Deep brain stimulation lead migration in a child secondary to osteogenesis at the burr hole site

Abstract

The frequency of deep brain stimulation (DBS) complications is low; however, lead migration is a common way DBS therapy can become ineffective. We present a case of a nine-year-old male with generalized dystonia who underwent bilateral GPi DBS lead placement. The efficacy of the DBS system was diminished over two years and one of the leads was noted to be displaced on skull X-rays and confirmed with a head CT. During surgery to replace it, bone growth within the burr hole site was noted to have occurred and determined to be the cause for the lead migration. This is the first known case reporting osteogenesis at the burr hole site as a cause of lead migration. This complication should be kept in mind when performing DBS in children to refine a surgical technique that could prevent osteogenesis at the burr hole. Keywords: Deep brain stimulation, Dystonia, Osteogenesis