Nunez Alfonso Enrique Martinez, Kusyk Dorian M, Wong Joshua K, Okun Michael S, Hilliard Justin D
Norman Fixel Institute for Neurological Disorders, Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, US.
Tremor Other Hyperkinet Mov (N Y). 2025 Apr 7;15:12. doi: 10.5334/tohm.993. eCollection 2025.
A 59-year-old woman with a previous subthalamic nucleus deep brain stimulation (DBS) implanted for Parkinson's disease developed a hardware related infection.
Wound dehiscence and infection developed and necessitated removal of the DBS system. The patient experienced excellent therapeutic benefit from her DBS and expressed concern about device removal.
The patient was offered the option of a lesioning procedure which could be performed during hardware explantation. An operative procedure was conducted where the intracranial DBS lead was connected to a radiofrequency system in a deliberate effort to create a targeted subthalamotomy through the existing DBS lead. A multilevel lesion was generated using the contacts on the directional DBS lead. Following the lesion the DBS lead and hardware were removed.
Creating a lesion through a DBS lead using radiofrequency ablation is a therapeutic option for patients not interested in later re-implantation or for those with a history of multiple DBS related infections. Lesioning through segmented leads introduces more complexity into the procedure.
一名59岁女性，之前因帕金森病植入了丘脑底核深部脑刺激（DBS）装置，发生了与硬件相关的感染。
出现伤口裂开和感染，需要移除DBS系统。该患者从DBS中获得了极佳的治疗效果，并对移除装置表示担忧。
为患者提供了在硬件取出过程中可进行的毁损手术选项。实施了一项手术，在术中将颅内DBS电极连接到射频系统，有意通过现有的DBS电极进行有针对性的丘脑底核切开术。使用定向DBS电极上的触点产生了多级毁损。毁损完成后，移除了DBS电极和硬件。
通过射频消融利用DBS电极制造毁损对于那些对后期重新植入不感兴趣或有多次与DBS相关感染病史的患者来说是一种治疗选择。通过分段电极进行毁损会使手术更加复杂。
