Seizure incidence after deep brain stimulation: a meta-analysis of risk factors and target-specific outcomes in non-epileptic disorders.

Abstract

Introduction: The reports of seizures following Deep Brain Stimulation (DBS) are low; however, these seizures would be debilitating. Current literature has not provided a comprehensive analysis of seizure incidence post-DBS across various neuropsychiatric disorders. Additionally, there is a lack of insight into the contributing factors and the underlying mechanisms associated with this occurrence.

Aim: This systematic review and meta-analysis investigated the incidence of epilepsy in patients with neurological disorders who have undergone DBS, excluding those with drug-resistant epilepsy.

Method and material: The study was conducted according to PRISMA guidelines and involved thorough data extraction from several databases, specifically PubMed, Scopus, Embase, Web of Science, and the Cochrane Library, until 28-Feb-2025. We performed this Meta-analysis by using Comprehensive meta-analysis (CMA) software version 3.0 for the statistical analysis Results: This systematic review and meta-analysis encompassed 33 studies, and 5,488 patients. The most frequently neurological disorder which underwent DBS in this review, was Parkinson's Disease. Our meta-analysis revealed that the incidence of seizures following DBS was 2.9% (95% CI: 0.020 to 0.042; p-value < 0.001). A strong positive correlation was identified between the rate of intracerebral hemorrhage (ICH) and seizure occurrence, with a Pearson correlation coefficient of 0.635 (p-value: 0.007). Furthermore, there is a significant increase in the likelihood of seizure occurrences following globus pallidus internus- DBS compared to subthalamic nucleus- DBS.

Conclusion: Patients with neurological disorders following DBS may experience seizures; however, the incidence of such occurrences is low and typically resolves spontaneously.