You're probably wondering what to expect if you choose DBS. Here are the steps.
A neurosurgeon will implant the DBS system in two steps. First, the surgeon will place the thin wires (leads) that will carry electrical signals to precise areas of your brain. Second, the surgeon will place the small pacemaker-like device, or neurostimulator, under the skin of your chest.
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. Remember, the duration and procedural steps can vary by doctor and hospital.
Very thin wires called leads deliver electrical signals from the neurostimulator to the brain.
The neurostimulator creates the electrical pulses that help control movement symptoms of Parkinson's, including tremor, slowed movement, and stiffness.
Your doctor will use a programming device to adjust the settings.
You may have a device, similar to a remote control, that allows you to turn the system on and off and check the battery. You may also be able to adjust the stimulation within options programmed by your doctor.
This step is designed to get you and the surgical team ready for DBS surgery. You may need an MRI scan to capture an image of your brain. The MRI image helps the neurosurgeon to plan and place the leads exactly in the right place.
A neurosurgeon will implant the DBS system in two steps. Your neurosurgeon will place the leads 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 leads are placed in the best location to control your movement symptoms. Though you will be awake, you will not feel 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 stimulates an area of the brain to test results.
As the second step, the neurostimulator may be placed on the same day, or on a different day. For this part of the surgery, you will be under general anaesthesia.
After checking that the leads 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 leads to the neurostimulator using extensions that run under the skin from the chest to your neck and head.
Generally, you will be ready to return home a few days after surgery. Healing at home can continue for several weeks. It’s normal to feel some discomfort or pain at the incision sites; this is managed with medication. The neurologist or DBS-specialised nurse will discuss resuming activity and exercise.
The device will be turned on at the first programming session. At that time, medication may also be adjusted. Programming begins after you have healed from surgery. With the help of a clinician programmer device that receives and sends signals from and to your neurostimulator, the neurologist can select the optimal stimulation parameters to control your symptoms. You may even start to feel more like your old self again.