Why is this procedure done?
Deep brain stimulation is also called DBS. A special tool is placed in your body. It sends tiny electric signals to areas of your brain. The signals are sent to the places that cause signs like tremors or stiffness. They may also cause slow movements or problems walking. The electric signals block the signals in your brain that are causing these signs. ‚
DBS is a choice for patients with Parkinsons disease. It is also used in some other conditions. This procedure is only done if other treatments have not worked. It will not cure your disease. It may help your signs. There are three parts needed to do deep brain stimulation. ‚
- Small patches that are attached to your brain. These are called electrodes.
- A device that is placed under your skin. It sends the electric signals to the electrodes. This is called an impulse generator or IPG.
- Wires that connect the IPG and the electrodes
DBS surgery is done in two steps. First, the electrodes are placed in your brain. A week or so later, the IPG is placed and hooked to the electrodes. ‚
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What will the results be?
- Improved signs
- Improved quality of life
- Reduced use of drugs to treat your signs
What happens before the procedure?
Your doctor will take your history. Talk to the doctor about: ‚
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- If you are not feeling well. An infection from a cold or sore throat may raise the risk of infection.
Your doctor will do an exam and may order: ‚
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home. ‚
The doctor or staff may ask you to shampoo your hair using a special shampoo the night before the procedure. ‚
What happens during the procedure?
Step One of the procedure: ‚
- Once you are in the operating room, staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you relaxed. It will also help you stay pain free during your surgery. You may still be awake during your surgery. Children are most often asleep for the surgery.
- The doctor will put a special frame called a halo around your head. This will hold your head in position for your surgery.
- Your head may be shaved in the area where the doctor will make a cut. The doctor will make a cut on your scalp. Next, the doctor will drill into a small part of your skull to get to your brain. The electrodes are placed in a certain part of your brain. This is based on your signs and the pictures from your CT and MRI scan.
- The doctor will send a small amount of electrical signals to your brain to make sure that the electrodes are working well. The doctor may ask you few questions during this time.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages.
- Your surgery may last for a few hours. It depends on the part of your brain that will be accessed.
Step Two of the procedure: ‚
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. You will be asleep during this part of your surgery.
- Your doctor will make a cut near your collarbone. The doctor will place the IPG under your skin. The doctor will make another small cut behind your ear. The doctor will guide the wires under your skin. These will connect the electrodes and the IPG. They will pass from your head, down your neck, going to your shoulders.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages. The wires should not be seen outside your body.
- This second surgery may take 2 to 3 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 2 to 3 days after the first procedure. The second time, you may only have to stay for a day or so.
- Your face or head may be swollen for a few days.
- You may feel sore and have pain after your surgery. The doctor will give you drugs to relieve the pain.
- The staff will help you walk around your room. This will help prevent blood clot formation. They will teach you how to do coughing and deep breathing exercises. This will help you clear your lungs and help prevent infection.
- After your second surgery, the device will be programmed to fit your needs. It may take a few tries to program the device perfectly.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Take your drugs as your doctor has taught you. Follow your doctors guidelines.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages.
- When you may take a bath or shower.
- If you should lift things over 10 pounds.
- When you may go back to your normal activities like work, driving, or sex.
- Be sure to wash your hands before touching your wound or dressing.
- Learn how to care for your IPG.
- Wear a medical alert ID or bracelet to let others know of your IPG.
- Keep written information about your IPG in a safe place. This includes the manufacturer, serial number, and the date it was placed.
- Remember that the battery life for an IPG is about 3 to 5 years.
- Learn what to expect from your device and when to call the doctor.
- Keep the special magnet the doctors give you in a safe place. This will be used to turn your IPG on and off. This magnet may damage TV sets or computer discs.
What follow-up care is needed?
- Your doctor may ask you to visit the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
What lifestyle changes are needed?
- You may have to limit your activity. Talk to your doctor about the right amount of activity for you.
- Tell airport personnel that you have an IPG. Do this before going through the security process. Remind them that the detector should not be placed over your IPG for more than a few seconds. Your doctors office can give you a prescription to validate this.
What problems could happen?
- Device malfunction
- Paralysis
- Changes in memory and thinking ability
- Changes in behavior
- Seizure
- Bleeding
- Infection
Where can I learn more?
American Association of Neurological Surgeons ‚
http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Deep%20Brain%20Stimulation.aspx ‚
National Institute of Mental Health ‚
http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml ‚
National Institute of Neurological Disorders and Stroke ‚
http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚