title: [Surgical complications of deep brain stimulation: clinical experience of 184 cases].
abstract: OBJECTIVE
  Deep brain stimulation (DBS) is an effective treatment of movement disorders and psychiatric diseases. However, this surgery is still time consuming and associated with complications, among which we aimed to identify non-stimulo-induced adverse effects. Hence, we retrospectively systematically analyzed patients operated on, at our institution, using magnetic resonance imaging (MRI) direct anatomic mapping.
  
  
  METHODS
  One hundred and seventy-five patients (184 surgeries) were performed between 1994 and 2008, for Parkinson's disease, essential tremor, dystonia and obsessive compulsive disorder. Primary anatomic targets were the subthalamic region, the intern pallidum and the thalamus. Final electrode positioning was adjusted according to intraoperative neuron recordings and acute stimulation tests. All surgically related adverse effects were collected. Life threatening or new non-planed surgery was considered as severe adverse effects.
  
  
  RESULTS
  Adverse effects occurred 10 times (5.4%) during MRI acquisition, 24 times (13%) with five serious (2.7%) including one1 death (0.5%) during electrodes implantation and 17 times (9.2%) with four serious (2.2%) during neuropacemaker implantation. Electrodes were repositioned in six cases (five patients, n=3.4%).
  
  
  CONCLUSIONS
  DBS efficiency is recognized however the significant incidence of adverse effects should prompt us to improve the procedures.
authors.affiliation: Service de neurochirurgie A, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 28, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France. vmendesmartins@ch-annecy.fr
authors.forename: V
authors.initials: V
authors.lastname: Mendes Martins
authors.forename: J
authors.initials: J
authors.lastname: Coste
authors.forename: P
authors.initials: P
authors.lastname: Derost
authors.forename: M
authors.initials: M
authors.lastname: Ulla
authors.forename: J
authors.initials: J
authors.lastname: Gabrillargues
authors.forename: F
authors.initials: F
authors.lastname: Durif
authors.forename: J
authors.initials: J
authors.lastname: Chazal
authors.forename: J-J
authors.initials: JJ
authors.lastname: Lemaire
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000379:methods; D004421:Dystonia / Q000601:surgery; D004567:Electrodes, Implanted; D020329:Essential Tremor / Q000601:surgery; D005260:Female; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D009771:Obsessive-Compulsive Disorder / Q000601:surgery; D010300:Parkinson Disease / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000601:surgery; D013788:Thalamus / Q000601:surgery