Deep Brain Stimulation (DBS)

There are a range of factors that could make you a good candidate for deep brain stimulation (DBS). Your movement disorders specialist can discuss these with you in detail.

DBS could help you:

• If you have dystonia or tremors without enough relief from medications. Other factors may help predict how much benefit you will receive from DBS.
• If you have Parkinson’s disease. Candidates should have a good response to medications but have complications from those medications. These may include the medication wearing off sooner and/or involuntary movements from the medications themselves.

After counseling and education, you should:

• Show a good understanding of how the therapy works.
• Have realistic expectations about benefits.
• Understand potential side effects and complications.

Ongoing Commitment to Your Care

To be a candidate for deep brain stimulation (DBS), you must be able and willing to come for frequent pre-operative and post-operative visits for the first three to six months after your surgery.

At first, you may come in as often as every two weeks for adjustments. Once your neurologist finds stable settings and establishes your new medication schedule, you won’t need to come in as often. You may need frequent adjustments for as long as three months.

Over time, you may need other changes as your disease progresses. If you live far from the hospital or have difficulty arranging transportation, please carefully consider these visits before deciding to have the surgery.

Six months after stimulation is started, we may recommend that you return for another follow-up visit and neuropsychological testing.

You likely won’t be a candidate for deep brain stimulation (DBS) if you have these situations:

• Medical condition that makes general anesthesia unsafe
• Abnormal brain MRI
• Active psychiatric problem such as depression or anxiety
• Another significant brain disorder
• Bleeding disorder
• Previous stroke
• Significant dementia or confusion

Any surgical procedure carries some risk. This is also true of deep brain stimulation (DBS) surgery. Your care team will carefully evaluate your overall health before they recommend you for this surgery. We take steps to make sure the risk of problems is low. Fortunately, neurologic side effects of DBS are very uncommon.

The most potentially serious side effect is bleeding in the part of the brain where the surgeon inserts each electrode. To help prevent bleeding, you shouldn’t take these or any other blood thinners for at least two weeks before surgery:

There are several possible problems related to equipment that may occur months to years after the system has been installed:

• Breakage of the electrode wire under the skin in the scalp or neck
• Skin infection
• Skin breakdown in the scalp

With the exception of certain types of hardware breakage, we can usually correct these problems without removing or replacing the brain electrode. Your neurologist and neurosurgeon will speak with you in more detail concerning these possible complications and answer any questions you may have.

Deep brain stimulation (DBS) programming takes place four to five weeks after your surgery. This gives your brain time to heal. We’ll give you special instructions regarding medications during this time.

This follow-up appointment can last anywhere from one to three hours. The length depends on if you have one or two electrodes and which neurologic condition you have. Please bring your medications with you and have someone drive you to and from the appointment.