Successful implantation of a deep brain stimulator for essential tremor in a patient with a preexisting cochlear implant: surgical technique: technical case report.

Abstract:

OBJECTIVE:Deep brain stimulation (DBS) has become routine for the treatment of Parkinson's disease and essential tremor. Because both of these disorders are common in patients older than the age of 60, neurosurgeons are likely to encounter increasing numbers of patients who require DBS surgery but who already have another electronic medical implant such as a cardiac pacemaker/defibrillator or intrathecal infusion pump, raising the concern that one device might interfere with the performance of the other. CLINICAL PRESENTATION:Herein we report a modification of surgical technique resulting in the successful use of thalamic DBS to treat disabling essential tremor in a man with a previously implanted cochlear implant. INTERVENTION AND TECHNIQUE:The presence of the cochlear implant necessitated a number of modifications to our standard surgical technique including surgical removal of the subgaleal magnet that holds the receiver to the scalp and the use of computed tomography instead of magnetic resonance imaging to target the thalamus. More than a year after surgery, the patient is enjoying continued tremor suppression and an enhanced quality of life. The presence of the DBS device has not interfered with the proper functioning of his cochlear implant. CONCLUSION:DBS can be used successfully in patients with a previously implanted cochlear implant. The operating neurosurgeon should be aware of the limitations of intraoperative imaging and the need to coordinate with an otologic surgeon for maximum patient benefit.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

De Los Reyes K,Chandrasekhar SS,Tagliati M,Alterman R

doi

10.1227/01.NEU.0000369646.01287.42

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

372; discussion 372

issue

6 Suppl Operative

eissn

0148-396X

issn

1524-4040

pii

00006123-201006001-00030

journal_volume

66

pub_type

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