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Recommendations for Deep Brain Stimulation Device Management During a Pandemic.

Svjetlana Miocinovic1, Jill L Ostrem2, Michael S Okun3

  • 1Department of Neurology, Emory University, Atlanta, GA, USA.

Journal of Parkinson'S Disease
|April 26, 2020
PubMed
Summary
This summary is machine-generated.

Patients with deep brain stimulation (DBS) require careful management during COVID-19 to avoid symptom worsening. Elective procedures should be postponed, prioritizing urgent interventions for critical conditions.

Keywords:
COVID-19DBS withdrawalbattery depletioncoronavirustelemedicine

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Area of Science:

  • Neurosurgery
  • Neurology
  • Infectious Diseases

Background:

  • COVID-19 pandemic necessitates postponement of elective medical procedures.
  • Deep brain stimulation (DBS) patients face unique challenges due to potential therapy interruption.

Purpose of the Study:

  • To outline management strategies for patients with existing deep brain stimulation (DBS) systems during the COVID-19 pandemic.
  • To guide decisions regarding the continuation or interruption of DBS therapy.

Main Methods:

  • Review of potential complications from DBS therapy cessation.
  • Assessment of remote monitoring and telemedicine for device management.
  • Case-by-case evaluation for implantable pulse generator replacement.

Main Results:

  • Interruption of DBS therapy can lead to severe symptom exacerbation, including DBS-withdrawal syndrome, status dystonicus, suicidal ideation, and increased seizure frequency.
  • DBS system infections may necessitate urgent surgical intervention.
  • Remote interrogation of device status is feasible via telemedicine.

Conclusions:

  • Elective DBS procedures and programming should be deferred during the pandemic.
  • Urgent interventions are crucial for patients at risk of severe complications.
  • Individualized decisions for IPG replacement should balance battery status and patient tolerance to therapy disruption, considering hospital resource allocation and safety protocols.