Deep brain stimulation for XXXX . Surgical technique.

@entity1 @entity3520 @entity548 @entity14243 @entity281 @entity3519 @entity7922
Stimulation electrodes are implanted under general anesthesia, without intra-operative electrophysiology or clinical testing, based only on stereotactic MRI and direct anatomical localization of the postero-ventro-basal @entity14243 . We retrospectively analyzed the surgical procedure that has been designed and implemented in our center, using the Leksell G frame, for initiating deep brain stimulation in 65 @entity3520 @entity1 . We report the surgical technique and the hardware and software complications. We recommend immediate postoperative stereotactic MRI under general anesthesia as a prerequisite to check the reliability of MR acquisition (magnet stability) and the exact localization of each electrode. This technique allowed us to reduce the duration of the operation to 4 h, including general anesthesia, frame fixation, MRI acquisition, implantation of two electrodes under radioscopic control, immediate postoperative stereotactic MRI and frame removal. Surgery-related morbidity was very low with a 0% @entity548 rate and three delayed @entity281 re-operated 6 months later. Hardware and software complications were rare. The advances in 3D-MR imaging permit the electrode implantation for deep brain stimulation without resorting to intraoperative localization techniques, which is especially helpful in @entity1 and for treating @entity3519 . The maximum follow-up period is 58 months (first case: November 1996). @entity14243 stimulation has proven to be an effective treatment for most @entity3520 with particular efficacy in the disease due to the @entity7922 mutation.
