The Most Prevalent Complications of DBS for Drug-Resistant Epilepsy Reported

Deep brain stimulation (DBS) for drug-resistant epilepsy (DRE) presents with notable complications, as revealed in the results of an analysis of the Food and Drug Administration's (FDA’s) Manufacturer and User Facility Device Experience (MAUDE) database of records from July 2013 to March 2024. Among 151 epilepsy-related reports, device-related issues (62.9%) and patient complaints (43.7%) were predominant. Results from this analysis were presented at the American Epilepsy Society (AES) 2024 Annual Meeting. 

 Key complications included:

• Impedance issues (22.5%)
• Device failure (21.2%)
• Inadequate stimulation (9.3%)

Patient complaints primarily involved:

• Increased seizure activity (13.2%)
• Infection (7.9%)
• Psychiatric alterations (6%)
• Hemorrhage (2.6%)

Treatment outcomes often necessitated surgical intervention (13.2%), with battery, hardware, or lead replacement (24%) being most common, followed by removal (15.2%) and reprogramming (7.9%).

These findings highlight the need for improved device reliability and strategies to mitigate complications, particularly those requiring surgical intervention. Neurologists should be aware of these potential complications when considering DBS for DRE patients and during post-implantation follow-up.