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Srvaughn

deep brain stimulator battery replacement

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To Whom It May Concern:

Have you ever heard of it being possible to get a battery change for the deep brain stimulator before you have reached ERI?

I am experiencing symptoms of motor skill decline due to my battery running lower.

I also have a high risk of falling and I'm on blood thinners and I experience difficulty breathing when my DBS is off. I am currently at battery life of 2.79.

Can you recommend a better way to approach this to make a battery replacement surgery date happen before you reach ERI? (my surgery center is 3 hours away)

 

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This is a really important question.  I will paste a paper we wrote about this and you can share the data with insurance companies.  It is best to have a plan and monitor closely DBS batteries.  If settings are high they may run out faster than expected. In some cases we preventatively replace the battery a month or two early and maybe even before ERI light....to prevent symptoms....hope that helps.

 
 
PLoS One. 2013;8(3):e58665. doi: 10.1371/journal.pone.0058665. Epub 2013 Mar 11.

Management of deep brain stimulator battery failure: battery estimators, charge density, and importance of clinical symptoms.

OBJECTIVE:

We aimed in this investigation to study deep brain stimulation (DBS) battery drain with special attention directed toward patient symptoms prior to and following battery replacement.

BACKGROUND:

Previously our group developed web-based calculators and smart phone applications to estimate DBS battery life (http://mdc.mbi.ufl.edu/surgery/dbs-battery-estimator).

METHODS:

A cohort of 320 patients undergoing DBS battery replacement from 2002-2012 were included in an IRB approved study. Statistical analysis was performed using SPSS 20.0 (IBM, Armonk, NY).

RESULTS:

The mean charge density for treatment of Parkinson's disease was 7.2 µC/cm(2)/phase (SD = 3.82), for dystonia was 17.5 µC/cm(2)/phase (SD = 8.53), for essential tremor was 8.3 µC/cm(2)/phase (SD = 4.85), and for OCD was 18.0 µC/cm(2)/phase (SD = 4.35). There was a significant relationship between charge density and battery life (r = -.59, p<.001), as well as total power and battery life (r = -.64, p<.001). The UF estimator (r = .67, p<.001) and the Medtronic helpline (r = .74, p<.001) predictions of battery life were significantly positively associated with actual battery life. Battery status indicators on Soletra and Kinetra were poor predictors of battery life. In 38 cases, the symptoms improved following a battery change, suggesting that the neurostimulator was likely responsible for symptom worsening. For these cases, both the UF estimator and the Medtronic helpline were significantly correlated with battery life (r = .65 and r = .70, respectively, both p<.001).

CONCLUSIONS:

Battery estimations, charge density, total power and clinical symptoms were important factors. The observation of clinical worsening that was rescued following neurostimulator replacement reinforces the notion that changes in clinical symptoms can be associated with battery drain.

PMID:
23536810
PMCID:
PMC3594176
DOI:
10.1371/journal.pone.0058665
[Indexed for MEDLINE]
Free PMC Article

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Isn’t it common practice to increase voltage and other parameters  to compensate during later stages of the battery?

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It is not common to increase voltage as the battery runs out.....it is possible but you have to be careful after replacement to set the parameters back to the lower level.

Rather than do this we like to replace the battery before symptoms recur.

Hope that helps.

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Is it an effective strategy to increase the voltage incrementally as battery gets depleted if the patient prefers to get the maximum life out of the battery for financial reasons?

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As long as you realize that when you change the battery you have to rest to the lower levels as it could lead to severe pulling or side effects (after the battery change).

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