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Anesthesia for Deep Brain Stimulation

  • Neuroanesthesia (M Smith, Section Editor)
  • Published:
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Abstract

Purpose of Review

Deep brain stimulation is used in the treatment of patients with functional neurological disorders but has expanded to include many other disorders. The target site for stimulation is dependent on the disease and symptoms of each patient. The procedure includes imaging techniques to visualize and establish coordinates to the nuclei, electrophysiological guidance with microelectrode recordings, and testing of an awake patient.

Recent Findings

The goals of anesthesia are to provide optimal surgical conditions and patient comfort, facilitate target localization and diagnosis, and treat complications. The choice of anesthetic agents and techniques will depend not only on the specific patient population and stimulation target but also varies according to institutional practice. Monitored anesthesia care, conscious sedation, and general anesthesia have all been used successfully. Perioperative complications include intracranial hemorrhage, seizures, and venous air embolism.

Summary

The anesthetic management will continue to evolve with new developments in surgical, imaging, and monitoring techniques, and the understanding of the effects of drugs on electrophysiological recordings.

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Abbreviations

GPe:

Globus pallidus externa

GPi:

Globus pallidus interna

MD:

Mediodorsal nucleus of thalamus

PU:

Putamen

STN:

Subthalamic nuclei

VA:

Ventral anterior nucleus of thalamus

VC:

Ventral caudal nucleus of thalamus

Vim:

Ventral intermedius nucleus of thalamus

VOP:

Ventral oralis posterior nucleus of thalamus

VP:

Visual pathway

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Papers of particular interest, published recently, have been highlighted as • Of importance; •• Of major importance

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Authors and Affiliations

  1. Department of Anesthesia, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada

    Lashmi Venkatraghavan & Pirjo Manninen

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  1. Lashmi Venkatraghavan
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  2. Pirjo Manninen
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Correspondence to Lashmi Venkatraghavan.

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Lashmi Venkatraghavan and Pirjo Manninen declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Neuroanesthesia.

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Venkatraghavan, L., Manninen, P. Anesthesia for Deep Brain Stimulation. Curr Anesthesiol Rep 6, 233–243 (2016). https://doi.org/10.1007/s40140-016-0165-6

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