scholarly journals Technical nuances to minimize common complications of deep brain stimulation

2017 ◽  
Vol 42 (videosuppl2) ◽  
pp. V2
Author(s):  
Paul House
Keyword(s):  
Deep Brain Stimulation ◽  
Surgical Technique ◽  
Brain Stimulation ◽  
Deep Brain Stimulator ◽  
Link Type ◽  
Prospective Trials ◽  
Skin Erosion ◽  
Deep Brain

The implantation of deep brain stimulator electrodes is associated with infrequent complications. These complications are consistent across prospective trials and include infection, skin erosion, hemorrhage, and lead misplacement. Nuances of surgical technique can be used to minimize the risk of these commonly noted complications. Several of these technical nuances are highlighted in this video submission.The video can be found here: https://youtu.be/GL09W9p013g.

scholarly journals Coaxial interleaved stimulation of the thalamus and subthalamus for treatment of Holmes tremor

2017 ◽  
Vol 42 (videosuppl2) ◽  
pp. V1 ◽  
Author(s):  
Hiroki Toda ◽  
Namiko Nishida ◽  
Koichi Iwasaki
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Novel Technique ◽  
Link Type ◽  
Holmes Tremor ◽  
Deep Brain ◽  
Stimulation Of

Holmes tremor is often treated with multiple deep brain stimulation (DBS) electrodes. The authors describe a novel technique to suppress the tremors by effectively utilizing a single electrode.A 16-year-old boy presented with severe right arm tremor following a midbrain injury. A DBS electrode was implanted into the ventral oralis nucleus of the thalamus (VO) and the subthalamic region. While individual stimulation of each target was ineffective, an interleaved dual stimulation of both targets has been effective for 6 years.Coaxial interleaved stimulation of the VO and the subthalamic region is useful for treating Holmes tremor.The video can be found here: https://youtu.be/tSwGh3vy68c.

scholarly journals Pallidotomy after chronic deep brain stimulation

2013 ◽  
Vol 35 (5) ◽  
pp. E5 ◽  
Author(s):  
Kristian J. Bulluss ◽  
Erlick A. Pereira ◽  
Carole Joint ◽  
Tipu Z. Aziz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Full Time ◽  
Progressive Dementia ◽  
Deep Brain Stimulator ◽  
Beneficial Effects ◽  
Unilateral Pallidotomy ◽  
Deep Brain

Recent publications have demonstrated that deep brain stimulation for Parkinson's disease still exerts beneficial effects on tremor, rigidity, and bradykinesia for up to 10 years after implantation of the stimulator. However with the progression of Parkinson's disease, features such as cognitive decline or “freezing” become prominent, and the presence of an implanted and functioning deep brain stimulator can impose a profound burden of care on the clinical team and family. The authors describe their experience in treating 4 patients who underwent removal of the implanted device due to either progressive dementia requiring full-time nursing or due to infection, and who subsequently underwent a unilateral pallidotomy.

Subthalamic nucleus deep brain stimulation in isolated dystonia

Neurology ◽  
2016 ◽  
Vol 88 (1) ◽  
pp. 25-35 ◽  
Author(s):  
Jill L. Ostrem ◽  
Marta San Luciano ◽  
Kristen A. Dodenhoff ◽  
Nathan Ziman ◽  
Leslie C. Markun ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Spasmodic Torticollis ◽  
Link Type ◽  
Term Tolerability ◽  
Stn Dbs ◽  
Deep Brain

Objective:To report long-term safety and efficacy outcomes of a large cohort of patients with medically refractory isolated dystonia treated with subthalamic nucleus (STN) deep brain stimulation (DBS).Methods:Twenty patients (12 male, 8 female; mean age 49 ± 16.3 years) with medically refractory isolated dystonia were studied (14 were followed for 36 months). The primary endpoints were change in Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) motor score and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total score at 36 months compared to preoperative baseline. Multiple secondary outcomes were also assessed (ClinicalTrials.govNCT00773604).Results:Eighteen of 20 patients showed improvement 12 months after STN DBS with sustained benefit persisting for 3 years (n = 14). At 36 months, BFMDRS motor scores improved 70.4% from a mean 17.9 ± 8.5 to 5.3 ± 5.6 (p = 0.0002) and total TWSTRS scores improved 66.6% from a mean 41.0 ± 18.9 to 13.7 ± 17.9 (p = 0.0002). Improvement at 36 months was equivalent to that seen at 6 months. Disability and quality of life measures were also improved. Three hardware-related and 24 stimulation-related nonserious adverse events occurred between years 1 and 3 (including 4 patients with dyskinesia).Conclusions:This study offers support for long-term tolerability and sustained effectiveness of STN DBS in the treatment of severe forms of isolated dystonia.Classification of evidence:This study provides Class IV evidence that STN DBS decreases long-term dystonia severity in patients with medically refractory isolated dystonia.

scholarly journals Pacemaker and Defibrillator Implantation and Programming in Patients with Deep Brain Stimulation

2019 ◽  
Vol 8 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Mark Elliott ◽  
Sheikh Momin ◽  
Barnaby Fiddes ◽  
Fahad Farooqi ◽  
SM Afzal Sohaib
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Case Reports ◽  
Cardiac Pacemaker ◽  
Cardiac Device ◽  
Deep Brain Stimulator ◽  
Device Implantation ◽  
Cardiac Devices ◽  
Potential Interactions ◽  
Deep Brain

The need for cardiac device implantation in patients receiving deep brain stimulation (DBS) is increasing. Despite the theoretical risk of the two systems interacting, there are no clear guidelines for cardiologists carrying out cardiac device implantation in this population. We performed a review of the literature and describe 13 case reports in which patients have both DBS and a cardiac pacemaker or ICD implanted. Except for one early study, in which an ICD shock reset the deep brain stimulator, no significant interactions have been reported. We discuss the potential interactions between DBS and cardiac devices, and provide practical advice for implanting cardiologists. We conclude that, provided that specific precautions are taken, cardiac device implantation is likely to be safe in patients with DBS.

Approach for tunneling the lead in deep brain stimulation

2010 ◽  
Vol 112 (6) ◽  
pp. 1277-1278 ◽  
Author(s):  
Andrew J. Fabiano ◽  
Robert J. Plunkett
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Pulse Generator ◽  
Electrode Placement ◽  
Deep Brain Stimulator ◽  
Electrode Implantation ◽  
Subsequent Operation ◽  
Implantation Procedure ◽  
Deep Brain

The implantation of a deep brain stimulator (DBS) is often a staged procedure that involves stereotactic placement of the neurostimulator electrode, followed by connection of the electrode to a pulse generator during a separate operation. The authors describe a practical technique for the retrograde tunneling of the stimulator lead during the initial electrode implantation procedure. After DBS electrode placement and securing of the lead, the lead is covered with a protective cap and boot, which are then folded back to tunnel a redundant loop of the lead in a retrograde fashion into a subgaleal pocket. This technique facilitates connection of the lead to the pulse generator connecting wire at the subsequent operation and may reduce lead damage.

Deep Brain Stimulation Generator Failure due to External Defibrillation in a Patient with Essential Tremor

2020 ◽  
pp. 1-2
Author(s):  
Gregory Davis ◽  
Zachary Levine
Keyword(s):  
Cardiac Arrest ◽  
Deep Brain Stimulation ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Case Reports ◽  
The Other ◽  
Deep Brain Stimulator ◽  
Rf Transmission ◽  
Deep Brain

There exist only two case reports to date of open cardiac defibrillation with deep brain stimulator system (DBS) implantation. We report a 64-year-old male with DBS system in place for essential tremor who underwent cardiac defibrillation after cardiac arrest. Afterwards, his device impedances were all high and his tremor symptoms returned. Both problems resolved with implantation of a new generator and required no changes to the intracranial leads or extension cables. This is significantly different from the two previous reports. One included a significantly different DBS system relying on transcutaneous RF transmission and reported a lesioning effect after cardioversion. The other utilized a modern DBS system but reported damage to the generator and intracranial leads. We report that only the generator sustained damage, and that there were no intracranial changes that occurred.

Deep brain stimulation for Parkinson's disease: Surgical technique and perioperative management

2006 ◽  
Vol 21 (S14) ◽  
pp. S247-S258 ◽  
Author(s):  
Andre Machado ◽  
Ali R. Rezai ◽  
Brian H. Kopell ◽  
Robert E. Gross ◽  
Ashwini D. Sharan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Surgical Technique ◽  
Brain Stimulation ◽  
Perioperative Management ◽  
Deep Brain
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