Objective: To identify and characterize cases of symptomatic peri-electrode edema after DBS.

Background: Peri-electrode edema is a rare complication of Deep Brain Stimulation (DBS) surgery. Its predisposing factors and etiology are unknown.

Method: Retrospective analysis of the medical records of patients submitted to DBS between 2006- September 2020.

Results: Three patients (two males), all with PD, were identified, aged between 53 and 73 years at surgery. One died 18 months later due to pneumonia. All patients underwent STN bilateral electrode implantation. They presented with agitation and weakness in left upper limb with myoclonus (one patient); slowness of thinking, delusion and agitation (one patient); and Wernicke’s aphasia (one patient). In two patients, the peri-electrode edema involved the whole electrode and in another it was superficial. Edema was bilateral in two cases. One patient had early-onset edema (<72h), while two cases presented with delayed-onset edema (>72h). All three patients had no evidence of infection and were treated with dexamethasone. Clinical improvement was consistently noted within one month with an imaging resolution between one and four months (two patients), whilst another maintained peri-electrode edema until death. Of note, one patient had a previous history of inflammatory bowel disease, another had hip replacement surgery 6 months prior to DBS, and the third developed a chronic inflammatory demyelinating polyradiculoneuropathy after DBS.

Conclusion: Peri-electrode edema is a rare complication of DBS and its clinical features are diverse. Early detection and treatment with steroids may avoid electrode removal and unneeded antibiotic use. The etiology of peri-electrode edema is unclear, although our case series suggests that autoimmunity may play a role.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/autoimmunity-may-contribute-to-peri-electrode-edema-after-deep-brain-stimulation-for-parkinsons-disease-a-case-series/