Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia
Background: Data on pediatric DBS is still limited because of small numbers in single center series and lack of systematic multi-center trials. Objectives: We evaluate short- and long-term adverse events (AEs) of patients undergoing deep brain stimulation (DBS) during childhood and adolescence. Meth...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-09-01
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| Series: | Brain Stimulation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X19301883 |
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doaj-073ae60054a7476b815fec04ffa8891f |
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| record_format |
Article |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
A. Koy N. Bockhorn A.A. Kühn G.-H. Schneider P. Krause K. Lauritsch K. Witt S. Paschen G. Deuschl J.K. Krauss A. Saryyeva J. Runge I. Borggraefe J.H. Mehrkens A. Horn J. Vesper A. Schnitzler S. Siegert M. Freilinger M. Eckenweiler V.A. Coenen V. Tadic J. Voges K.A.M. Pauls J. Wirths L. Timmermann M. Hellmich Mahmoud Abdallat Laura Cassini Ascencao Svetlana Grünwald Andreas Wloch Christoph Schrader Stefan J. Groiss Lars Wojtecki |
| spellingShingle |
A. Koy N. Bockhorn A.A. Kühn G.-H. Schneider P. Krause K. Lauritsch K. Witt S. Paschen G. Deuschl J.K. Krauss A. Saryyeva J. Runge I. Borggraefe J.H. Mehrkens A. Horn J. Vesper A. Schnitzler S. Siegert M. Freilinger M. Eckenweiler V.A. Coenen V. Tadic J. Voges K.A.M. Pauls J. Wirths L. Timmermann M. Hellmich Mahmoud Abdallat Laura Cassini Ascencao Svetlana Grünwald Andreas Wloch Christoph Schrader Stefan J. Groiss Lars Wojtecki Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia Brain Stimulation Adverse events Dystonia Deep brain stimulation Pediatric patients |
| author_facet |
A. Koy N. Bockhorn A.A. Kühn G.-H. Schneider P. Krause K. Lauritsch K. Witt S. Paschen G. Deuschl J.K. Krauss A. Saryyeva J. Runge I. Borggraefe J.H. Mehrkens A. Horn J. Vesper A. Schnitzler S. Siegert M. Freilinger M. Eckenweiler V.A. Coenen V. Tadic J. Voges K.A.M. Pauls J. Wirths L. Timmermann M. Hellmich Mahmoud Abdallat Laura Cassini Ascencao Svetlana Grünwald Andreas Wloch Christoph Schrader Stefan J. Groiss Lars Wojtecki |
| author_sort |
A. Koy |
| title |
Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia |
| title_short |
Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia |
| title_full |
Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia |
| title_fullStr |
Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia |
| title_full_unstemmed |
Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia |
| title_sort |
adverse events associated with deep brain stimulation in patients with childhood-onset dystonia |
| publisher |
Elsevier |
| series |
Brain Stimulation |
| issn |
1935-861X |
| publishDate |
2019-09-01 |
| description |
Background: Data on pediatric DBS is still limited because of small numbers in single center series and lack of systematic multi-center trials. Objectives: We evaluate short- and long-term adverse events (AEs) of patients undergoing deep brain stimulation (DBS) during childhood and adolescence. Methods: Data collected by the German registry on pediatric DBS (GEPESTIM) were analyzed according to reversible and irreversible AEs and time of occurrence with relation to DBS-surgery: Intraoperative, perioperative (<4 weeks), postoperative (4 weeks < 6 months) and long term AEs (>6 months). Results: 72 patients with childhood-onset dystonia from 10 DBS-centers, who received 173 DBS electrodes and 141 implantable pulse generators (IPG), were included in the registry. Mean time of postoperative follow-up was 4.6 ± 4 years. In total, 184 AEs were documented in 53 patients (73.6%). 52 DBS-related AEs in 26 patients (36.1%) required 45 subsequent surgical interventions 4.7 ± 4.1 years (range 3 months–15 years) after initial implantation. The total risk of an AE requiring surgical intervention was 7.9% per electrode-year. Hardware-related AEs were the most common reason for surgery. There was a tendency of a higher rate of AEs in patients aged 7–9 years beyond 6 months after implantation. Discussion: The intraoperative risk of AEs in pediatric patients with dystonia undergoing DBS is very low, whereas the rate of postoperative hardware-related AEs is a prominent feature with a higher occurrence compared to adults, especially on long-term follow-up. Conclusion: Factors leading to such AEs must be identified and patient management has to be focused on risk minimization strategies in order to improve DBS therapy and maximize outcome in pediatric patients. |
| topic |
Adverse events Dystonia Deep brain stimulation Pediatric patients |
| url |
http://www.sciencedirect.com/science/article/pii/S1935861X19301883 |
| work_keys_str_mv |
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| _version_ |
1724213601102725120 |
| spelling |
doaj-073ae60054a7476b815fec04ffa8891f2021-03-19T07:20:09ZengElsevierBrain Stimulation1935-861X2019-09-0112511111120Adverse events associated with deep brain stimulation in patients with childhood-onset dystoniaA. Koy0N. Bockhorn1A.A. Kühn2G.-H. Schneider3P. Krause4K. Lauritsch5K. Witt6S. Paschen7G. Deuschl8J.K. Krauss9A. Saryyeva10J. Runge11I. Borggraefe12J.H. Mehrkens13A. Horn14J. Vesper15A. Schnitzler16S. Siegert17M. Freilinger18M. Eckenweiler19V.A. Coenen20V. Tadic21J. Voges22K.A.M. Pauls23J. Wirths24L. Timmermann25M. Hellmich26Mahmoud Abdallat27Laura Cassini Ascencao28Svetlana Grünwald29Andreas Wloch30Christoph Schrader31Stefan J. Groiss32Lars Wojtecki33Department of Pediatrics, University Hospital of Cologne, Germany; Corresponding author. Department of Pediatrics, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.Department of Pediatrics, University Hospital of Cologne, GermanyDepartment of Neurology, Charité University Medicine, Berlin, GermanyDepartment of Neurosurgery, Charité University Medicine, Berlin, GermanyDepartment of Neurology, Charité University Medicine, Berlin, GermanyDepartment of Neurology, Charité University Medicine, Berlin, GermanyDeptartment of Neurology, Evangelic Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany; Research Center Neurosensory Science, Carl von Ossietzky University, Oldenburg, GermanyDepartment of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, GermanyDepartment of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, GermanyDepartment of Neurosurgery, Medical School, MHH, Hanover, GermanyDepartment of Neurosurgery, Medical School, MHH, Hanover, GermanyDepartment of Neurosurgery, Medical School, MHH, Hanover, GermanyDepartment of Pediatrics, Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Comprehensive Epilepsy Center, University Hospital, Ludwig Maximilians University of Munich, GermanyDepartment of Neurosurgery, University Hospital, Ludwig Maximilians University of Munich, GermanyDepartment of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Heinrich-Heine University, Dusseldorf, GermanyDepartment of Functional Neurosurgery and Stereotaxy, Medical Faculty, Heinrich-Heine University, Dusseldorf, GermanyDepartment of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Dusseldorf, GermanyDepartment of Paediatrics and Adolescent Medicine, Medical University of Vienna, AustriaDepartment of Paediatrics and Adolescent Medicine, Medical University of Vienna, AustriaDepartment of Neuropediatrics and Muscle Disorders, University Medical Center, Faculty of Medicine, University of Freiburg, GermanyDepartment of Stereotactic and Functional Neurosurgery, University Medical Center and Faculty of Medicine, Freiburg University, Freiburg i.Br., GermanyDepartment of Neurology, University Hospital of Lubeck, GermanyDepartment of Stereotactic Neurosurgery, University Hospital Magdeburg, Germany; Leibniz-Institute for Neurobiology, Magdeburg, GermanyDepartment of Neurology, University Hospital of Cologne, GermanyDepartment of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, GermanyDepartment of Neurology, University Hospital of Cologne, Germany; Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, GermanyInstitute of Medical Statistics and Computational Biology, University of Cologne, GermanyDepartment of Neurosurgery, Medical School, MHH, Hannover, GermanyDepartment of Neurosurgery, Medical School, MHH, Hannover, GermanyDepartment of Neurosurgery, Medical School, MHH, Hannover, GermanyDepartment of Neurosurgery, Medical School, MHH, Hannover, GermanyDepartment of Neurology, Medical School, MHH, Hannover, GermanyDepartment of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Dusseldorf, GermanyDepartment of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Dusseldorf, GermanyBackground: Data on pediatric DBS is still limited because of small numbers in single center series and lack of systematic multi-center trials. Objectives: We evaluate short- and long-term adverse events (AEs) of patients undergoing deep brain stimulation (DBS) during childhood and adolescence. Methods: Data collected by the German registry on pediatric DBS (GEPESTIM) were analyzed according to reversible and irreversible AEs and time of occurrence with relation to DBS-surgery: Intraoperative, perioperative (<4 weeks), postoperative (4 weeks < 6 months) and long term AEs (>6 months). Results: 72 patients with childhood-onset dystonia from 10 DBS-centers, who received 173 DBS electrodes and 141 implantable pulse generators (IPG), were included in the registry. Mean time of postoperative follow-up was 4.6 ± 4 years. In total, 184 AEs were documented in 53 patients (73.6%). 52 DBS-related AEs in 26 patients (36.1%) required 45 subsequent surgical interventions 4.7 ± 4.1 years (range 3 months–15 years) after initial implantation. The total risk of an AE requiring surgical intervention was 7.9% per electrode-year. Hardware-related AEs were the most common reason for surgery. There was a tendency of a higher rate of AEs in patients aged 7–9 years beyond 6 months after implantation. Discussion: The intraoperative risk of AEs in pediatric patients with dystonia undergoing DBS is very low, whereas the rate of postoperative hardware-related AEs is a prominent feature with a higher occurrence compared to adults, especially on long-term follow-up. Conclusion: Factors leading to such AEs must be identified and patient management has to be focused on risk minimization strategies in order to improve DBS therapy and maximize outcome in pediatric patients.http://www.sciencedirect.com/science/article/pii/S1935861X19301883Adverse eventsDystoniaDeep brain stimulationPediatric patients |