The number and nature of emergency department encounters in patients with deep brain stimulators.
Resnick AS, Foote KD, Rodriguez RL, Malaty IA, Moll JL, Carden DL, Krock NE, Medley MM, Burdick A, Haq IU, Okun MS. The number and nature of emergency department encounters in patients with deep brain stimulators. , 2010 Jan; 257(1):122-31
The purpose of this article was to look at reasons why people who have DBS go to the emergency room as well as to provide education and guidance on how to best treat those patients. The most common type of patient that presented to the ER was a male in his mid 50’s with either unilateral or bilateral implantation. Four main disease groups were looked at including Parkinson’s disease, essential tremor, dystonia, and other (multiple sclerosis, obsessive-compulsive disorder, or other tremor). Approximately one forth of the Parkinson’s disease group utilized the ER and most commonly went for evaluation of mental status changes (changes in one’s cognitive abilities). Other reasons were headache, infection related as well as not related to the hardware, pain, and passing out. It was not surprising that the main reason for PD patients to go to the ER was neurological in nature as that is a common effect of the disease itself. The amount of time that had passed since their surgery ranged quite a bit from 1 day post-op to 48 months post-op. The authors also looked to see if the ER visit was related to the DBS surgery or hardware and found that about half of the time the reason was not related to the procedure or resultant hardware for the PD patients. The study also provided easy to follow treatment algorithms (see article for specifics) for patients presenting to the ER that has DBS, regardless of the disease state. The researchers conclude that as DBS continues to be a successful treatment for movement disorders, as well as other neurological conditions, that our health care systems need to be better educated and prepared for that DBS patient walking through the door regardless if that reason is DBS related or not.