Deep brain stimulation hardware complications: the role of electrode impedance and current measurements.
Deep brain stimulation (DBS) is an effective therapy for advanced Parkinson's disease patients. Successful DBS outcomes depend on appropriate patient selection, surgical placement of the lead, intact hardware systems, optimal programming, and medical management. Despite its importance, there is little guidance in reference to hardware monitoring, hardware troubleshooting, and patient management. Technical manuals produced by the hardware manufacturer (Medtronic, Minneapolis, MN) are not presented in an applied clinical format, making impedance and current measurements difficult to interpret when the results are not straightforward. We present four patients with evolving DBS hardware complications that occurred during long-term follow-up, that shaped our clinical protocol for long-term care management and hardware troubleshooting.
Farris
Sierra
S
Booth Gardner Parkinson's Care Center, Evergreen Hospital, Kirkland, Washington 98034, USA.
Vitek
Jerrold
J
Giroux
Monique L
ML
D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000295:instrumentation*; D017097:Electric Impedance; D004567:Electrodes, Implanted / Q000009:adverse effects; D004582:Electronics, Medical / Q000295:instrumentation*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D012086:Reoperation