Deep brain stimulation (or DBS) involves implantation of electrodes within certain regions of the brain. These electrodes provide electric impulses that regulate abnormal impulses. Alternatively, the electrical impulses can affect specific cells and chemicals present in the brain.
When it comes to deep brain stimulation surgery, seizures may occur as a complication. Mentioned below is all that you need to know about DBS and seizures.
How Common Is The Risk Of Seizures Post-Surgery?
A study was conducted to assess the risk factors for postoperative seizures post-DBS lead-implantation surgery and the impact of such seizures on length of stay as well as discharge disposition. The researchers successfully reviewed a consecutive series of 161 cases that involved patients who successfully underwent the implantation of 288 electrodes for the treatment of movement disorders. The aims of the study included determination of the absolute risk when it comes to postoperative seizures, description of the timing as well as type of seizures, identification of statistically significant risk factors for seizures, and determination if there are possible indications prophylaxis of seizures post-DBS lead (or electrode) implantation.
The study showed that 7 of the 161 patients experienced postoperative seizures, which were all precisely documented to have been generalised, tonic-clonic seizures. In 5 of the 7 cases, individuals experienced just a single seizure. Similarly, in 5 of the 7 cases, patients experienced seizures within 24 hours post-surgery. In 6 of the 7 cases, seizures were experienced within 48 hours of the surgery. Univariate analysis successfully identified three significant risk factors for postoperative seizures: (1) abnormal findings when it comes to postoperative imaging, and (2) trans-ventricular electrode trajectories.
The findings of the study indicate that seizures are an uncommon complication when it comes to DBS surgery and usually occurs within 48 hours post-surgery.
In another study of “Complications of DBS” conducted by Professor Paresh Doshi at the Jaslok Hospital Research Centre and published in the Neuromodulation journal, he showed that in a series of 519 cases of DBS, there was not a single case of seizure.
Researchers say that the risk of seizure, is dependent on each individual and can be significantly reduced by proper planning techniques to avoid occurrence of the same.
Causes Seizures In DBS?
The results of the study also provide an indication that haemorrhage, ischemia, or oedema on postoperative images (or abnormal imaging findings) increase the risk of postoperative seizures by as much as 30- to 50-fold, thus providing statistical credence to the long-held notion that seizures are also associated with intracranial vascular events. Even when it comes to the setting of post-implantation imaging abnormality, there is no need of anticonvulsant therapy because none of the patients developed chronic epilepsy.
Can Seizures Be Prevented?
Seizures that are associated with electrode placement in DBS are uncommon and usually occur early during the postoperative period, and rarely lead to epilepsy. According to one study, characteristics of the patients (such as age) may play a more significant role in perioperative variables when it comes to determining the risk of seizures. Multi-institutional studies may additionally help define as well as mitigate the possible risk of seizures post—DBS-surgery.
To Sum It Up
Several studies have been conducted to ascertain if DBS causes seizures. The results show that seizures are an uncommon complication, and if they do occur, they do so usually within 48 hours after DBS surgery.
References:
- https://www.mayoclinic.org/tests-procedures/deep-brain-stimulation/about/pac-20384562
- https://thejns.org/view/journals/j-neurosurg/135/1/article-p279.xml#:~:text=DBS%20implantation%E2%80%93associated%20seizure%20is,(3.1%25%20of%20patients)
- https://www.researchgate.net/publication/51104196_Comprehensive_analysis_of_risk_factors_for_seizures_after_deep_brain_stimulation_surgery_Clinical_article
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