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Life-threatening DBS withdrawal syndrome in Parkinson's disease can be treated with early reimplantation.

Abstract：

INTRODUCTION:The deep brain stimulation (DBS) withdrawal syndrome (DBS-WDS) is a rare, life-threatening complication in Parkinson's disease (PD) patients with long disease duration and stimulation when stimulation is terminated for extended periods mostly due to infection of the DBS-hardware. METHODS, RESULTS:In five patients explantation became necessary because of infection after a mean of 11.4 years (range 4-15 years) of DBS and a mean disease duration of 24.6 years (range 3-22 years). Mean UPDRS motor-score pre-explantation was 38 points (range 24-55 points) which increased to a mean of 78.4 points (range 58-90 points) after explantation, despite optimal Levodopa dosing. Reimplantation of the hardware after 23 days (range 3-45 days) under antibiotic treatment led to an improvement to a mean of 40 points (range 25-73 points) and a complication free survival. CONCLUSION:Early reimplantation of the DBS-hardware is a treatment option of the DBS-WDS when the life-threatening urgency overrides surgical standards. Observation of the syndrome indicates pharmacological unresponsiveness of the dopaminergic system in advanced PD and long-term DBS.

journal_name

Parkinsonism Relat Disord

journal_title

Parkinsonism & related disorders

authors

Reuter S,Deuschl G,Berg D,Helmers A,Falk D,Witt K

doi

10.1016/j.parkreldis.2018.06.035

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

88-92

eissn

1353-8020

issn

1873-5126

pii

S1353-8020(18)30303-1

journal_volume

56

pub_type

杂志文章

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