Deep brain stimulation (DBS) is a procedure where electrodes are implanted within certain areas of the brain. These electrodes create electrical signals that help treat neurological conditions by regulating abnormal signals that often cause tremors and other common movement symptoms associated with conditions like Parkinson’s disease, essential tremor, and dystonia.
If medication has become less effective over time, or potential side-effects from medication interfere with your quality of life, DBS may be a viable treatment option for your movement disorder or other neuropsychiatric condition.
Patients selected for DBS must undergo an extensive evaluation process performed by our multidisciplinary team of experts to ensure this is a suitable treatment option based on your condition, family history, and other risk factors.
Some of the conditions that are treated with DBS include:
Before the procedure, a head frame is positioned on to the patient’s head using surgical pins or screws to ensure the patient remains still during brain imaging.
The deep brain stimulation system will be implanted by your neurosurgeon in two phases. During phase one, a small hole is created in the skull. Leads enter the hole, carrying electrodes to the sites identified as contributing symptoms.
In phase two, the patient will return for a second operation, about one week later. During this time, one or two battery-powered pulse generator devices (one device per lead) will be implanted just beneath the skin below the collar bone. A wire, placed under your skin, attaches to the generator to the existing lead in the brain.
About 2 to 4 weeks after surgery, patients will return for a visit to have the pulse generator turned on by a hand-held device and adjusted until symptoms are improved. Several follow-up visits will need to occur in order to modify the stimulation to best relieve symptoms. Regularly scheduled long-term follow-ups will ensure the system is still working properly, and any necessary adjustments to the stimulation can be made at this time.
Local anesthetic is used for areas of the head where pins or screws are applied. At the beginning to the procedure, you will be sedated while the surgical team prepares the skull for the lead placement. While most patients are awake for the actual lead and electrode placement to allow the team to interact with you in order to test stimulation, you won’t feel any pain as the brain doesn’t experience pain.
For patients who aren’t able to tolerate the procedure awake, the lead and electrode placement can be done with general anesthesia. General anesthesia is also used when for the implantation for the pulse generator in the chest.
While there is potential risk involved with DBS, most patients who undergo this treatment option have positive, effective results with mild side effects. Before considering surgery, you may consider a less invasive treatment options such as medication or physical therapy.
Some potential hardware complications may include:
- Movement of the leads
- Lead failure
- Failure of DBS system
- Pain over pulse generator device
- Infection around device
Potential surgical complications include:
- Brain hemorrhage
- Lack of improvement for certain symptoms
- Waning mental or emotional status
Other side-effects include:
- Unintended movements
- Feet feel like they’re stuck to the floor
- Worsening of balance and speech
- Numbness and tingling
- Double vision
*These side effects can be reversed with adjustments of the device
DBS is a surgical treatment option for patients with movement disorders whose symptoms cannot be treated with medication or physical therapy. It offers a chance at a better quality of life for those impacted by various types of neurological conditions.
Unlike other surgical options, DBS doesn’t cause any permanent damage to the brain. The stimulator can be turned off at any time without long-term consequences. Electrical stimulation is also adjustable to the patient’s condition.
Patients typically stay in the hospital 1 to 2 days following the DBS procedure. Most patients go home the same day their battery is placed. Your stitches or staples will be removed 10 to 14 days after surgery.
Keep each of your pin sites covered with band aids until they’re dry, and change daily as necessary. Avoid the surgical area when washing, and only wash your head with a damp cloth. Only use shampoo after your stitches or staples have been removed – and very gently. Do not irritate the surgical area.
Don’t resume light activity until two weeks post-surgery. Do not lift more than 5 lbs. for at least two weeks. For heavy activity, wait four to six weeks after surgery. Depending on how strenuous your work is, you may be able to return to work at this time. If you have any questions about activity, call your doctor. You want to give your wound time to heal properly.
Most insurance companies provide coverage for this procedure. Contact your provider directly to check your coverage of deep brain stimulation based on your medical condition.