Artikel
Surgical complications in deep brain stimulation of the subthalamic nucleus for Parkinson's disease – experience from a single centre
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Autoren
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C. Fronda
- Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
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P. P. Panciani
- Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
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L. Lopiano
- Clinica Neurologica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
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M. Zibetti
- Clinica Neurologica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
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M. Lanotte
- Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
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A. Ducati
- Clinica Neurochirurgica, Università di Torino e A.S.O. San Giovanni Battista, Molinette, Torino
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. Several studies have reported both short- and long-term improvements of Unified Parkinson's Disease Rating Scale (UPDRS) motor scores in the medication OFF condition ranging from 40 to 70%. The most frequent complications related to the procedure are: intracerebral hemorrhage (1,2-6%), infections (2,5-15%), lead misplacement (12,5%), hardware related complications, as lead fracture and lead migration, skin erosions, CSF leak, battery failures (overall up to 26%). The object of this study was to assess the surgery-related and hardware-related complications of deep brain stimulation of the subthalamic nucleus at a single centre.
Methods: A total of 145 consecutive patients underwent bilateral deep brain stimulation device implantation in the subthalamic nucleus between 1998 and 2007 (290 procedures).
Results: The surgical complications observed were: a seroma in the site of implant of the IPG requiring the removal of the generator and a later reimplantation (0,7% of patients), one lead misplacement (0.35% of leads) and isolated seizure in two patients (1,4%). No patient had post-operative neurological deficit. All patients underwent post-operative CT and/or MRI scan, no post-operative hemorrhage was detected. One patient (0,7%) presented severe pneumocephalus with psychomotor agitation that required sedation and intubation. No infection occurred. Hardware-related complications were: migration of the lead-extension connector without skin erosion in one patient (0,7%), with subsequent replacement of the connector; IPG malfunctioning in one patient for a generator failure (0,7%).
Conclusions: In our experience DBS has proven to be a safe procedure for the treatment of advanced Parkinson's disease. Important complications determining serious deficits are rare and several of the potential hardware-related complications may be avoidable with increased surgical experience.
