title: Deep Brain Stimulation during Pregnancy and Delivery: Experience from a Series of "DBS Babies".
abstract: BACKGROUND
  Deep brain stimulation (DBS) is widely used to improve quality of life in movement disorders (MD) and psychiatric diseases. Even though the ability to have children has a big impact on patients' life, only a few studies describe the role of DBS in pregnancy.
  
  
  OBJECTIVE
  To describe risks and management of women treated by DBS for disabling MD or psychiatric diseases during pregnancy and delivery.
  
  
  METHODS
  We report a retrospective case series of women, followed in two DBS centers, who became pregnant and went on to give birth to a child while suffering from disabling MD or psychiatric diseases [Parkinson's disease, dystonia, Tourette's syndrome (TS), Obsessive Compulsive Disorder (OCD)] treated by DBS. Clinical status, complications and management before, during, and after pregnancy are reported. Two illustrative cases are described in greater detail.
  
  
  RESULTS
  DBS improved motor and behavioral disorders in all patients and allowed reduction in, or even total interruption of disease-specific medication during pregnancy. With the exception of the spontaneous early abortion of one fetus in a twin pregnancy, all pregnancies were uneventful in terms of obstetric and pediatric management. DBS parameters were adjusted in five patients in order to limit clinical worsening during pregnancy. Implanted material limited breast-feeding in one patient because of local pain at submammal stimulator site and led to local discomfort related to stretching of the cable with increasing belly size in another patient whose stimulator was implanted in the abdominal wall.
  
  
  CONCLUSIONS
  Not only is it safe for young women with MD, TS and OCD who have a DBS-System implanted to become pregnant and give birth to a baby but DBS seems to be the key to becoming pregnant, having children, and thus greatly improves quality of life.
authors.affiliation: Department of Neurology, Policlinico San Donato, Milan University , Milan , Italy ; Clinical Center for Neurotechnology, Neurostimulation and Movement Disorders, Fondazione IRCCS Ca' Granda - Ospedale Maggiore di Milano , Milan , Italy ; Department of Neurology, Grenoble University Hospital , Grenoble , France.
authors.forename: Emma
authors.initials: E
authors.lastname: Scelzo
authors.affiliation: Department of Neurosurgery, Ludwig-Maximilians-University , Munich , Germany.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Mehrkens
authors.affiliation: Department of Neurology, Ludwig-Maximilians-University , Munich , Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Bötzel
authors.affiliation: Department of Neurology, Grenoble University Hospital , Grenoble , France ; Grenoble Institute of Neurosciences, INSERM U836, Joseph Fourier University , Grenoble , France.
authors.forename: Paul
authors.initials: P
authors.lastname: Krack
authors.affiliation: Department of Neurology, Porto University Hospital , Porto , Portugal.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mendes
authors.affiliation: Grenoble Institute of Neurosciences, INSERM U836, Joseph Fourier University , Grenoble , France ; Department of Neurosurgery, Grenoble University Hospital , Grenoble , France.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Chabardès
authors.affiliation: Grenoble Institute of Neurosciences, INSERM U836, Joseph Fourier University , Grenoble , France ; Department of Neuropsychiatry, Grenoble University Hospital , Grenoble , France.
authors.forename: Mircea
authors.initials: M
authors.lastname: Polosan
authors.affiliation: Grenoble Institute of Neurosciences, INSERM U836, Joseph Fourier University , Grenoble , France ; Department of Neurosurgery, Grenoble University Hospital , Grenoble , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Seigneuret
authors.affiliation: Department of Neurology, Grenoble University Hospital , Grenoble , France ; Grenoble Institute of Neurosciences, INSERM U836, Joseph Fourier University , Grenoble , France.
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
authors.affiliation: Department of Neurology, Grenoble University Hospital , Grenoble , France ; Grenoble Institute of Neurosciences, INSERM U836, Joseph Fourier University , Grenoble , France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Fraix
keywords: Parkinson disease; Tourette’s syndrome; deep brain stimulation; dystonia; obsessive compulsive disorder; pregnancy; teratogenicity