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CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(02): 407-410
DOI: 10.4103/ajns.AJNS_148_16
Case Report

Cerebrospinal fluid egress from the quadripolar deep brain stimulation electrode for anterior nucleus of the thalamus for refractory epilepsy

Byung-chul Son
1   Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
2   Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul
,
Jin-gyu Choi
1   Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
,
Sang-woo Ha
3   Department of Neurosurgery, Chosun University Hospital, College of Medicine, Chosun University, Gwangju
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Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is an effective treatment for refractory epilepsy. Due to the unique location of ANT in the thalamus facing the lateral and third ventricles, transventricular DBS lead placement is an essential part of ANT DBS. However, there is no report regarding hardware problems including impedance variability in transventricular ANT DBS due to limited experience. A 45-year-old male patient with previously effective, bilateral ANT DBS presented with increasing seizure frequency and a shortened battery longevity within 2 years. Magnetic resonance imaging showed that the left-sided DBS lead was in the third ventricle leaning on the medial wall of ANT. Electrode revision was performed. Upon disconnecting the proximal lead from the extension connection, cerebrospinal fluid egress through fine gaps between the metallic electrode contacts, and electrode spacing was observed. This case raises a concern about the transventricular approach for ANT lead placement because the currently available DBS electrode lead is not waterproofed. A careful, longitudinal follow-up of DBS impedance for ANT DBS is warranted.

Key-words:

Anterior nucleus of the thalamus - cerebrospinal fluid - deep brain stimulation - electrode - epilepsy


Publication History

Article published online:
14 September 2022

© 2018. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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