Deep Brain Stimulation

Treatment

If you’re suffering from a movement disorder such as Parkinson’s or essential tremor, and your symptoms cannot be adequately controlled with medications, you may want to consider deep brain stimulation (DBS).

DBS uses very thin wires, called leads, to send out electrical signals to different areas of the brain, depending on the movement disorder. It essentially functions like a “pacemaker” for the brain. For example, the electrical pulses can help control tremors, stiffness & slow movements associated with Parkinson’s disease.

DBS involves inserting electrodes in the brain and wires that connect to a pulse generator, also known as a neurostimulator. The DBS generator is implanted under your skin in your chest area and controlled by a remote to activate the electrical stimulation going to your brain.

Although DBS will not slow the progression of the underlying neurologic disorder, it does allow many people to better manage their symptoms, reduce their medications and improve their quality of life.

Deep Brain Stimulation Procedure

1. Consultation & Pre-Qualification

The first step is to meet with a movement disorder neurologist to discuss if deep brain stimulation is right for you. 

DBS may be beneficial for patients with:

  • Parkinson’s disease
  • Essential tremor

If you are a candidate for DBS, your doctor will refer you to a neurosurgeon and neuropsychologist for testing. The neuropsychologist will make sure you do not have dementia or other cognitive disorders, which could potentially prevent you from having DBS surgery. You may also see a speech therapist and physical therapist for an initial evaluation.

2. Deep Brain Stimulation Surgery & Implantation

Stage 1 - During the first surgery, a neurosurgeon implants the electrode in your brain.

After placing the electrodes and connecting the wires (leads), the neurosurgeon performs tests to ensure everything is working properly. You'll be awake during the entire procedure so you can confirm the leads are placed in the optimal areas to help control your movement symptoms. Most patients require an overnight hospital stay for monitoring following this first procedure.

Stage 2 - About a week later, you will undergo a second surgical procedure to implant the pulse generator under the skin in your chest area. Then the neurosurgeon will connect the pulse generator to the leads placed in stage one. You will be asleep under general anesthesia for this procedure. It's likely you'll be able to go home after the procedure and won't require an overnight stay.

3. Programming the Neurostimulator 

About a month following the DBS lead(s) and neurostimulator placement, you'll meet with your neurologist to activate and program your neurostimulator.

You'll be able to turn the stimulation on and off with a remote control that communicates with the generator inside your chest. Your doctor will make programming adjustments as needed, which may require several appointments. Your neurologist and care team will also address your medications and dosages, making sure they work as effectively as possible.

Deep Brain Stimulation Risks

Deep brain stimulation is a serious and potentially risky procedure that doesn’t work for everyone. It’s important to discuss the risks and potential benefits with your Mercy neurology care team. Our goal is to help minimize involuntary movements and other symptoms so you can live the best life possible.

Possible risk factors of deep brain stimulation include:

  • Infection
  • Bleeding In the brain
  • Seizures
  • Stroke

Do I Qualify for DBS?

The best candidates for DBS will meet most of the following criteria:

  • You’ve experienced symptoms for at least five years.
  • You have “on/off” fluctuations, with or without dyskinesia.
  • You respond well to medications like carbidopa/levodopa.
  • Your doctor has already tried different combinations of carbidopa/levodopa and dopamine agonists.
  • You’ve tried other medications, such as entacapone, tolcapone, selegiline, apomorphine or amantadine, without results.
  • You have symptoms that interfere with your daily activities.
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