Objective: To study the effect of reimplanted DBS after the infection and removing in the cases of 2 dystonia patients in Federal Center of Neurosurgery (FCN), Tyumen, Russia.

Background: Deep brain stimulation (DBS) is a option of treatment for patients with movement disorders. Infections are the most common complication of DBS system implantation and have been reported to be between 0% and 15% in most studies.1

Method: Between 2012-2021 at the FCN Tyumen 66 dystonia patients underwent DBS surgery, from this number, 5 patients has been diagnosed with infected DBS systems and removed the DBS, and 2 patients has been reimplanted. Complete data of these 2 patients has been collected, including anamnesis, before first surgery BFMDS score, during infected state, after removing and after reimplantation. Moreover, their programming parametres in each condition of the patient also has been reported.

Results: #1. Female, dystonia has been diagnosed in 2014, at age of 42, no dystonia history. Dystonia started with the left hand and progressed to the generalized, had mutiple injections with botulino-toxinum with no significant effect. In 2016, at age of 44, undergone first DBS GPi surgery, BFMDS – 92. After surgery BFMDS was 12, programming parametres of IPG: Ch 1. 2 -. 3+. 90ms, 160 hz, 3,5 mA. Ch 2. 9- .10+. 90ms, 160 hz, 3,5 mA. In 2017, age 45, after one year, patient complained to the local inflammation in the IPG implanted area, nausea, subfebrile temperature and worsening of dystonia state BFMDS – 23. During examination was found that all DBS system was infected, soon it has been removed. BFMDS – 88. In 2018, age 46, BFMDS – 90, patient was reimplanted with another DBS system. programming parametres of IPG: Ch 1. 2 -. 3+. 90ms, 180 hz, 2,5 mA. Ch 2. 9- .10+. 90ms, 180 hz, 2,5 mA. BFMDS – 10.

Conclusion: This case report shoved that infected DBS should not be ending of perspective to further neuromodulation to the life-changing surgery for the patients.

References: 1. Moser, M., Chitta, S., O’Brien, P. F., Caras, A., & Holloway, K. L. (2022). Recrudescent infection after deep brain stimulator reimplantation, Journal of Neurosurgery (published online ahead of print 2022). Retrieved Mar 15, 2022, from https://thejns.org/view/journals/j-neurosurg/aop/article-10.3171-2021.11.JNS211425/article-10.3171-2021.11.JNS211425.xml

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MDS Abstracts - https://www.mdsabstracts.org/abstract/reimplantation-of-the-dbs-to-the-patient-with-generalized-dystonia/