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Perioperative seizures following deep brain stimulation in patients with multiple sclerosis

Reuben D Johnson1, Syed R Qadri, C Joint

  • 1Nuffield Department of Surgery, University of Oxford and Oxford Functional Neurosurgery, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK. reubenjohnson@doctors.org.uk

British Journal of Neurosurgery
|May 15, 2010
PubMed

Insights

Deep brain stimulation (DBS) is generally safe, but patients with multiple sclerosis (MS) experienced a higher rate of seizures. Further research is needed to assess the role of anticonvulsants in MS patients undergoing DBS.

Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Devices

Background:

  • Deep brain stimulation (DBS) is an established neurosurgical procedure for treating tremor and other neurological disorders.
  • A total of 386 DBS procedures have been performed in Oxford.
  • Peri-operative seizures are a rare complication of DBS.

Observation:

  • Two cases of peri-operative seizures occurred in patients with multiple sclerosis (MS) undergoing thalamic DBS for tremor.
  • These seizures represent an 8-fold increase in incidence compared to the expected rate for DBS procedures.

Findings:

  • The incidence of peri-operative seizures in MS patients undergoing DBS is significantly higher than in the general DBS population.
  • Both reported cases involved thalamic DBS for tremor in patients with MS.

Implications:

  • The findings suggest a potential increased risk of seizures in MS patients undergoing DBS.
  • Further investigation is warranted to determine the necessity and efficacy of peri-operative anticonvulsant medication in this specific patient group.
  • Additional data from larger cohorts of MS patients undergoing DBS are required to confirm these observations and guide clinical practice.

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