title: Long-term surgical and hardware-related complications of deep brain stimulation.
abstract: OBJECTIVE
  To evaluate the incidence of surgical and hardware-associated complications of deep brain stimulation (DBS) for a range of movement disorders.
  
  
  METHODS
  The study design is a retrospective analysis and review of surgical and hardware complications of DBS performed by a single surgeon from 1999 to 2009. A total of 153 cases of DBS (298 electrodes) for various movement disorders and a minimum follow-up of 1 year have been included. Two patients could not be implanted. A further 54 patients who underwent change of the implantable pulse generator (IPG) have been included for analysis of hardware-related complications.
  
  
  RESULTS
  The mean follow-up was 64 ± 36.15 (range = 12-129) months for the DBS group. Twenty-four (15.6%) patients developed complications. Confusion occurred in 3.9%, vasovagal attack in 1.9%, lead migration/misplaced lead in 2.5%, erosion and infection in 4.5% and IPG malfunction occurred in 1.4% of the patients. When calculated with respect to the number of electrodes and IPG replacements, the complication rate was lower (11.9%). Three patients had their system explanted, two of them being patients with dystonia who had inadvertently damaged their operative site.
  
  
  CONCLUSIONS
  DBS surgery is a relatively safe surgery, with most of the complications being minor, without long-term morbidity. The complication rate in elderly (age ≥65 years) is comparable to that in younger patients. However, confusion is more frequent in this age group, and patients and relatives can be prepared to accept this as a transient morbidity.
authors.affiliation: In-charge Stereotactic and Functional Neurosurgical Program, Jaslok Hospital and Research Centre, Mumbai, India. pareshkd@gmail.com
authors.forename: Paresh K
authors.initials: PK
authors.lastname: Doshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000453:epidemiology; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology; D006801:Humans; D058542:Implantable Neurostimulators / Q000009:adverse effects*; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000628:therapy*; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult