Neurological Rehabilitation Center Godeshöhe, Bonn, Germany.
St George's, University of London, London, UK.
Clin Neurophysiol. 2018 Mar;129(3):592-601. doi: 10.1016/j.clinph.2017.12.035. Epub 2018 Jan 10.
Deep brain stimulation (DBS) is a highly efficient, evidence-based therapy for a set of neurological and psychiatric conditions and especially movement disorders such as Parkinson's disease, essential tremor and dystonia. Recent developments have improved the DBS technology. However, no unequivocal algorithms for an optimized postoperative care exist so far. The aim of this review is to provide a synopsis of the current clinical practice and to propose guidelines for postoperative and rehabilitative care of patients who undergo DBS. A standardized work-up in the DBS centers adapted to each patient's clinical state and needs is important, including a meticulous evaluation of clinical improvement and residual symptoms with a definition of goals for neurorehabilitation. Efficient and complete information transfer to subsequent caregivers is essential. A coordinated therapy within a multidisciplinary team (trained in movement disorders and DBS) is needed to achieve the long-range maximal efficiency. An optimized postoperative framework might ultimately lead to more effective results of DBS.
脑深部电刺激（DBS）是一组神经和精神疾病的高效、基于证据的治疗方法，尤其是运动障碍，如帕金森病、原发性震颤和肌张力障碍。最近的发展改善了 DBS 技术。然而，迄今为止，尚无明确的优化术后护理的算法。本综述的目的是概述当前的临床实践，并为接受 DBS 的患者的术后和康复护理提出指导方针。在 DBS 中心对每位患者的临床状态和需求进行标准化的评估很重要，包括对临床改善和残留症状进行细致的评估，并确定神经康复的目标。高效和完整地向后续护理人员传递信息至关重要。需要在一个多学科团队（接受过运动障碍和 DBS 培训）中进行协调的治疗，以实现长期的最大效率。优化的术后框架最终可能会使 DBS 取得更有效的结果。
