Stability of symptom control after replacement of impulse generators for deep brain stimulation

作者：Allert Niels^*; Kirsch Holger; Weirich Waldemar; Karbe Hans

来源：Journal of Neurosurgery, 2009, 110(6): 1274-1277.

DOI：10.3171/2009.I.JNS081352

• dystonia
• deep brain stimulation
• impulse generator
• tremor

Object. Impulse generators (IPGs) for deep brain Stimulation (DBS) need to be replaced when their internal batteries fail or when technical problems Occur. New IPGs are routinely programmed with the previous stimulation parameters. In this Study. the authors evaluate the stability of symptom control after such IPG replacements.
Methods. The authors retrospectively analyzed the outcome of 56 IPG replacements in 42 patients with various movement disorders treated using DBS.
Results. Stable symptom control was found in 65% of single-channel IPG replacements and 53% of dual-channel lPG replacements. Worsening of symptoms resulted primarily from changes ill Stimulation effects requiring reprogramming of stimulation parameters (17% of dual-channel IPG and 25% of single-channel IPG). In 14% of dual-channel IPG replacements. instability resulted from erroneous extension adjustment with change in laterality. A new short circuit of active with previously inactive contacts of the quadripolar stimulation lead resulted in a worsening of symptoms in 4% of replacements.
Conclusions. Replacement of the IPG requires careful follow-up of patients with DBS to ensure stable symptom control. (DOI: 10.3171/2009.I.JNS0813521)

• 出版日期2009-6