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1.
Front Aging Neurosci ; 15: 1258190, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38046469

RESUMO

Introduction: Parkinson's disease (PD) is a progressive and debilitating neurological disorder. While dopaminergic medication improves PD symptoms, continued management is complicated by continued symptom progression, increasing medication fluctuations, and medication-related dyskinesia. Deep brain stimulation (DBS) surgery is a well-accepted and widespread treatment often utilized to address these symptoms in advanced PD. However, DBS may also lead to complications requiring hospitalization. In addition, patients with PD and DBS may have specialized care needs during hospitalization. Methods: This systematic review seeks to characterize the complications and risk of hospitalization following DBS surgery. Patient risk factors and modifications to DBS surgical techniques that may affect surgical risk are also discussed. Results: It is found that, when candidates are carefully screened, DBS is a relatively low-risk procedure, but rate of hospitalization is somewhat increased for DBS patients. Discussion: More research is needed to determine the relative influence of more advanced disease vs. DBS itself in increased rate of hospitalization, but education about DBS and PD is important to insure effective patient care within the hospital.

2.
Mov Disord Clin Pract ; 7(7): 859-860, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33043085
3.
World Neurosurg ; 84(2): 591.e1-5, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25841757

RESUMO

BACKGROUND: Despite the best efforts to ensure stereotactic precision, deep brain stimulation (DBS) electrodes can wander from their intended position after implantation. We report a case of downward electrode migration 10 years following successful implantation in a patient with Parkinson disease. METHODS: A 53-year-old man with Parkinson disease underwent bilateral implantation of DBS electrodes connected to a subclavicular 2-channel pulse generator. The generator was replaced 7 years later, and a computed tomography (CT) scan confirmed the correct position of both leads. The patient developed a gradual worsening affecting his right side 3 years later, 10 years after the original implantation. A CT scan revealed displacement of the left electrode inferiorly into the pons. The new CT scans and the CT scans obtained immediately after the implantation were merged within a stereotactic planning workstation (Brainlab). RESULTS: Comparing the CT scans, the distal end of the electrode was in the same position, the proximal tip being significantly more inferior. The size and configuration of the coiled portions of the electrode had not changed. At implantation, the length was 27.7 cm; after 10 years, the length was 30.6 cm. CONCLUSIONS: These data suggests that the electrode had been stretched into its new position rather than pushed. Clinicians evaluating patients with a delayed worsening should be aware of this rare event.


Assuntos
Estimulação Encefálica Profunda/instrumentação , Eletrodos Implantados , Migração de Corpo Estranho/etiologia , Doença de Parkinson/cirurgia , Ponte , Complicações Pós-Operatórias/etiologia , Núcleo Subtalâmico/cirurgia , Desenho de Equipamento , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Reação a Corpo Estranho/diagnóstico por imagem , Reação a Corpo Estranho/etiologia , Reação a Corpo Estranho/cirurgia , Granuloma de Corpo Estranho/diagnóstico por imagem , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico por imagem , Ponte/diagnóstico por imagem , Ponte/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Reoperação , Núcleo Subtalâmico/diagnóstico por imagem , Tomografia Computadorizada por Raios X
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