Universität zu Köln

Koy, A., Bockhorn, N., Kuehn, A. A., Schneider, G-H, Krause, P., Lauritsch, K., Witt, K., Paschen, S., Deuschl, G., Krauss, J. K., Saryyeva, A., Runge, J., Borggraefe, I, Mehrkens, J. H., Horn, A., Vesper, J., Schnitzler, A., Siegert, S., Freilinger, M., Eckenweiler, M., Coenen, V. A., Tadic, V, Voges, J., Pauls, K. A. M., Wirths, J., Timmermann, L. and Hellmich, M. (2019). Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia. Brain Stimul., 12 (5). S. 1111 - 1121. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-4754

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Abstract

Background: Data on pediatric DBS is still limited because of small numbers in single center series and lack of systematic multi-center trials. Objectives: We evaluate short- and long-term adverse events (AEs) of patients undergoing deep brain stimulation (DBS) during childhood and adolescence. Methods: Data collected by the German registry on pediatric DBS (GEPESTIM) were analyzed according to reversible and irreversible AEs and time of occurrence with relation to DBS-surgery: Intraoperative, perioperative (<4 weeks), postoperative (4 weeks <6 months) and long term AEs (>6 months). Results: 72 patients with childhood-onset dystonia from 10 DBS-centers, who received 173 DBS electrodes and 141 implantable pulse generators (IPG), were included in the registry. Mean time of postoperative follow-up was 4.6 +/- 4 years. In total, 184 AEs were documented in 53 patients (73.6%). 52 DBS-related AEs in 26 patients (36.1%) required 45 subsequent surgical interventions 4.7 +/- 4.1 years (range 3 months-15 years) after initial implantation. The total risk of an AE requiring surgical intervention was 7.9% per electrode-year. Hardware-related AEs were the most common reason for surgery. There was a tendency of a higher rate of AEs in patients aged 7-9 years beyond 6 months after implantation. Discussion: The intraoperative risk of AEs in pediatric patients with dystonia undergoing DBS is very low, whereas the rate of postoperative hardware-related AEs is a prominent feature with a higher occurrence compared to adults, especially on long-term follow-up. Conclusion: Factors leading to such AEs must be identified and patient management has to be focused on risk minimization strategies in order to improve DBS therapy and maximize outcome in pediatric patients. (C) 2019 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koy, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bockhorn, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuehn, A. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, G-H UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lauritsch, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Witt, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Paschen, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Deuschl, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krauss, J. K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saryyeva, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Runge, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggraefe, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehrkens, J. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vesper, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnitzler, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siegert, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Freilinger, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eckenweiler, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Coenen, V. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tadic, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Voges, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pauls, K. A. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wirths, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-143554
DOI:	10.1016/j.brs.2019.04.003
Journal or Publication Title:	Brain Stimul.
Volume:	12
Number:	5
Page Range:	S. 1111 - 1121
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-4754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HARDWARE-RELATED COMPLICATIONS; CEREBRAL-PALSY; MOVEMENT-DISORDERS; FOLLOW-UP; MANAGEMENT; SURGERY; INFECTIONS; EXPERIENCE Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14355