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Chapter 9 - Assessing patient outcome and troubleshooting deep brain stimulation

Published online by Cambridge University Press:  10 November 2010

By
Frandy Susatia ,
Kelly D. Foote ,
Herbert Ward  and
Michael S. Okun
Edited by
William J. Marks, Jr
William J. Marks, Jr
Affiliation:
University of California, San Francisco
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Summary

This chapter reviews methods of assessing outcomes following deep brain stimulation (DBS) and the approach to troubleshooting problems with DBS that may be responsible for poorer than expected outcomes. Assessment of outcome after DBS includes measurement of: impairment; disability; health-related quality of life (HRQL); and quality of life (QOL). A neuropsychological and neuropsychiatric examination should be performed in DBS candidates to identify problems and predisposing factors. An important concept in the evaluation and assessment of DBS patients is to utilize a multidisciplinary, or team, approach. Assessment and management of surgery-related issues and complications can be challenging in the acute time following DBS implantation surgery. Assessment of patients for DBS candidacy is best performed using a multidisciplinary team approach. Problems encountered with DBS surgery can be divided into four main categories: surgery-related; device-related; stimulation-related; and other issues, including disease progression, and poor DBS candidate/lack of the multidisciplinary team evaluation.

Keywords

deep brain stimulationelectrical chargeelectrode configurationstissue damagestimulation parametersneurotransmittersneuromodulators
Type
Chapter
Information
Deep Brain Stimulation Management , pp. 91 - 130
Publisher: Cambridge University Press
Print publication year: 2010

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