Peri-lead edema in deep brain stimulation: common complication or rare challenge?

Area of Science:

• Neurosurgery
• Neurology
• Medical Imaging

Background:

• Peri-lead edema (PLE) is a known complication of deep brain stimulation (DBS).
• While often asymptomatic, severe PLE can cause neurological symptoms, affecting patient outcomes.
• This study focuses on symptomatic PLE in DBS patients.

Purpose of the Study:

• To analyze the presentation and management of symptomatic PLE in patients undergoing DBS for movement disorders.
• To evaluate the effectiveness of corticosteroid treatment for symptomatic PLE.
• To assess the impact of PLE on the continuation of DBS therapy.

Main Methods:

• Retrospective review of 191 patients who underwent DBS.
• Identification and evaluation of symptomatic PLE cases using postoperative imaging and clinical follow-ups.
• Treatment of symptomatic PLE with corticosteroids, monitored via imaging and neurological assessments.

Main Results:

• Five patients (2.6%) developed symptomatic PLE, presenting with cognitive decline and motor disturbances.
• Symptoms appeared several weeks to months postoperatively.
• Corticosteroid therapy led to clinical improvement and edema resolution in all cases, enabling successful re-initiation of DBS therapy.

Conclusions:

• Symptomatic PLE is a rare but significant complication of DBS.
• Early detection and prompt corticosteroid management are crucial for symptom resolution and continued DBS therapy.
• Further research and vigilant postoperative monitoring are essential for improved PLE management.