Procedure guide · Functional neurosurgery and neurology
Deep brain stimulation (DBS) uses a small implanted device to send electrical pulses to specific areas of the brain. MedlinePlus compares the device to a heart pacemaker. It is used for conditions such as Parkinson disease when medicines no longer control symptoms. It eases symptoms but the underlying disease continues. A specialist team decides who is suitable.
What is deep brain stimulation?
MedlinePlus describes four parts. Thin insulated wires called leads are placed in the brain. Anchors hold them on the skull. A neurostimulator produces the current and is usually placed under the skin below the collarbone. In some people an extension wire runs under the skin to connect the lead to the stimulator.
Placement happens in one or two operations. The lead is usually placed while the patient is awake under local anaesthetic. The team may ask you to speak or move to check the position. The stimulator is then implanted under general anaesthetic. CT or MRI scans guide the surgeon before the operation.
Who may it suit?
MedlinePlus lists uses including Parkinson disease, essential tremor, dystonia, epilepsy, obsessive-compulsive disorder, treatment-resistant depression and chronic pain. A neurologist, neurosurgeon and sometimes a psychologist assess each person. MedlinePlus names factors needing careful review. These include age over 70, high blood pressure, heavy alcohol use, smoking and blood-thinning medicines.
Risks include infection, bleeding in the brain, speech or vision changes and balance problems. Device parts can also move, break or fail. The team will explain which risks apply to you.
Programming is part of the treatment
After surgery the stimulator is switched on and adjusted at later visits. MedlinePlus calls this programming. It does not need surgery. Plan where these adjustments will happen once you are home.
Which reports does a specialist usually ask for?
Send a letter from your neurologist describing the diagnosis, how long you have had it and the medicines tried with doses. Videos of your symptoms on and off medicine can help a movement disorder team, if they ask for them. Send recent brain MRI images in original format. Include any memory or psychological assessments. List all medicines, especially blood thinners.
How do you plan the trip?
The stages are assessment, lead placement, stimulator implantation and the first programming. Some teams do these close together and others space them out. Ask how your team works. Bring an attendant for the whole stay. MedlinePlus notes the device will set off airport security alarms. So carry the device card the hospital gives you. Before leaving, agree who will adjust the settings at home. Ask also how battery replacement will be handled in future. Your surgeon decides when it is safe to fly.
What should you ask the hospital?
- Which specialists will assess whether DBS suits me?
- Will lead placement be awake, and what will I be asked to do?
- How many programming visits do you expect before I go home?
- Is there a doctor in my country who can adjust this device?
- Is the battery rechargeable or standard, and how is it replaced?
- What device documents should I carry when flying?
Questions people ask
Does deep brain stimulation stop Parkinson disease?
No. MedlinePlus is clear that DBS does not remove the disease itself. It can reduce symptoms such as tremor, stiffness and slow movement. Most people still take medicines, often at lower doses.
Can deep brain stimulation be reversed?
MedlinePlus says the procedure can be reversed if needed. The stimulator can also be adjusted without surgery. Your team will explain what reversal would involve for you. Ask before surgery what removal would involve.
How long does the stimulator battery last?
MedlinePlus says a standard battery usually lasts 3 to 5 years and a rechargeable one about 9 years. Replacement needs a minor procedure. Plan with your team where this would be done.
Sources
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.