Deep Brain Stimulation

WHAT IS DEEP BRAIN STIMULATION?

Deep Brain Stimulation (DBS) works by implanting fine wires (electrodes) into specific parts of the brain. The electrical pulse inhibits the activity in the brain surrounding the wire


How is deep brain stimulation performed?

Before surgery you will have a special frame attached to your head. This is usually done with local anaesthetic and is not too bothersome. Then you will have a brain scan before being taken to the operating theatre. Some more local anaesthetic and some light sedation will be given before one or two small holes are shaved in your skull. This does not hurt, and is usually much less uncomfortable than going to the dentist!

The electrode (wire) is then slowly inserted and the electrical activity will be monitored to guide its final placement. Once we are confident that we are in the right position, we will stimulate through the tip of the electrode to look for side effects. You will then undergo another brain scan and, if the results are satisfactory, you will be taken back to the operating theatre (sometimes on the same day) for the second stage.

The second stage involves giving you a general anaesthetic and running the wires under your skin from your head to your chest. They are connected to a battery placed under the skin just below your collarbone (sometimes the battery is placed in your abdominal region or flank). You will be discharged from hospital several days later. Your neurologist will adjust your stimulation settings and medications progressively over a number of months.

What happens when you go home?

You will need to take it easy for 6 weeks. You should do an hour of gentle exercise such as walking, every day or two.

Your GP should check your wounds 4 days after discharge. You should not sign or witness any legal documents until you have been seen by your GP. You will be given instructions about when the staples need to be removed (either by your GP or by the Precision Brain Spine and Pain Centre Clinical Care Coordinator).

You will be reviewed after several weeks by your neurologist and neurosurgeon. You should not drive a motor vehicle or operate heavy machinery until they give you the go ahead.

If you have had deep brain stimulation you will also be given some detailed information about things you must avoid, such as metal detectors at airports. It is critical that you read such information thoroughly.

The consent process

You will be asked to sign a consent form before surgery. This form confirms that you understand all of the treatment options, as well as the risks and potential benefits of surgery. You should also understand the costs involved with surgery before going ahead, and should discuss this with your surgeon. If you are unsure, you should ask for further information and only sign the form when you are completely satisfied.