Objective: To report a case of peri-electrode edema after Deep Brain Stimulation (DBS), and discuss its main aspects.

Background: PD is a neurodegenerative condition, and one of its main treatments is DBS, which involves implanting electrodes in the basal ganglia to electrically stimulate these regions. Post-implantation complications, although uncommon, can occur, with peri-electrode edema being a rarely reported one. It usually occurs in the first weeks after the procedure and is generally asymptomatic. The cause is unclear, but possible factors include infection, venous thrombosis, intraoperative microhemorrhage due to the recording microelectrode (MER), or immune reaction to the hardware. Prognosis is generally favorable, with resolution typically occurring within weeks, as observed in the reported case. Initial treatment is conservative and includes using dexamethasone for a variable period of time, which accelerates radiological resolution. Hardware removal is unnecessary given the complication’s benign course.

Method: Descriptive observational study.

Results: A 70-year-old male with idiopathic Parkinson’s disease (PD) underwent DBS implantation in the bilateral subthalamic nucleus (STN), showing significant improvement in postoperative motor symptoms. 30 days after hospital discharge, apathy was noted. Magnetic resonance imaging (MRI) revealed peri-electrode hyperintensity at the left subthalamic nucleus, correlating with the patient’s symptoms given the likely involvement of the somatosensory area. Treatment with dexamethasone (cumulative dose of 120 mg, decreasing over 15 days), led to symptomatic improvement. A follow-up MRI one month later indicated edema resolution. Serial serum tests and vital signs remained normal throughout treatment, showing no evidence of infection.

Conclusion: Peri-electrode edema is a rare, usually asymptomatic complication of DBS with rapid resolution. There are certain aspects still underexplored in existing literature, highlighting the significance of conducting further studies on this topic.

References: HAMANI, Clement et al. Subthalamic Nucleus Deep Brain Stimulation: basic concepts and novel perspectives. Eneuro, [S.L.], v. 4, n. 5, p. 1-14, set. 2017. Society for Neuroscience. http://dx.doi.org/10.1523/eneuro.0140-17.2017.
KOGAN, Michael et al. Deep Brain Stimulation for Parkinson Disease. Neurosurgery Clinics Of North America, [S.L.], v. 30, n. 2, p. 137-146, abr. 2019. Elsevier BV. http://dx.doi.org/10.1016/j.nec.2019.01.001.
MACEROLLO, Antonella et al. Subthalamic nucleus deep brain stimulation for Parkinson’s disease: current trends and future directions. Expert Review Of Medical Devices, [S.L.], v. 17, n. 10, p. 1063-1074, 6 abr. 2020. Informa UK Limited. http://dx.doi.org/10.1080/17434440.2020.1747433.
HARTMANN, Christian J. et al. An update on best practice of deep brain stimulation in Parkinson’s disease. Therapeutic Advances in Neurological Disorders, v. 12, mar. 2019. https://doi.org/10.1177/1756286419838096
OLSON, Markey C. et al. Deep brain stimulation in PD: risk of complications, morbidity, and hospitalizations: a systematic review. Frontiers in Aging Neuroscience, v. 15, nov. 2023. https://doi.org/10.3389/fnagi.2023.1258190
TIAN, Yu et al. The need to be alert to complications of peri‐lead cerebral edema caused by deep brain stimulation implantation: a systematic literature review and meta‐analysis study. CNS Neuroscience & Therapeutics, v. 28, n. 3, p. 332-342, mar. 2022. https://doi.org/10.1111/cns.13802

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MDS Abstracts - https://www.mdsabstracts.org/abstract/peri-electrode-edema-after-deep-brain-stimulation-implantation-case-report-and-literature-review/