gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Implantation of electrodes for deep brain stimulation of the subthalamic nucleus with the aid of intraoperative microrecordings under general anesthesia

Implantation von Elektroden zur tiefen Hirnstimulation in den Nukleus subthalamicus unter Vollnarkose mit Mikroableitung

Meeting Abstract

  • corresponding author F. Hertel - Neurochirurgische Abteilung, Bruederkrankenhaus, Trier
  • M. Züchner - Neurochirurgische Abteilung, Bruederkrankenhaus, Trier
  • C. Decker - Neurochirurgische Abteilung, Bruederkrankenhaus, Trier
  • P. Gemmar - University of applied sciences, center of applied and innovative informatics, Trier
  • I. Weimar - Neurologische Abteilung, Bruederkrankenhaus, Trier
  • B. Noll - Anesthesiologische Abteilung, Bruederkrankenhaus, Trier
  • M. Bettag - Neurochirurgische Abteilung, Bruederkrankenhaus, Trier

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.08.01

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Veröffentlicht: 8. Mai 2006

© 2006 Hertel et al.
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Objective: Deep brain stimulation (DBS) is widely accepted and efficacious in the treatment of advanced Parkinson's disease (PD) and other movement disorders.The standard implantaion procedure is performed under local anesthesia (LA). Certain groups of patients may be not be eligible for surgery due to clinical reasons, such as massive fear, reduced cooperation or coughing attacks.

Methods: The data of 9 patients with advanced PD (mean Hoehn and Yahr status 4,2) who were operated with DBS of the STN under general anesthesia (GA) were retrospectively analysed. All operations were performed under analgosedation with propofol/remifentanyl and intraoperative microelectrode recording (MER). The planning was performed with CT/MRI matching.

Results: The daily off phases were reduced from 50 to 17%, whereas the UPDRS III score could be reduced from 43 (preop) to 19 (stim on, med off) and 12 (stim on, med on). The STN could be identified intraoperatively in all cases with MER. 2 patients had a transient neuropsychological deterioration after surgery, but both had also preexisting episodes of desorientation. One IPG had to be removed due to an infection 2 months after surgery. No further clinical significant complications were observed.

Conclusions: STN surgery for advanced PD seems to be possible with good clinical results under GA. Even intraoperative MER of the STN region can be performed with reliable results under GA with a special protocol. This technique may enlarge the group of patients eligible for STN sugery in advanced PD. Though the clinical improvements, as well as the parameter settings in this series seem to be within the range of the current literature, further randomized controlled studies are necessary to compare the results of STN DBS between general anesthesia and local anesthesthesia