CONSIDERING DBS SURGERY
Patients are probably wondering what to expect if they choose deep brain stimulation (DBS) treatment for essential tremor. Here are the steps. Along the way, the patient will have the support and expertise of a neurologist and neurosurgeon who have special training and experience with DBS Therapy.
EVALUATION
The neurologist — typically a movement disorder specialist — will evaluate to see if DBS is a good option. The evaluation usually includes:
- Medical history
- Neurological exam of the movements, both on and off medications
- MRI of the brain to check whether there are any issues that would pose a risk during the surgery
- Lab tests, such as a blood test to make sure the blood clots properly
- Neuropsychological tests
The doctor will share the results with the patient, and together they will decide whether or not to go forward with the therapy.
PLANNING — PREPARING FOR SURGERY
The doctor will create images and maps of the patient's brain to help guide the placement of leads during the surgery. The patient will have an MRI or CT scan to capture images of their brain.
SURGERY — PLACING THE SYSTEM
There are two parts to the DBS surgery: implanting a thin wire (lead) in the brain and placing the pacemaker-like device, called the neurostimulator, under the skin of the chest. The two parts may be done on the same day, or two different days.
PROGRAMMING — GETTING THE INITIAL SETTINGS RIGHT
A few weeks later, the doctor will turn on the neurostimulator and adjust the stimulation to best control the symptoms while minimising side effects.
- Most people don't feel the stimulation at all when it’s first turned on, but some feel a brief tingling.
- It will take a few programming sessions to find the stimulation levels that work best — don't get discouraged.
CONTINUOUS THERAPY
- After surgery return to the usual activities, always following the doctor's guidance on what's okay and what to avoid.
- DBS delivers therapy 24 hours a day.
- DBS doesn’t require any maintenance from the patient (except for recharging a rechargeable system).
CHECKUPS — ONGOING CARE
It's extremely important for patients to attend all of their checkups with the doctor who manages their DBS therapy. The doctor will:
- Make sure that the DBS system is working properly.
- Adjust the stimulation to best control your symptoms.
- Check the battery of the neurostimulator to see when a device replacement is required.