Skip to main content
SpringerLink
Log in

Functional Brain Surgery (Stereotactic Surgery, Deep Brain Stimulation)

  • Chapter
  • First Online:
Book cover Anesthesiology

  • 3017 Accesses

Abstract

Deep Brain stimulation (DBS) as a neurosurgical treatment modality for movement disorders has evolved significantly since its inception in the early 80s. With rapid technological advancements, the scope of DBS has expanded and now encompasses treatment for refractory epilepsy, chronic pain conditions and certain neuropsychiatric disorders.

The minimally invasive nature of DBS surgery provides a better patient safety and recovery profile when compared to permanent and often more invasive neurosurgical lesioning techniques. Although, the understanding of the postulated mechanisms of DBS treatment is constantly evolving, it continues to offer a modern-day remedy for refractory movement disorders.

The anesthetic considerations for DBS surgery are wide-ranging and any peri-operative planning mandates a multi-disciplinary approach. The anesthetic challenges are not just limited to the provision of sound anesthetic care during the implantation of DBS electrodes but also extend to situations where patients with deep brain stimulators present for non-DBS related surgeries.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Miocinovic S, Somayajula S, Chitnis S, Vitek JL. History, applications, and mechanisms of deep brain stimulation. JAMA Neurol. 2013;70:163–71.

    Article  PubMed  Google Scholar 

  2. Sharma M, Naik V, Deogaonkar M. Emerging applications of deep brain stimulation. J Neurosurg Sci. 2016;60(2):242–55.

    PubMed  Google Scholar 

  3. Williams NR, Okun MS. Deep brain stimulation (DBS) at the interface of neurology and psychiatry. J Clin Invest. 2013;123(11):4546–56.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Benabid AL, Pollak P, Louveau A, et al. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol. 1987;50:344–6.

    PubMed  CAS  Google Scholar 

  5. Okun MS. Deep-brain stimulation for Parkinson’s disease. N Engl J Med. 2012;367:1529–38.

    Article  CAS  PubMed  Google Scholar 

  6. Davie CA. A review of Parkinson’s disease. Br Med Bull. 2008;86(1):109–27.

    Article  CAS  PubMed  Google Scholar 

  7. DeMaagd G, Philip A. Parkinson’s disease and its management: part 1: disease entity, risk factors, pathophysiology, clinical presentation, and diagnosis. P T. 2015;40(8):504–32.

    PubMed  PubMed Central  Google Scholar 

  8. Massano J, Bhatia KP. Clinical approach to Parkinson’s disease: features, diagnosis, and principles of management. Cold Spring Harb Perspect Med. 2012;2(6):a008870.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Venkatraghavan L, Luciano M, Manninen P. Anesthetic management of patients undergoing deep brain stimulator insertion. Anesth Analg. 2010;110:1138–45.

    PubMed  Google Scholar 

  10. Larson PS. Deep brain stimulation for movement disorders. Neurotherapeutics. 2014;11(3):465–74.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Kocabicak E, Temel Y, Hollig A, et al. Current perspectives on deep brain stimulation for severe neurological and psychiatric disorders. Neuropsychiatr Dis Treat. 2015;11:1051–66.

    PubMed  PubMed Central  Google Scholar 

  12. Benabid AL, Torres N. New targets for DBS. Parkinsonism Relat Disord. 2012;18:S21–3.

    Article  PubMed  Google Scholar 

  13. Johnson MD, Miocinovic S, McIntyre CC, Vitek JL. Mechanisms and targets of deep brain stimulation in movement disorders. Neurotherapeutics. 2008;5:294–308.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Grant R, Gruenbaum SE, Gerrard J. Anaesthesia for deep brain stimulation: a review. Curr Opin Anaesthesiol. 2015;28:505–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Scharpf DT, Sharma M, Deogaonkar M, et al. Practical considerations and nuances in anesthesia for patients undergoing deep brain stimulation implantation surgery. Korean J Anesthesiol. 2015;68:332–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Venkatraghavan L, Manninen P. Anesthesia for deep brain stimulation. Curr Anesthesiol Rep. 2016;6(3):233–43.

    Article  Google Scholar 

  17. Sharma M, Rhiew R, Deogaonkar M, et al. Accuracy and precision of targeting using frameless stereotactic system in deep brain stimulator implantation surgery. Neurol India. 2014;62:503–9.

    Article  PubMed  Google Scholar 

  18. Sharma M, Deogaonkar M. Accuracy and safety using intraoperative O-arm during placement of deep brain stimulation electrodes without electrophysiological recordings. J Clin Neurosci. 2016;27:80–6.

    Article  PubMed  Google Scholar 

  19. Erickson KM, Cole DJ. Anesthetic considerations for awake craniotomy for epilepsy and functional neurosurgery. Anesthesiol Clin. 2012;30:241–68.

    Article  PubMed  Google Scholar 

  20. Yeoh TY, Manninen P, Kalia SK, Venkatraghavan L. Anesthesia considerations for patients with an implanted deep brain stimulator undergoing surgery: a review and update. Can J Anesth. 2017;64:308–19.

    Article  PubMed  Google Scholar 

  21. Chen SY, Tsai ST, Lin SH, et al. Subthalamic deep brain stimulation in Parkinson’s disease under different anesthetic modalities: a comparative cohort study. Stereotact Funct Neurosurg. 2011;89:372–80.

    Article  PubMed  Google Scholar 

  22. Kim W, Song IH, Lim YH, et al. Influence of propofol and fentanyl on deep brain stimulation of the subthalamic nucleus. J Korean Med Sci. 2014;29(9):1278–86.

    Article  CAS  PubMed  Google Scholar 

  23. Kwon WK, Kim JH, Lee JH, et al. Microelectrode recording (MER) findings during sleep-awake anesthesia using dexmedetomidine in deep brain stimulation surgery for Parkinson’s disease. Clin Neurol Neurosurg. 2016;143:27–33.

    Article  PubMed  Google Scholar 

  24. Martinez-Simon A, Alegre M, Honorato-Cia C, et al. Effect of dexmedetomidine and propofol on basal ganglia activity in Parkinson disease: a controlled clinical trial. Anesthesiology. 2017;126(6):1033–42.

    Article  CAS  PubMed  Google Scholar 

  25. Bindu B, Bithal PK. Anaesthesia and deep brain stimulation. J Neuroanaesthesiol Crit Care. 2016;3:197–204.

    Article  Google Scholar 

  26. Chen T, Mirzadeh Z, Chapple K, et al. “Asleep” deep brain stimulation for essential tremor. J Neurosurg. 2015;27:1–8.

    Google Scholar 

  27. Mann JM, Foote KD, Garvan CW, et al. Brain penetration effects of microelectrodes and DBS leads in STN or GPi. J Neurol Neurosurg Psychiatry. 2009;80:794–7.

    Article  CAS  PubMed  Google Scholar 

  28. Moro E, Lozano AM, Pollak P, et al. Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson’s disease. Mov Disord. 2010;25:578–86.

    Article  PubMed  Google Scholar 

  29. Fenoy FJ, Simpson RK Jr. Risks of common complications in deep brain stimulation surgery: management and avoidance. J Neurosurg. 2014;120:132–9.

    Article  PubMed  Google Scholar 

  30. Venkatraghavan L, Chinnapa V, Peng P, Brull R. Non-cardiac implantable electrical devices: brief review and implications for anesthesiologists. Can J Anaesth. 2009;56:320–6.

    Article  PubMed  Google Scholar 

  31. Nutt JG, Anderson VC, Peacock JH, et al. DBS and diathermy interaction induces severe CNS damage. Neurology. 2001;56:1384–6.

    Article  CAS  PubMed  Google Scholar 

  32. Poon CC, Irwin MG. Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices. Br J Anaesth. 2009;103:152–65.

    Article  CAS  PubMed  Google Scholar 

  33. Larson PS, Richardson RM, Starr PA, Martin AJ. Magnetic resonance imaging of implanted deep brain stimulators: experience in a large series. Stereotact Funct Neurosurg. 2008;86:92–100.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Queen Elizabeth Hospital, Birmingham, UK

    Ilyas Qazi F.R.C.A. & Hannah Church F.R.C.A.

Authors
  1. Ilyas Qazi F.R.C.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hannah Church F.R.C.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Hospital University Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Basavana G. Goudra

  2. Department of Anesthesiology, Emory University, Atlanta, Georgia, USA

    Michael Duggan

  3. Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Vidya Chidambaran

  4. University Hospitals Birmingham, Birmingham, United Kingdom

    Hari Prasad Krovvidi Venkata

  5. Emory University Hospital, Atlanta, Georgia, USA

    Elizabeth Duggan

  6. University of Alabama at Birmingham, Birmingham, Alabama, USA

    Mark Powell

  7. All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India

    Preet Mohinder Singh

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Qazi, I., Church, H. (2018). Functional Brain Surgery (Stereotactic Surgery, Deep Brain Stimulation). In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_61

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-74766-8_61

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74765-1

  • Online ISBN: 978-3-319-74766-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation