk factors for skin complications after DBS, other than PD itself.

Keywords

Deep brain stimulationParkinson’s diseaseSkin erosions and infections

Copyright information

© Springer-Verlag 2009