Fulminant non-infectious peri-electrode edema after deep brain stimulation system implantation in a pediatric patient

The need to be alert to complications of peri‐lead cerebral edema caused by deep brain stimulation implantation: A systematic literature review and meta‐analysis study

Background

The compatibility of deep brain stimulation (DBS) hardware and MRI scans has greatly improved the diagnostic rate of postoperative peri‐lead edema (PLE). However, the etiology, incidence, and prognostic outcomes of this complication have not been established.

Objective

The incidence of PLE and associated symptoms, the process of occurrence and progression of this complication, as well as treatment strategies were evaluated.

Methods

We conducted a Preferred Reporting Items for Systematic Reviews and Meta‐Analyses compliant systematic review of all studies that reported on incidences of PLE and associated symptoms after DBS implantation. Through systematic literature review, we evaluated its causes, neuropsychiatric symptoms, duration, treatment methods, and prognostic outcomes.

Results

Our search retrieved 10 articles, including 5 articles on PLE and 10 articles on symptomatic PLE. The incidence of PLE was 35.8% (95% CI: 17.0%–54.6%), while the incidence of symptomatic PLE was 3.1% (95% CI: 1.5%–4.7%) accounting for 8.7% of PLE.

Conclusions

This complication is not as rare as previously reported. Therefore, it requires significant attention after DBS implantation. The correlation between its causes, duration, symptoms, and the area involved in edema should be assessed in long‐term prospective clinical studies with large sample sizes.