Stimulation Complications

Stimulation-related adverse effects depend on the exact location of the lead and the intensity of stimulation. The majority of these adverse effects can be reduced by changing the active electrode contact or by reducing the stimulation intensity. These adverse effects include eyelid apraxia, double vision, dystonic posturing, dysarthria, dyskinesia, paresthesia, limb and facial muscle spasms, depression, mood changes, paresthesias, visual disturbances, and pain. Occasionally, nonspecific sensations like anxiety, panic, palpitations, and nausea can also occur. If these adverse effects persist, this usually indicates that the electrode is not in the ideal position.

There has been some concern about an increase in suicide after DBS. Burkhard et al. (51) reported a suicide rate of 4.6% in patients with movement disorders and DBS. Risk factors in this report were history of severe depression and multiple successive DBS surgeries. There was no relationship found with the underlying condition, DBS target, stimulation parameters, or treatment adjustments. Benabid et al. (52) have also suggested that depression and suicide in patients after DBS are related to pre-existing conditions rather than the surgical procedure or subsequent stimulation.

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