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Deep Brain Stimulation (DBS)
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Deep brain stimulation (DBS) involves implanting electrodes within certain areas of the brain. These electrodes produce electrical impulses that regulate abnormal impulses. Or the electrical impulses can affect certain cells and chemicals within the brain.
The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in your upper chest. A wire that travels under your skin connects this device to the electrodes in your brain.
Deep brain stimulation is commonly used to treat a number of conditions, such as:
The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in your upper chest. A wire that travels under your skin connects this device to the electrodes in your brain.
Deep brain stimulation is commonly used to treat a number of conditions, such as:
- Parkinson's disease
- Essential tremor
- Dystonia
- Epilepsy
- Obsessive-compulsive disorder
- Tourette syndrome
- Huntington's disease and chorea
- Chronic pain
- Cluster headache
Although deep brain stimulation is generally safe, any type of surgery has the risk of complications. Also, the brain stimulation itself may cause side effects.
Surgery risks. Deep brain stimulation involves boring small holes in the skull to implant the electrodes, and surgery to implant the device that contains the batteries under the skin in the chest. Complications of surgery may include:
Possible side effects after surgery. Side effects associated with deep brain stimulation may include:
Possible side effects of stimulation
Deep brain stimulation is a serious and potentially risky procedure. Even if you might be eligible for deep brain stimulation, you and your doctors must carefully weigh the risks and potential benefits of the procedure.
Next, preparing for surgery. Before surgery, you need to have medical tests to make sure that deep brain stimulation is safe for you and is a good option in your case. You also need brain-imaging studies, such as an MRI, before the surgery, to map the areas of your brain where the electrodes will be implanted.
What you can expect.
Surgery risks. Deep brain stimulation involves boring small holes in the skull to implant the electrodes, and surgery to implant the device that contains the batteries under the skin in the chest. Complications of surgery may include:
- Bleeding in the brain (hemorrhage)
- Stroke
- Infection
- Breathing problems
- Nausea
- Heart problems
- Incision scarring
Possible side effects after surgery. Side effects associated with deep brain stimulation may include:
- Seizure
- Infection
- Headache
- Insomnia
- Memory problems
- Temporary pain and swelling at the implantation site
Possible side effects of stimulation
- Numbness or tingling sensations
- Muscle tightness of the face or arm
- Speech problems
- Balance problems
- Lightheadedness
- Unwanted mood changes, such as mania and depression
Deep brain stimulation is a serious and potentially risky procedure. Even if you might be eligible for deep brain stimulation, you and your doctors must carefully weigh the risks and potential benefits of the procedure.
Next, preparing for surgery. Before surgery, you need to have medical tests to make sure that deep brain stimulation is safe for you and is a good option in your case. You also need brain-imaging studies, such as an MRI, before the surgery, to map the areas of your brain where the electrodes will be implanted.
What you can expect.
In general, here's how surgery for deep brain stimulation works.
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Stimulation may be constant, 24 hours a day, or your doctor may advise you to turn your pulse generator off at night and back on in the morning, depending on your condition. You can turn stimulation on and off with a special remote control that you'll take home with you. In some cases, your doctor may program the pulse generator to let you make minor adjustments at home.
The battery life of your generator varies with usage and settings. The battery may last between three and five years. When the battery needs to be replaced, your surgeon will replace the generator during an outpatient procedure.
You must remain in close contact with your surgeon and neurologist to make sure that the pulse generator is working correctly.
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- Brain surgery. For the brain surgery portion, your care team fits you with a special head frame to keep your head still during the procedure (stereotactic head frame). Then, they use magnetic resonance imaging (MRI) to map your brain and identify the area in your brain where they'll place the electrodes. You'll be given a local anesthetic to numb your scalp before surgery. You won't need an anesthetic in your brain itself because the brain has no pain receptors.
Your surgeon implants a thin wire lead with four contacts (electrodes) at the tips into a specific area of your brain. A wire runs under your skin to a generator (neurostimulator) implanted near your collarbone.
You'll remain awake and alert during the procedure so that your neurologist can talk to you to make sure the right areas of your brain are being stimulated. Your responses help your health care team place the lead in the correct place while minimizing side effects. During surgery, both the neurologist and surgeon carefully monitor your brain to help ensure correct electrode placement.
- Chest wall surgery. During the second portion of the surgery, the surgeon implants the part of the device that contains the batteries (pulse generator) under the skin in your chest, near your collarbone. This usually occurs a few days after the brain surgery. General anesthesia is used during this procedure. Wires from the brain electrodes are placed under your skin and guided down to the battery-operated pulse generator. The generator is programmed to send continuous electrical pulses to your brain. You control the generator, and you can turn it on or off using a special remote control.
- After the procedure After surgery, you'll need to take antibiotics to lower the risk of infection. A few weeks after surgery, the pulse generator in your chest is activated in your doctor's office. The doctor can be easily program your pulse generator from outside your body using a special remote control. The amount of stimulation is customized to your condition.
Stimulation may be constant, 24 hours a day, or your doctor may advise you to turn your pulse generator off at night and back on in the morning, depending on your condition. You can turn stimulation on and off with a special remote control that you'll take home with you. In some cases, your doctor may program the pulse generator to let you make minor adjustments at home.
The battery life of your generator varies with usage and settings. The battery may last between three and five years. When the battery needs to be replaced, your surgeon will replace the generator during an outpatient procedure.
You must remain in close contact with your surgeon and neurologist to make sure that the pulse generator is working correctly.
Results
Deep brain stimulation won't cure your disease, but it may help lessen your symptoms. If deep brain stimulation works, your symptoms will improve significantly, but they usually don't go away completely. In some cases, medications may still be needed for certain conditions. Deep brain stimulation isn't successful for everyone. There are a number of variables involved in the success of deep brain stimulation. It's important to talk with your doctor before surgery about what type of improvement you can expect for your condition.
http://www.mayoclinic.org/tests-procedures/deep-brain-stimulation/basics/definition/prc-20019122
Deep brain stimulation won't cure your disease, but it may help lessen your symptoms. If deep brain stimulation works, your symptoms will improve significantly, but they usually don't go away completely. In some cases, medications may still be needed for certain conditions. Deep brain stimulation isn't successful for everyone. There are a number of variables involved in the success of deep brain stimulation. It's important to talk with your doctor before surgery about what type of improvement you can expect for your condition.
http://www.mayoclinic.org/tests-procedures/deep-brain-stimulation/basics/definition/prc-20019122
