TREPANA��O VIII
Os problemas de comportamento obsessivo seriam freq�entes em pacientes submetidos �s famosas opera��es de estimula��o profunda do c�rebro, tamb�m conhecidad como de marca-passo cerebral, uma t�cnica que tem sido usada em portadores de DP por vezes em substitui��o �s chamadas palidotomias. Os franc�fonos usam TOC (trouble obsessionel du compotement) para se referir a esses problemas. Segundo Maryse, uma participante do f�rum Parkliste, o assunto teria sido objeto de uma not�cia divulgada hoje pelo canal de TV internacional da Fran�a. (veja �ntegra da msg abaixo)
� Marize ainda quem nos fala de um estudo com 79 pacientes operados com a t�cnica de estimula��o profunda, onde cerca de 25% teve problemas que v�o de quebra de eletrodos, oxida��o, infec��o, rejei��o, fios partidos e curtos circuitos, o que exigiu opera��es complementares para corrigir os problemas. (Veja �ntegra da msg abaixo)
-----Mensagem Original-----
De: M.Schild
Enviado: ter�a-feira, 5 de novembro de 2002 14:13
Para: Parkliste
Assunto: Neurostimulation -TOC

Ce matin au 7-9 de f.Inter, ils parlaient d'une MP qui s'est fait stimuler.
On ne disait rien sur les resultats sur sa MP mais par contre que ca l'avait
gueri de sa TOC (trouble obsessionel du compotement) Elle n'arretait pas de
nettoyer sa maison et sa hantise etait de mourir dans une maison sale.
Plusieurs cas de ce genre ont ete gueris par une stimulation parait-il...
Maryse


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-----Mensagem Original-----
De: M.Schild
Enviado: sexta-feira, 1 de novembro de 2002 08:29
Para: Parkliste
Assunto: problemes mecaniques

Cette etude faite sur 79 patients a qui on a implante des electrodes, tous
operes par le meme neurochirurgien et portant sur une duree de 12 mois a 33
mois post-op, fait etat de problemes lies au materiel dans 1/4 des patients.
Ils sont dus a des fractures d'electrodes, erosion,infections, rejet, fils
detaches, courts-circuits.
Il a fallu 29 operations supplementaires pour corriger ces problemes. La
moyenne d'apparition des problemes est de 10 mois post-op.


Long-term hardware-related complications of deep brain stimulation
MY Oh, A Abosch, SH Kim, AE Lang, AM Lozano
Neurosurgery, 2002;50:1268-1276

Hardware-related complications occurred in one quarter of patients with
implanted DBS electrodes in this long-term follow-up study.

A retrospective chart review was conducted for 84 consecutive patients (53
PD, 9 ET, 12 other diagnoses) treated at a single center by a single surgeon
over 6 years. Four patients did not receive implanted electrodes due to lack
of benefit during trial stimulation, and one did not due to intraoperative
hemorrhage. In the remaining 79 patients, 124 electrodes were implanted.
Minimum follow-up was 12 months, and the mean follow-up was 33 months. Twenty
patients had 26 hardware-related complications, involving 23 electrodes.
There were 4 lead fractures, 4 lead migrations, 3 short- or open circuits, 12
erosions and/or infections, 2 foreign-body reactions, and 1 CSF leak.
Twenty-nine additional procedures were required to address these
complications.

The authors note, "Unlike lesioning procedures, in which complications would
be evident early in the operation, the potential for hardware-related
complications of DBS continue as long as the system remains implanted. In our
study, the mean time to complication was 10 months, which suggests that the
majority of DBS-related lesions would have been missed had we ended our
patient follow-up at 6 months."



Copyright 2002 WE MOVE
Editor: Richard Robinson (rrobinson@wemove.org)
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