Will deep brain stimulation increase the incidence of induced psychosis? Post-operation follow-ups for 1 hundred patients from 2004-2017

深部脑刺激术会增加诱发性精神病的发生率吗?2004年至2017年100例患者的术后随访研究

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Abstract

Generally regarding as a safe treatment for Parkinson's disease (PD) for the past 20 years, deep brain stimulation (DBS) is also an example of precision medicine where surgeons need to titrate individual patient's stimulating electrodes one by one down to the scale of micrometer for the maximum therapeutic effect. In order to prevent operation induced psychiatric complications and minimize any other potential side effects, we have followed 103 patients received this treatment provided by a single surgeon in the same medical institution from 2004 to 2017. We identified each patient complaint from nursing care records and complication data from medical charts during the perioperative hospitalization period to see if any of them correlate statistical significantly with the DBS lead placement procedure. Top five frequent complaints including fever, constipation, nausea, headache, wound pain. The majority of post-operative complaints turned out to be the same as general post-operative / post-anesthesia side effects rather than the DBS operation itself. However, a few rare but critical complications such as post-operative intracranial hemorrhage (ICH), postoperative epidural hematoma (EDH) were identified as well. These patients' subsequent treatments and prognosis were documented for revising the operating procedure in the future. Our retrospective study reconfirmed that DBS is indeed a relatively safe procedure and improve the life quality of PD patients in general. Hopefully, the through preoperative preparation and careful surgical approach will safeguard the patient's prognosis.

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