Hardware-Related Complications of Deep Brain Stimulation: A Review of the Published Literature

Abstract

Hardware-related complications have been commonly described after deep brain stimulation. We searched the PubMed database using the key words ‘adverse effects’ and ‘deep brain stimulation’. Out of 254 studies, we identified 10 articles that primarily addressed morbidity and hardware-related adverse effects in 922 patients. The most commonly reported hardware-related complications were infections (6.1% of the patients), migration or misplacement of the leads (5.1% of the patients), lead fractures (5.0% of the patients), and skin erosion (1.3% of the patients). Refinements in surgical technique, technological improvements, and a greater experience with the procedures will likely decrease the incidence of hardware-related side effects in the future.

Post-Operative Management of Parkinson Patients with Deep Brain Stimulation

“…A short circuit, in contrast, can result in sudden spread of electrical current to adjacent nervous tissue like the pyramidal tract or the oculomotor nerve with consequent tetanic muscle contraction or eye deviation. A secondary dislocation of stimulation electrodes has been reported in early studies of hardware complications (Blomstedt & Hariz, 2005;Hamani & Lozano, 2006). However, with improved surgical techniques it has become very uncommon in our own experience.…”

“…In contrast, complete fractures of electrodes or extension leads necessitate surgical revision. Lead fractures have been reported in up to 5 % of the patients in earlier reports (Hamani & Lozano, 2006). In most of these cases the connection between stimulation electrode and extension lead was located below the mastoid.…”

Deep Brain Stimulation for the Treatment of Severe, Medically Refractory Obsessive-Compulsive Disorder

“…Remaining complications, such as stroke or intracranial hemorrhage without lasting symptoms, skin erosions, seizures, device failure, and infection, have been reported to occur at rates of 3% to 15%. 18 The relative safety of DBS coupled with identification of potential efficacious therapeutic targets has led to trials of its effectiveness in treatment-refractory OCD. 6,19,20 The results of these trials led to the US Federal Drug Administration's Humanitarian Device Exemption approval of DBS for treatmentrefractory OCD in 2009.…”

Intraparenchymal Cyst Development after Deep Brain Stimulator Placement

“…The most devastating immediate complication is stroke or intracranial hemorrhage, which has been reported in approximately 1-2% of patients [1,2]. The most commonly reported hardware-related complications include infections (6.1%), migration or misplacement of the leads (5.1%), lead fractures (5.0%) and skin erosion (1.3%) [3,4]. These delayed complications can be particularly frustrating as patients are often already benefiting from their DBS and have started to have an improved quality of life [5].…”