Brain

Deep Brain Stimulation (DBS)

More than 150,000 patients have undergone DBS. The present day techniques make it a very safe procedure.

Risks & Complications of Deep Brain Stimulation

Deep Brain Stimulation is a relatively safe neurosurgical procedure with low mortality. However, similar to other surgical procedures, DBS surgeries are complicated by intraop­erative and postoperative complications e.g. intracranial bleeding, seizure, stroke, hardware malfunction, infection, prolonged length of hospitalization, and postoperative confusion.

Regarding complications of DBS surgery, a study by Dr. Doshi in 2011 with a mean duration of follow-up of more than 5 years showed confusion in 3.9%, hardware infection in 4.5%, and malfunction of the implantable pulse generator (IPG) in 1.4% in a series of 153 patients.

This also includes most serious complication of intracerebral haemorrhage during DBS surgery in only 1.2% of patients, one of the lowest in the world.

A recent study among more than 500 patients who have undergone DBS surgery showing further reduction in rate of different complications is coming up for publication.

Electromagnetic pulses from medical devices such as mag­netic resonance imaging and defibrillators, trauma due to blunt force can also cause hardware failure.

Patients may also get suboptimal response in case of inaccurate electrode positioning or faulty programming.

These all problems can be avoided by taking proper precautions during surgery & post-surgical period.

Another common complication of DBS surgery is the skin erosion or thinning over the implants. There are various reasons for this e.g. superficial subcutaneous pocket for IPG, ageing process, weight of the IPG etc.

Patients should also watch out for the extension wire connector site located behind the ears as it’s another common area for erosion. They should maintain good personal hygiene and take proper care of the implant sites, right from the scalp to the pacemaker site over the chest wall.

Many times, patients develop stimulation related side effects like speech and gait disturbances, tingling and numbness (also called as paraesthesia) in the regions of stimulation.

This problem can be minimised or eliminated by careful programming and adjustments of medications.