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Unusual complications of deep brain stimulation

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Abstract

Deep brain stimulation (DBS) has emerged as a successful therapy for the treatment of several neurological disorders with potential implications in management of psychiatric disease. A variety of well-characterized hardware and surgical complications have been reported after the procedure, including postoperative hardware infection, system failure, and intracranial hemorrhage. Fortunately, serious surgical complications are rare, but they can lead to immediate or long-term disability. As the number of patients undergoing DBS continues to increase, newer and less common complications continue to emerge. It is imperative that clinicians become familiar with these complications in order to promptly recognize them and institute adequate early treatment. In this report, we examine the occurrence of unusual complications after DBS with emphasis on surgical, hardware, and stimulation-related complications.

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Authors and Affiliations

  1. Department of Neurology, Albany Medical College, 47 New Scotland Ave, Albany, NY, 12208, USA

    Fumin Tong & Adolfo Ramirez-Zamora

  2. Department of Neurosurgery, Albany Medical College, 47 New Scotland Ave, Albany, NY, 12208, USA

    Lucy Gee & Julie Pilitsis

Authors
  1. Fumin Tong
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  2. Adolfo Ramirez-Zamora
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  3. Lucy Gee
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  4. Julie Pilitsis
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Correspondence to Adolfo Ramirez-Zamora.

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Selçuk Peker, Istanbul, Turkey

DBS surgery has been carried out with various indications for the last few years. Using this method, it has been possible to offer thousands of patients a better quality of life. However, as with any surgical technique, experience is paramount in DBS surgery. The rate of complications is much lower in experienced clinics. The duration of surgeries in clinics that treat multiple cases is much shorter, making this a factor in decreasing complication development in older patients. According to some authors, microelectrode recording is a reason for this increase in intracranial complications. However, our experience indicates that this is not quite the case. The selection of cases is an important factor. It is necessary to work with experienced movement-disorder specialist neurologists as a team; otherwise, systemic problems become an invitation to complications.

In my opinion, another crucial thing is to report such cases when they arise without hesitation. This way, other colleagues would be informed by these experiences. A lot of very interesting complications come up in various meetings among colleagues but remain unreported.

It is foreseen that the frequency of DBS surgery will increase in the upcoming years, as well as the variety in its complications.

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Tong, F., Ramirez-Zamora, A., Gee, L. et al. Unusual complications of deep brain stimulation. Neurosurg Rev 38, 245–252 (2015). https://doi.org/10.1007/s10143-014-0588-9

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  • DOI: https://doi.org/10.1007/s10143-014-0588-9

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