Congratulations on your new publication!
Congratulations to Drs. Alfonso Martinez Nunez, Dorian Kusyk, Joshua Wong, Michael Okun and Justin Hilliard, on the publication of “Lesioning Through a Directional Deep Brain Stimulation Lead in the Subthalamic Nucleus,” which appears in the April edition of Tremor and Other Hyperkinetic Movements.
Abstract
Clinical Vignette: A 59-year-old woman with a previous subthalamic nucleus deep brain stimulation (DBS) implanted for Parkinson’s disease developed a hardware related infection.
Clinical Dilemma: Wound dehiscence and infection developed and necessitated removal of the DBS system. The patient experienced excellent therapeutic benefit from her DBS and expressed concern about device removal.
Clinical Solution: The patient was offered the option of a lesioning procedure which could be performed during hardware explantation. An operative procedure was conducted where the intracranial DBS lead was connected to a radiofrequency system in a deliberate effort to create a targeted subthalamotomy through the existing DBS lead. A multilevel lesion was generated using the contacts on the directional DBS lead. Following the lesion the DBS lead and hardware were removed.
Gap in Knowledge: Creating a lesion through a DBS lead using radiofrequency ablation is a therapeutic option for patients not interested in later re-implantation or for those with a history of multiple DBS related infections. Lesioning through segmented leads introduces more complexity into the procedure.