Nevrly Martin, Blazek Filip, Krahulik David, Otruba Pavel, Cechakova Eva, Afifi Ahmed Naser Mohamed, Kanovsky Petr
Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czechia.
Department of Neurosurgery, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czechia.
Front Surg. 2025 Aug 21;12:1591985. doi: 10.3389/fsurg.2025.1591985. eCollection 2025.
Peri-lead edema (PLE) is a commonly observed but often asymptomatic complication of deep brain stimulation (DBS). While usually transient and benign, severe cases of PLE can result in neurological symptoms, impacting patient outcomes. This case series explores the clinical course, management, and outcomes of symptomatic PLE in a series of five patients undergoing DBS.
To analyze the presentation and management strategies for symptomatic peri-lead edema identified in patients undergoing DBS for movement disorders.
A retrospective review of 191 patients who underwent DBS at the University Hospital in Olomouc, Czech Republic, between 2008 and 2024 was conducted. Postoperative imaging and clinical follow-ups were used to identify and evaluate cases of symptomatic PLE. Patients who developed symptomatic PLE were treated with corticosteroids and monitored through imaging and neurological assessments.
Among the 191 patients, we identified 5 (2.6%) who developed symptomatic PLE characterized by cognitive decline, motor disturbances, and, in some cases, pseudocyst formation. Symptoms typically presented several weeks to months postoperatively. Management with corticosteroid therapy resulted in clinical improvement and resolution of edema in all cases. Following the resolution of PLE, DBS therapy was successfully re-initiated, achieving favorable therapeutic outcomes.
Symptomatic PLE is a rare but clinically significant complication of DBS. Early detection and timely management with corticosteroids are critical for symptom resolution and successful continuation of DBS therapy. Vigilant postoperative monitoring and further research are essential to improve understanding and management of PLE.
电极周围水肿（PLE）是深部脑刺激（DBS）常见但通常无症状的并发症。虽然通常是短暂且良性的，但严重的PLE病例可导致神经症状，影响患者预后。本病例系列探讨了5例接受DBS治疗的患者中症状性PLE的临床过程、管理及结局。
分析接受DBS治疗运动障碍患者中症状性电极周围水肿的表现及管理策略。
对2008年至2024年在捷克共和国奥洛穆茨大学医院接受DBS治疗的191例患者进行回顾性研究。通过术后影像学检查和临床随访来识别和评估症状性PLE病例。出现症状性PLE的患者接受皮质类固醇治疗，并通过影像学检查和神经学评估进行监测。
在191例患者中，我们识别出5例（2.6%）出现症状性PLE，其特征为认知功能下降、运动障碍，在某些情况下还伴有假性囊肿形成。症状通常在术后数周或数月出现。皮质类固醇治疗使所有病例的临床症状得到改善，水肿消退。PLE消退后，DBS治疗成功重新启动，取得了良好的治疗效果。
症状性PLE是DBS罕见但具有临床意义的并发症。早期发现并及时使用皮质类固醇治疗对于症状缓解和DBS治疗的成功持续至关重要。术后进行密切监测以及进一步研究对于提高对PLE的认识和管理至关重要。
