Intraoperative Test Stimulation with a Modified Implantable Pulse Generator in Deep Brain Stimulation

2000 ◽  
Vol 142 (5) ◽  
pp. 587-589 ◽  
Author(s):  
J. K. Krauss ◽  
T. Pohle
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Pulse Generator ◽  
Implantable Pulse Generator ◽  
Test Stimulation ◽  
Intraoperative Test ◽  
Deep Brain

Reoperation for device infection and erosion following deep brain stimulation implantable pulse generator placement

2020 ◽  
Vol 133 (2) ◽  
pp. 403-410 ◽  
Author(s):  
Travis J. Atchley ◽  
Nicholas M. B. Laskay ◽  
Brandon A. Sherrod ◽  
A. K. M. Fazlur Rahman ◽  
Harrison C. Walker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Pulse Generator ◽  
Rank Test ◽  
Implantable Pulse Generator ◽  
Device Infection ◽  
Deep Brain

OBJECTIVEInfection and erosion following implantable pulse generator (IPG) placement are associated with morbidity and cost for patients with deep brain stimulation (DBS) systems. Here, the authors provide a detailed characterization of infection and erosion events in a large cohort that underwent DBS surgery for movement disorders.METHODSThe authors retrospectively reviewed consecutive IPG placements and replacements in patients who had undergone DBS surgery for movement disorders at the University of Alabama at Birmingham between 2013 and 2016. IPG procedures occurring before 2013 in these patients were also captured. Descriptive statistics, survival analyses, and logistic regression were performed using generalized linear mixed effects models to examine risk factors for the primary outcomes of interest: infection within 1 year or erosion within 2 years of IPG placement.RESULTSIn the study period, 384 patients underwent a total of 995 IPG procedures (46.4% were initial placements) and had a median follow-up of 2.9 years. Reoperation for infection occurred after 27 procedures (2.7%) in 21 patients (5.5%). No difference in the infection rate was observed for initial placement versus replacement (p = 0.838). Reoperation for erosion occurred after 16 procedures (1.6%) in 15 patients (3.9%). Median time to reoperation for infection and erosion was 51 days (IQR 24–129 days) and 149 days (IQR 112–285 days), respectively. Four patients with infection (19.0%) developed a second infection requiring a same-side reoperation, two of whom developed a third infection. Intraoperative vancomycin powder was used in 158 cases (15.9%) and did not decrease the infection risk (infected: 3.2% with vancomycin vs 2.6% without, p = 0.922, log-rank test). On logistic regression, a previous infection increased the risk for infection (OR 35.0, 95% CI 7.9–156.2, p < 0.0001) and a lower patient BMI was a risk factor for erosion (BMI ≤ 24 kg/m2: OR 3.1, 95% CI 1.1–8.6, p = 0.03).CONCLUSIONSIPG-related infection and erosion following DBS surgery are uncommon but clinically significant events. Their respective timelines and risk factors suggest different etiologies and thus different potential corrective procedures.

scholarly journals “Asleep” deep brain stimulation for essential tremor

2016 ◽  
Vol 124 (6) ◽  
pp. 1842-1849 ◽  
Author(s):  
Tsinsue Chen ◽  
Zaman Mirzadeh ◽  
Kristina Chapple ◽  
Margaret Lambert ◽  
Rohit Dhall ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Activities Of Daily Living ◽  
General Anesthesia ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Daily Living ◽  
Perioperative Complications ◽  
Test Stimulation ◽  
Intraoperative Test ◽  
Deep Brain

OBJECT Deep brain stimulation (DBS) performed under general anesthesia (“asleep” DBS) has not been previously reported for essential tremor. This is in part due to the inability to visualize the target (the ventral intermediate nucleus [VIM]) on MRI. The authors evaluate the efficacy of this asleep technique in treating essential tremor by indirect VIM targeting. METHODS The authors retrospectively reviewed consecutive cases of initial DBS for essential tremor performed by a single surgeon. DBS was performed with patients awake (n = 40, intraoperative test stimulation without microelectrode recording) or asleep (n = 17, under general anesthesia). Targeting proceeded with standardized anatomical coordinates on preoperative MRI. Intraoperative CT was used for stereotactic registration and lead position confirmation. Functional outcomes were evaluated with pre- and postoperative Bain and Findley Tremor Activities of Daily Living scores. RESULTS A total of 29 leads were placed in asleep patients, and 60 were placed in awake patients. Bain and Findley Tremor Activities of Daily Living Questionnaire scores were not significantly different preoperatively for awake versus asleep cohorts (p = 0.2). The percentage of postoperative improvement was not significantly different between asleep (48.6%) and awake (45.5%) cohorts (p = 0.35). Euclidean error (mm) was higher for awake versus asleep patients (1.7 ± 0.8 vs 1.2 ± 0.4, p = 0.01), and radial error (mm) trended higherfor awake versus asleep patients (1.3 ± 0.8 vs 0.9 ± 0.5, p = 0.06). There were no perioperative complications. CONCLUSIONS In the authors’ initial experience, asleep VIM DBS for essential tremor without intraoperative test stimulation can be performed safely and effectively.

scholarly journals Patient Experience with Rechargeable Implantable Pulse Generator Deep Brain Stimulation for Movement Disorders

2019 ◽  
Vol 97 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Kyle T. Mitchell ◽  
Monica Volz ◽  
Aaron Lee ◽  
Marta San Luciano ◽  
Sarah Wang ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Patient Experience ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Pulse Generator ◽  
Implantable Pulse Generator ◽  
Deep Brain

Replacement of a deep brain stimulation implantable pulse generator with a rechargeable device

2014 ◽  
Vol 18 (3) ◽  
pp. 140-142
Author(s):  
Danny Tat-Ming Chan ◽  
Xian-Lun Zhu ◽  
Claire Ka-Yee Lau ◽  
Rosanna Kit-Man Wong ◽  
Wai-Sang Poon
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Pulse Generator ◽  
Implantable Pulse Generator ◽  
Deep Brain
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