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With DBS therapy, a team consisting of a neurologist, a neurosurgeon, and nurses works together to help you manage your therapy for Parkinson's disease. More
If you are a candidate for deep brain stimulation (DBS) therapy, the DBS system will be implanted during surgery. After your body heals, your clinician will program the stimulation and adjust it to the level that works best for you.
Factors Your Doctor May Consider
DBS is not right for everyone. Only a doctor experienced with DBS can determine if you are a candidate. Generally, the therapy is not for recently diagnosed individuals, or for those who are doing well on medication for Parkinson's disease. More
Surgery: What to Expect
People who receive a DBS system usually describe the surgical procedure as demanding and exhausting. Your doctor will be able to answer any questions you may have about the procedure. More
Deep brain stimulation (DBS) therapy for Parkinson's disease is not right for everyone. Only a doctor experienced with DBS can determine if you are a candidate. Generally, the therapy is not recommended for people who have been recently diagnosed with Parkinson's disease, or for those who are doing well on medication.
You may be a candidate for DBS if:
You experience troubling "off" periods (periods when medication is not helping enough and you are experiencing symptoms)
You experience dyskinesias (involuntary excessive movements)
You are not responsive to doses of dopaminergic drugs in a typical day
If You Are a Candidate
If your doctor determines you are a candidate for DBS, you will need to make the final decision about whether or not to choose the treatment.
Here are some suggestions to help you decide whether DBS is right for you:
Request information from your doctor
Carefully weigh the benefits and risks of the treatment
Make sure you're comfortable with your doctor. He or she should be helpful, supportive, and ready to answer any questions you may have
Try to talk with people who have received DBS therapy
Before you meet with your doctor, think about what you hope to learn. Prepare questions, and be ready to provide information about your medical history.
You'll work with a variety of healthcare professionals if you are determined to be a candidate for deep brain stimulation (DBS) therapy for Parkinson's disease.
Part of the healthcare team's job is to make sure you're comfortable and satisfied with your therapy. Always ask for clarification if there's something you don't understand. Also, make sure to communicate any concerns you may have regarding the procedure or follow-up treatment.
Remember: You'll get the best results from your treatment by actively participating in discussions with the members of your healthcare team.
People who receive a DBS system usually describe the surgical procedure as demanding and exhausting. There may be some discomfort during the initial stages of the surgery. However, the placement of the lead is not painful (your brain is not sensitive to pain). Your doctor will be able to answer any questions you may have about the procedure.
Before the Procedure
The evening before surgery, you may be instructed to stop taking all of your medications. This step lets your healthcare team best determine the effect of DBS therapy on your symptoms.
You will be admitted to the hospital either the night before or the morning of your surgery. You may have your head shaved prior to surgery to help prevent infection.
During the Procedure
The duration of the procedure and the specific steps involved can vary. The surgery typically lasts 4 to 8 hours.
Your surgery may consist of the following steps:
A metal frame may be attached to your head. The headframe is a special instrument that allows the neurosurgeon to find the correct path to the target site in your brain.
Pictures of your brain will be taken using an MRI, CAT scan, or both. These images will allow your surgeon to determine where to place the leads.
Your scalp and skull will be numbed to minimise any discomfort. In the surgical room, a small hole will be drilled in your skull for the lead. Later in the surgery, a cap will be placed over this hole.
Your surgeon will stimulate areas of your brain to determine the best lead placement. You will be lightly sedated but awake so that you can help your doctor determine when your symptoms are best controlled.
If your symptoms are suppressed due to stimulation during a test stimulation, the neurostimulator and extension will then be implanted. Your symptom control will be checked again. The lead position will be held in place with the cap covering the hole.
The head frame will be removed. If you don't have the extension and the neurostimulator implanted right away (sometimes surgeons implant the DBS system in two stages), you will typically be able to go home in 24 to 48 hours. Your doctor will decide the length of your hospital stay.
When you have the extension and neurostimulator implanted, you will be sedated and asleep. Your doctor will decide the length of your hospital stay.
After the Procedure
Once your body has healed following the implant procedure, your clinician will program the neurostimulator to start sending the electrical pulses that help control your symptoms. He or she will adjust your stimulation wirelessly. The process is non-invasive and may take a few hours to complete.
It may take several visits to adjust the stimulation before the best settings for you are determined. Over time as the disease progresses, further adjustments may be necessary.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
