Neurosurgery
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Deep Brain Stimulation (DBS) is a type of brain surgery to treat certain neurological conditions such as Parkinson’s Disease and Essential Tremor. During the procedure, electrodes are implanted into the brain and connected to a neurostimulator device. Once healed from the initial procedure, the device will control electrical stimulations to key parts of the brain. It can help reduce tremor, slowness, stiffness and walking problems found in Parkinson’s Disease as well as Essential Tremor.

What are the Benefits?

Benefits to Deep Brain Stimulation include:

  • Symptom reduction with reduced tremor, dyskinesia, slowness and stiffness
  • Little to no damage of the surrounding brain tissue
  • Individualized treatment with the frequency and intensity controlled by the physician and patient and can be adjusted as needed over time.
  • Can be applied to both sides of the brain instead of only one side
  • Decreased medication needs for many patients
  • The electrical stimulation may be adjusted over time as the condition progresses, so there is no need for additional surgery
  • The therapy can be turned off or removed, so the therapy is reversible should future treatment options be developed
  • FDA approved

How Does it Work?

Deep Brain Stimulation is actually several surgeries held on different days followed by careful programming of the intensity and frequency.

• Surgery 1: Brain Mapping and Electrode Placement Procedure

During the first procedure, which can last 4 – 6 hours, the patient has a head frame placed on their head and then has scans of the head so the neurosurgeon can carefully plan the implantation. During this time, the headframe is attached to the OR table to ensure there is no movement during the procedure. Once the planning is complete, quarter-sized holes are drilled into the skull to allow the surgeon access to the brain. To ensure the correct location of each, the surgeon will ask the patient, who is awake for most or all of the procedure, to perform certain tasks such as counting or moving their hand.

Topical anesthetic is used when the head frame is being installed. Light sedation may be used while making the access holes in the skull, but the patient is brought out of sedation in order to perform the required tasks during the procedure. This is the most time-consuming part of the procedure as each task must be completed on both sides of the brain. The patient doesn’t feel pain during this time as the brain itself doesn’t feel pain. There are test stimulations performed to evaluate the impact on symptoms.

Once the placement is completed, the incisions are closed up and the patient has an additional scan to ensure everything is in the correct place. Typically patients spend that night in the hospital and go home the following day.

• Surgery 2: Neurostimulator Placement and Connection

Approximately 1 week after the first procedure, the patient returns for a second procedure. The neurostimulator is implanted in the chest / abdominal area. Small incisions are made in the scalp and near the collarbone to ensure the leads can be under the skin and connected to the device.

The procedure is done under general anesthesia, and the patient is asleep the entire time. It takes approximately 1 hour in the OR, and the patient goes home the same day.

• Neurology Office Visit: Neurostimulator Programming

Approximately 10 days to 2 weeks after the second procedure, patients are scheduled for an office visit with the neurologist. The patient performs different tasks to determine the correct levels. It typically takes 3-4 visits to establish the correct level of intensity and frequency.

Patient Stories

Is Deep Brain Stimulation Right for You?
Talk to your provider to determine if Deep Brain Stimulation might be right for you. All patients referred for the procedure will undergo patient evaluation to be sure that the treatment is appropriate for your individual situation. This evaluation will include assessment of the severity of the condition and overall health.

Take the Next Step
To find out if you might be a candidate for Deep Brain Stimulation, please:

  • Call us at 757-534-5200 or
  • Email our program coordinator [this should link to the to be created email list]

If you qualify, the program coordinator will schedule an appointment with a provider from our Movement Disorders team for an in-person evaluation.

How to Learn More

Sign up for our email list to receive our Movement Disorders newsletter and be notified when Riverside's Movement Disorders Physicians offer community presentations.