Deep Brain Stimulation Emergencies: How the New Technologies Could Modify the Current Scenario

Area of Science:

• Neurology
• Neurosurgery
• Biomedical Engineering

Background:

• Deep brain stimulation (DBS) has been a cornerstone treatment for Parkinson's disease for 25 years.
• Despite its efficacy, a spectrum of postoperative urgent situations and emergencies associated with DBS therapy is increasingly recognized.
• These complications can arise in various phases, including perioperative and long-term follow-up periods.

Purpose of the Study:

• To comprehensively review the spectrum of DBS-related emergencies in Parkinson's disease patients.
• To categorize these emergencies into perioperative and postoperative scenarios.
• To explore the potential benefits of novel devices and programming strategies in managing these critical situations.

Main Methods:

• Systematic review of literature on DBS-related emergencies in Parkinson's disease.
• Categorization of complications based on timing (perioperative, postoperative) and symptom control (motor, non-motor).
• Analysis of emerging technologies and programming advancements for emergency management.

Main Results:

• Identified diverse perioperative emergencies, including intraoperative and early postoperative complications.
• Described postoperative issues related to suboptimal motor and non-motor symptom control during initial programming and long-term management.
• Highlighted the potential of new DBS devices and programming techniques to mitigate emergency situations.

Conclusions:

• DBS for Parkinson's disease necessitates awareness and preparedness for a range of potential emergencies.
• Emerging technologies and advanced programming offer promising avenues for improved management of DBS-related complications.
• Proactive identification and management strategies are crucial for optimizing patient outcomes in DBS therapy.