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Allergy Considerations in Implanted Neuromodulation Devices.

Austin Brown¹, Nataniel J Mandelberg², Diana Munoz-Mendoza³

¹College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Neuromodulation : Journal of the International Neuromodulation Society

|January 11, 2021

Summary

This summary is machine-generated.

Allergic reactions to neuromodulation devices are rare but require careful management. Screening patients for allergies and a multidisciplinary approach are key to preventing and treating these complications.

Keywords:

Allergic reaction allergy complications deep brain stimulation (DBS)electrodes hardware failure hypersensitivity neuromodulation responsive neurostimulation (RNS)spinal cord stimulation (SCS)vagus nerve stimulation (VNS)

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Area of Science:

Neurosurgery
Allergy and Immunology
Biomaterials

Background:

Allergic reactions to implanted neuromodulation devices are uncommon and poorly understood.
Current management guidelines for these reactions are lacking.
Reviewing cases and cross-disciplinary experiences can inform prevention and treatment.

Purpose of the Study:

To review published cases of allergic reactions to implanted neuromodulatory devices.
To leverage experiences from other specialties (dentistry, orthopedics, cardiology, neurosurgery) to formulate recommendations.
To provide guidance on the prevention and management of allergic reactions to neuromodulation devices.

Main Methods:

Comprehensive literature review and assessment of published cases.
Analysis of allergic reactions to similar implantable devices in other medical fields.
Synthesis of findings to develop clinical recommendations.

Main Results:

Allergic reactions to neuromodulatory devices are rare, with 13 cases documented.
Common symptoms include dermatitis, erythema, and pruritus, mimicking infection.
While corticosteroids helped one case, most required device explantation; modified reimplantation was successful in some instances.

Conclusions:

Pre-implantation screening for contact allergies is recommended.
A multidisciplinary approach involving neurosurgeons, allergists, and manufacturers is crucial for suspected cases.
Rule out infection, utilize patch testing, and collaborate with manufacturers for potential device modification.