Retrospective evaluation of side effects of Deep Brain Stimulation and Implantable Pulse Generator changes in patients followed in Neurology Clinic of EUTF Hospital

In this study, EUTF neurology clinic follow-up with Deep Brain Stimulation (DBS) and Internal Pulse Generator (IPG) change was applied Parkinson's disease (PD), Essential Tremor (ET), Dystonia diagnosis of a total of 121 patient files retrospectively evaluated. Disease type-subtypes, relationship with DBS target, frequency of side effects, adverse effects and severity, timing of adverse events and improvement status; specific adverse effects on the presence of neurological, psychiatric, surgical related, and side effects related to the equipment were collected under the main headings and it was aimed to reveal their relation with the demographic characteristics, disease type, disease year-duration-severity of the patients. In our study, any side effects of DBS in Parkinson's patients were significantly more frequent than tremor patients. Again, psychiatric side effects were significantly more frequent in Parkinson's patients. Hardware-related side effect presence; In relation to the age at which the DBS was made, the incidence of weight gain was found to be sex-related (more frequent in women),general psychiatric side effects (impulse control disorder and psychosis) were also associated with the presence of any nonmotor symptoms before DBS. Preoperative Rem Behavior Disorder (RBD) seen in patients in which psychiatric and associated with stimulation side effects were more common. The hardware-related side effect was more frequent in dystonia patients; İn paralel with this the age DBS was performed and lower disease prevelence were more frequent. Stimulation-related side effects was more common in patients with higher levodopa equivalent doses and nonmotor symptom presence before DBS surgery. Side effects due to battery replacement were observed more often in patients with longer follow-up after DBS and in patients with higher pre-DBS.The appearance of balance and gait disorders; it was more frequent in patients with older age at onset of illness and age at DBS surgery. In all patients with STN DBS compared with Globus Pallidus İnternus-Subtalamic Nucleus(GPI-STN), weight gain was found to be significantly more frequent in STN DBS. Weight gain is more common in women. Comparing the dystonia and Parkinson disease patients with GPI DBS; certain psychiatric side effects, impulse control disorder, psychotic disorder were signicantly more frequent in patients with Parkinson Disease than patients with Dystonia. Compared with the GPI and STN groups in the Parkinson's disease, the GPI group had a higher psychotic disorder frequency. In conclusion, a number of factors related to the patient, disease, or operation; such as patients with DBS who have a history of illness onset, age at operation, gender, preoperative Levodopa dose, diagnosis, type of DBS performed, duration of follow-up after DBS, presence of non-motor symptom and RDB, have been associated with the occurrence of certain side effects. Attention to these features and factors before and after DBS; the physician will be more cautious in terms of the occurrence of these side effects and appropriate treatment will be given at the appropriate time and may contribute to the reduction of morbidity and mortality due to these side effects in patients.