title: Adverse events associated with deep brain stimulation for movement disorders: analysis of 510 consecutive cases.
abstract: BACKGROUND
  Although numerous studies have focused on the efficacy of deep brain stimulation (DBS) for movement disorders, less is known about surgical adverse events, especially over longer time intervals.
  
  
  OBJECTIVE
  Here, we analyze adverse events in 510 consecutive cases from a tertiary movement disorders center at up to 10 years postoperatively.
  
  
  METHODS
  We conducted a retrospective review of adverse events from craniotomies between January 2003 and March 2013. The adverse events were categorized into 2 broad categories--immediate perioperative and time-dependent postoperative events.
  
  
  RESULTS
  Across all targets, perioperative mental status change occurred in 18 (3.5%) cases, and symptomatic intracranial hemorrhage occurred in 4 (0.78%) cases. The most common hardware-related event was skin erosion in 13 (2.5%) cases. The most frequent stimulation-related event was speech disturbance in 16 (3.1%) cases. There were no significant differences among surgical targets with respect to the incidence of these events. Time-dependent postoperative events leading to the revision of a given DBS electrode for any reason occurred in 4.7% ± 1.0%, 9.3% ± 1.4%, and 12.4% ± 1.5% of electrodes at 1, 4, and 7 years postoperatively, respectively. Staged bilateral DBS was associated with approximately twice the risk of repeat surgery for electrode replacement vs unilateral surgery (P = .020).
  
  
  CONCLUSIONS
  These data provide low incidences for adverse events in a large series of DBS surgeries for movement disorders at up to 10 years follow-up. Accurate estimates of adverse events will better inform patients and caregivers about the potential risks and benefits of surgery and provide normative data for process improvement.
authors.affiliation: ‡Division of Neurosurgery, The University of Alabama at Birmingham, Birmingham, Alabama; §Division of Neurology, The University of Alabama at Birmingham, Birmingham, Alabama; ¶Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama; ‖School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Daxa M
authors.initials: DM
authors.lastname: Patel
authors.forename: Harrison C
authors.initials: HC
authors.lastname: Walker
authors.forename: Rebekah
authors.initials: R
authors.lastname: Brooks
authors.forename: Nidal
authors.initials: N
authors.lastname: Omar
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ditty
authors.forename: Barton L
authors.initials: BL
authors.lastname: Guthrie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000009:adverse effects*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies