Anesthesia for Deep Brain Stimulation

Abstract

Deep brain stimulation is used in the treatment of patients with functional neurological disorders but has expanded to include many other disorders. The target site for stimulation is dependent on the disease and symptoms of each patient. The procedure includes imaging techniques to visualize and establish coordinates to the nuclei, electrophysiological guidance with microelectrode recordings, and testing of an awake patient. The goals of anesthesia are to provide optimal surgical conditions and patient comfort, facilitate target localization and diagnosis, and treat complications. The choice of anesthetic agents and techniques will depend not only on the specific patient population and stimulation target but also varies according to institutional practice. Monitored anesthesia care, conscious sedation, and general anesthesia have all been used successfully. Perioperative complications include intracranial hemorrhage, seizures, and venous air embolism. The anesthetic management will continue to evolve with new developments in surgical, imaging, and monitoring techniques, and the understanding of the effects of drugs on electrophysiological recordings.