Deep Brain Stimulation

Deep brain stimulation can help control symptoms associated with neurological disorders such as Parkinson’s disease, essential tremor and dystonia by providing constant electrical stimulation in the brain. 

It can also help improve sleep, motor function and overall quality of life. While the procedure cannot cure these conditions or replace medications altogether, some patients can reduce the amount of medication they are taking to help control their symptoms.

Patients that have had Parkinson’s disease for at least five years, who have a good response to levodopa and who have developed involuntary movements or side effects that cannot be effectively treated with medications are good candidates for this procedure.

For patients with dystonia that affects a portion or multiple parts of their body which cannot be managed with injections or medication, deep brain stimulation is also an option.

For patients with dystonia that affects a portion or multiple parts of their body that cannot be managed with injections or medication, deep brain stimulation is also an option.

During your first surgery, electrode(s) will be implanted in your brain. First, a stereotactic frame is attached to your head using four pins while using local anesthesia.

Once the frame is in place, a provider will take a head CT to map out the path of the electrode during surgery. 

Your surgical team will shave your hair and numb your scalp where they will make the incision. A surgeon will make small holes in your skull for each incision to allow for placement of the electrodes.

A recording electrode is then passed through these holes and moved forward in small increments, allowing the surgical team to hear the firing of brain cells to help determine the correct placement of the electrode. Your movements or tremors may also be evaluated to help determine if the electrode is in the right area. 

Once the target area is found, the recording electrode is switched out for the permanent electrode and the electrode is tested, delivering stimulation to your brain to see if there are any significant side effects. 

During this time, you’ll be asked to perform different movements and tell the surgical team if you feel any of your symptoms change. 

Once the electrode is in the proper place, a cap is placed over the hole in the skull to keep the electrode in place, and your surgical team will close the incisons with staples or sutures.  

After surgery, your team will perform another CT scan to confirm proper placement of the electrodes. You can expect to stay in the hospital overnight. Most patients are discharged the next day.  

After your first surgery, you should resume taking medications as directed.

About a week after your first surgery, you’ll return to the hospital so your surgical team can place a stimulator in your chest or abdomen while under general anesthesia. Then, the team will connect an extension wire to the electrode leads placed previously in your brain to the stimulator in your chest or abdomen. The wires are all tunneled under the skin so that no wires are exposed outside the body.

You can expect to go home the same day if there are no complications.

About one to two weeks after your second surgery, you’ll visit the outpatient office to have your stimulator programmed. It may take a few visits to optimize your deep brain stimulator’s programming. 

You’ll also be provided with a programmer to control your settings and turn the stimulator off and on as needed at home. If you have a rechargeable battery, you’ll be given a home battery charger.

The benefits of deep brain stimulation vary from patient to patient, but in general, it helps manage symptoms long term. It can also help reduce the amount of medication patients need to take, though it does not replace medication completely.