Identification and management of deep brain stimulation intra- and postoperative urgencies and emergencies☆
Received 30 June 2009; received in revised form 23 September 2009; accepted 1 October 2009.
Abstract
Deep brain stimulation (DBS) has been increasingly utilized for the therapeutic treatment of movement disorders, and with the advent of this therapy more postoperative urgencies and emergencies have emerged. In this paper, we will review, identify, and suggest management strategies for both intra- and postoperative urgencies and emergencies. We have separated the scenarios into 1 – surgery/procedure related, 2 – hardware related, 3 – stimulation-induced difficulties, and 4 – others. We have included ten illustrative (and actual) case vignettes to augment the discussion of each issue.
aDepartment of Neurology, University of Florida College of Medicine/Shands Hospital, Movement Disorders Center, McKnight Brain Institute, Gainesville, FL, USA
bDepartment of Neurosurgery, University of Florida College of Medicine/Shands Hospital, Movement Disorders Center, McKnight Brain Institute, Gainesville, FL, USA
cDepartment of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
dDivision of Applied System Neuroscience, Department of Advanced Medical Science, Nihon University School of Medicine, Tokyo, Japan
eDepartment of Neurology, Columbia University College of Physicians and Surgeons/Columbia-Presbyterian Medical Center, New York, NY, USA
Corresponding author at: Department of Neurology, McKnight Brain Institute, Medical Director National Parkinson Foundation, 100 S Newell Dr, Room L3-101, Gainesville, FL 32610, USA. Tel.: +1 352 273 5550; fax: +1 352 273 5575.
☆ The review of this paper was entirely handled by the Co-Editor-in-Chief, Zbigniew Wszolek.
ABSTRACT