Therapeutic Measures for Infections Originating from Scalp Incisions Following Deep Brain Stimulation in Patients with Parkinson's Disease

Background

Deep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD). However, infection following DBS surgery is a serious complication that can lead to the recurrence and worsening of Parkinson's symptoms or related hardware reimplantation, causing considerable patient suffering and financial burden.

Objective

This study aims to compare the therapeutic efficiency of different treatment approaches for scalp incision infections after DBS surgery in PD patients.

Methods

We conducted a retrospective review of patients with PD who experienced scalp infections following DBS at our hospital between January 2017 and December 2021. The patients were divided into 2 groups based on whether affected implants were removed or not. Fisher's exact test was applied to compare the reinfection rates between groups A and B.

Results

In group A, 4 patients underwent debridement only, and all of them experienced reinfection between 2 and 25 months after the initial treatment. In group B, 9 patients underwent debridement and removal of potentially affected implants. Among them, 8 patients underwent reimplantation of the DBS device within 3–6 months after the initial treatment, and no cases of reinfection occurred. However, 1 patient experienced reinfection in the postauricular incision and percutaneous tunnel 5 months after the initial treatment, resulting in the complete removal of the entire DBS system. The reinfection rate in group B (11.11%) was significantly lower than that in group A (100%, P = 0.007).

Conclusions

Scalp incision infections following DBS surgery can affect deep tissues, and the implementation of a comprehensive treatment strategy involving local debridement and removal of potentially affected implants can significantly reduce the risk of infection recurrence and its spread.