Table 29:

Average Costs of Managing Adverse Effects and Complications

Resource Item	Total Cost, $	Resources Used (Source)
Short-term adverse effects and complications
Gait disturbance	108.95	One repeat neurologist visit (assumption); 25% of patients prescribed physical therapy (Elias et al, 201638)
Paresthesia or numbness	84.95	One repeat neurologist visit (assumption)
Speech disorder	84.95	One repeat neurologist visit (assumption)
Headache	84.95	One repeat neurologist visit; over-the-counter pain medication (assumption)
Intracranial hemorrhage	7,634.74	Half of cases symptomatic (assumption; cost of symptomatic intracranial hemorrhage obtained from OCC)
Infection following deep brain stimulation	22,461.04	60% require reoperation; 40% treated as outpatients (Fenoy et al, 2012101; Fenoy et al, 201478)
Infection following radiofrequency thalamotomy	5,591.82	60% treated as inpatients, 40% treated as outpatients (expert opinion)
Permanent adverse effects
Gait disturbance	0	No treatment required (expert opinion); 20% of patients require a walker (Elias et al, 201638)a
Paresthesia or numbness	0	No treatment required (expert opinion)
Speech disorder	0	Speech therapy for some patients (expert opinion)a
Deep brain stimulation–hardware-related complications
Lead fracture or migration	25,111.88	Reoperation to replace the lead (Fenoy et al, 201478)
Device malfunction	37,377.05	Reoperation to replace the device (Fenoy et al, 201478)

^aWe did not include the costs of assistive devices and speech therapy, as they are usually not covered by public payers.