Fulminant non-infectious peri-electrode edema after deep brain stimulation system implantation in a pediatric patient.

Document Type

Article

Publication Date

2-2022

Identifier

DOI: 10.1007/s00381-021-05224-6

Abstract

Non-infectious peri-electrode edema is a rare complication after implantation of a deep brain stimulation (DBS) electrode. DBS is frequently used in the management of movement disorders with increasing interest surrounding its value in more rare disorders associated with movement abnormalities. This is the report of a 10-year-old male with Cockayne syndrome who acutely developed symptomatic non-infectious, non-hemorrhagic peri-electrode edema 18 days postoperatively from implantation of a DBS system targeting the bilateral globus pallidus internus. CT head confirmed extensive vasogenic edema along the entire length of the left electrode, and infectious workup was negative. The patient required admission to the pediatric intensive care unit for management utilizing steroid, hypertonic, and hyperosmolar therapy due to the amount of mass effect. Symptoms reduced over a 7-day hospital stay and were completely resolved at 1 month without removal of the DBS system. Management of this rare entity remains controversial and often involves the use of steroids and anti-epileptic prophylaxis. This represents the first case of non-infectious peri-electrode edema reported in a pediatric patient and is especially notable for its fulminant nature.

Journal Title

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

Volume

38

Issue

2

First Page

447

Last Page

454

Keywords

Cockayne syndrome; Deep brain stimulation; Movement disorders; Pediatric; Peri-electrode edema

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