Deep brain stimulation

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.

Patients are first placed under general anesthesia prior to the onset of the surgery. There is no special headframe that is placed on the patient while they are awake. This procedure is unique as it uses an intraoperative MRI and a special targeting apparatus for placing the deep brain stimulation leads while the patient is fully asleep under general anesthesia.

The entire deep brain stimulation system will be implanted by your neurosurgeon in a single surgery. After the patient is placed under general anesthesia small hole is created in the skull. Leads are placed within the brain using a unique MRI-guided targeting system, which is capable of placing electrodes to specified brain regions with submillimeter accuracy.

During the second phase of the surgery, a battery-powered pulse generator is implanted under the skin of the chest just below the collar bone. A wire that runs under the skin within the neck connects the generator to the existing lead(s) 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.

The entirety of asleep, MRI-guided DBS surgery is performed under general anesthesia. This means that not only will patients will be fully asleep for duration of surgery, they will also be able to take all medications on the morning of the surgery and they are not required to perform various tasks during the surgery.

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
• Infection
• Lack of improvement for certain symptoms
• Headache
• Waning mental or emotional status

Other side-effects include:

• Unintended movements
• 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, epilepsy and neuropsychiatric 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. Your stitches or staples will be removed 10 to 14 days after surgery.

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 at least 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.