THE DOCTOR HAS RECOMMENDED DBS
It's natural to wonder what to expect when choosing deep brain stimulation (DBS) therapy for Epilepsy. Along the way, the support and expertise of a neurologist, epileptologist, and neurosurgeon who have training and experience with DBS will be available.
1. EVALUATION
The neurologist — typically an epileptologist — will evaluate the patient to see if DBS is a good option. The evaluation usually includes:
- Medical history
- Electroencephalogram (EEG) to help determine the location of seizures in the brain and type of seizures the patient is having
- MRI of the brain to identify structural abnormalities, including brain lesions, that could be causing the seizures, and to check whether there are any issues that would pose a risk during the surgery
- Lab tests, such as a blood test to further assess conditions that may be triggering the seizures and to make sure the patient's blood clots properly
- Neuropsychological tests to evaluate the impact of the seizures on cognitive functioning
The doctor will share the results the patient, and together will decide whether to go forward with the therapy.
2. PLANNING — PREPARING FOR SURGERY
The doctor will create images and maps of the brain to help guide the placement of leads during the surgery. An MRI or CT scan will be conducted to capture images of the brain.
3. SURGERY — PLACING THE SYSTEM
There are two parts to the DBS surgery: implanting very thin wires (leads) 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.
4. Programming — Stimulation Settings
A few weeks later, the doctor will turn on the neurostimulator and adjust the stimulation to best control the symptoms while minimising side effects.
- It will take a few programming sessions to find the stimulation levels that work best for each patient.
- Follow-up visits will be scheduled to check the results and adjust as needed. These appointments are key to getting the desired results over time.
5. CONTINUOUS THERAPY
Over time, the doctor will adjust the therapy settings in the device to meet the specific needs. Individualised therapy settings are programmed in the clinic using wireless communication between the implanted device and a clinician programmer. Every individual is different, so programming optimisation may take place over several months to find the settings that best reduce your seizures and potential side effects.
Always follow the doctor's guidance about which activities are okay and which to avoid.
6. CHECKUPS — ONGOING CARE
It's extremely important to attend all of the checkups with the doctor who manages the DBS therapy. The doctor will:
- Make sure that the DBS system is working properly.
- Adjust the stimulation to best control the symptoms.
- Check the battery of the neurostimulator to see if a device replacement will be needed soon.
