CT-guided asleep DBS

Deep brain stimulation (DBS) electrodes can be safely and accurately placed under general anesthesia using intraoperative computerized tomographic image guidance. Accuracy of placement is comparable with, or exceeds, electrode placement using microelectrode recording (MER)-guided procedures that require an awake patient. Intracranial air, and the possible attendant brain shift it entails, can be effectively eliminated by this method. Accurate placement can be assured by intraoperative imaging obtained before the conclusion of the procedure. The results of asleep DBS for Parkinson disease (PD) are equivalent to MER-guided procedures for motor outcomes (UPDRS III) and superior in the domains of speech, language, and quality of life. For routine placement of DBS leads for PD, asleep DBS should be the procedure of choice.