Tremor and other hyperkinetic movements (New York, N.Y.) · 2025
Lesioning Through a Directional Deep Brain Stimulation Lead in the Subthalamic Nucleus.
СтатьяКлинический случайПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Nunez Alfonso Enrique Martinez, Kusyk Dorian M, Wong Joshua K, Okun Michael S, Hilliard Justin D
Аннотация
CLINICAL VIGNETTE: A 59-year-old woman with a previous subthalamic nucleus deep brain stimulation (DBS) implanted for Parkinson's disease developed a hardware related infection.
CLINICAL DILEMMA: Wound dehiscence and infection developed and necessitated removal of the DBS system. The patient experienced excellent therapeutic benefit from her DBS and expressed concern about device removal.
CLINICAL SOLUTION: The patient was offered the option of a lesioning procedure which could be performed during hardware explantation. An operative procedure was conducted where the intracranial DBS lead was connected to a radiofrequency system in a deliberate effort to create a targeted subthalamotomy through the existing DBS lead. A multilevel lesion was generated using the contacts on the directional DBS lead. Following the lesion the DBS lead and hardware were removed.
GAP IN KNOWLEDGE: Creating a lesion through a DBS lead using radiofrequency ablation is a therapeutic option for patients not interested in later re-implantation or for those with a history of multiple DBS related infections. Lesioning through segmented leads introduces more complexity into the procedure.
CLINICAL DILEMMA: Wound dehiscence and infection developed and necessitated removal of the DBS system. The patient experienced excellent therapeutic benefit from her DBS and expressed concern about device removal.
CLINICAL SOLUTION: The patient was offered the option of a lesioning procedure which could be performed during hardware explantation. An operative procedure was conducted where the intracranial DBS lead was connected to a radiofrequency system in a deliberate effort to create a targeted subthalamotomy through the existing DBS lead. A multilevel lesion was generated using the contacts on the directional DBS lead. Following the lesion the DBS lead and hardware were removed.
GAP IN KNOWLEDGE: Creating a lesion through a DBS lead using radiofrequency ablation is a therapeutic option for patients not interested in later re-implantation or for those with a history of multiple DBS related infections. Lesioning through segmented leads introduces more complexity into the procedure.