Management of infected cerebellar stimulation systems.
Over a 7-year period (February 1974 through February 1981), 318 patients underwent the implantation of cerebellar stimulation systems for the reduction of spasticity (98%) or epilepsy (2%). A total of 518 procedures were carried out to implant and maintain the equipment during this period. Fourteen patients developed infections in the tissue around their implanted systems, which represented 4.4% of the patients or 2.7% of the procedures performed. Staphylococcus aureus was the infectious agent in 7 cases (50%), the clinical features of which occurred usually within 1 month. Staphylococcus epidermidis infected 5 patients with features presenting late (more than 2 years) after the initial implantation. The management involved antibiotic therapy for 2 weeks in all 14 patients. In 12 patients, the entire system was removed, with 100% eradication of the infection. In the other 2 patients, the radio receiver and lead wires up to but not including the cerebellar electrode pads were removed. One of these 2 patients has been free of infection for 4 years. The other had S. aureus cultured from removed electrode pads after 6 weeks. Of the 14 cases, morbidity was severe in only 1 patient. Seven patients underwent reimplantation 6 weeks after the infection.
D000667:Ampicillin / Q000627:therapeutic use; D002531:Cerebellum / Q000502:physiology*; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004827:Epilepsy / Q000628:therapy*; D006801:Humans; D009128:Muscle Spasticity / Q000628:therapy*; D009254:Nafcillin / Q000627:therapeutic use; D009474:Neurons; D010068:Oxacillin / Q000627:therapeutic use; D019736:Prostheses and Implants / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology
D009254:Nafcillin; D000667:Ampicillin; D010068:Oxacillin