You're probably wondering what to expect if you choose deep brain stimulation for Parkinson’s.
Along the way, you will have the support and expertise of a neurologist and neurosurgeon who have special training and experience with deep brain stimulation.
Before the Procedure
Your doctor will give you instructions about preparing for your surgery, including instructions for medications, eating, or drinking before surgery, and how long they anticipate you will be staying in the hospital. Your doctor may want to shave a portion of or your entire head for the procedure. Ask your doctor about everything to expect at your procedure.
Imaging and Mapping the Brain
You will have an MRI or CT scan to provide your surgeon with images and maps of your brain. Your doctor may attach a frame, or halo, to your head to help hold it steady during the scan. Your doctor will use these images to calculate 3-dimensional coordinates of brain locations for lead placement.
A neurosurgeon will implant the DBS system in two steps:
Depending on your surgeon's preference these steps can either be done in one day or two separate days over the course of a few weeks.
Placing the Lead(s)
Your neurosurgeon will place the lead(s) first, guided by the images and maps of your brain. For this part of the surgery, you will be awake so you can confirm that the lead(s) are placed in the best location to control your movement symptoms. Though you will be awake, and could feel some pressure, you should feel no pain.
The surgeon may ask you to move your arms or legs, tap your fingers, move your hands, or pretend to drink from a cup, then stimulate an area of the brain to test results.
Implanting the Neurostimulator (Battery)
The neurostimulator may be placed at this time, or on a different day. For this part of the surgery, you will be under general anesthesia.
After checking that the lead(s) are properly positioned, your surgeon will place the neurostimulator under the skin of your chest, just below the collarbone. Then your surgeon will connect the lead(s) to the neurostimulator using extensions that run under the skin from the chest to your neck and head.
Healing and Care After Surgery
Most people spend a day or two at the hospital. Healing may take several weeks. You will have pain medications for any discomfort you may have at the incision sites.
While healing, avoid strenuous activities and heavy lifting. Don't raise your arms above your shoulders, and don't bend or stretch your neck excessively. As always follow your doctor's instructions.
Your doctor will help you decide when you're ready to return to activities and will turn your device on at your first programming session a couple weeks after your surgery.
Risks of the Surgery
DBS Therapy requires brain surgery. Risks of brain surgery may include serious complications such as coma, bleeding inside the brain, stroke, seizures, and infection. Some of these may be fatal.
Once implanted, the system may become infected, parts may wear through your skin, and the lead or lead/extension connector may move. DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause your symptoms to return or worsen.
Talk to your doctor about the risks that may be applicable to your specific situation.
A few weeks later, your doctor will turn on the neurostimulator and adjust the stimulation to best control your symptoms while minimizing side effects.
Then it's time to get back to your life!
It's extremely important to attend all of your checkups with the doctor who manages your DBS therapy. Your doctor will: