Deep Brain Stimulation
Deep brain stimulation (DBS) is a neurosurgical treatment which delivers tiny electrical signals to the brain. The signals reorganize the brain's electrical impulses, reducing symptoms of conditions causing movement disorders, such as tremors. DBS is approved by the U.S. Food and Drug Administration to treat conditions including essential tremor and Parkinson's disease.
The Neuroscience Institute at Virginia Mason has successfully used DBS in the treatment of patients with movement disorders. Neurologist John Roberts, MD, and neurosurgeon Farrokh Farrokhi, MD, have extensive experience treating a range of movement disorders and working with DBS patients.
Deep brain stimulation has dramatically changed the lives of many patients with uncontrollable tremors. Patients often can resume normal activities and get back to active and fulfilling lives. The need for anti-tremor medications is often reduced or eliminated following successful DBS surgery.
How Does Deep Brain Stimulation Work?
To treat a patient with DBS, a neurosurgeon implants a thin, insulated wire lead with electrodes at the tip into the affected area of the brain. A wire running under the skin connects to a battery-operated pulse generator implanted near the collarbone. The generator sends continuous electrical pulses to the brain. The device can be easily turned off when the patient swipes a special magnet over it. DBS patients typically turn off the device at night, as symptoms often stop during sleep.
To ensure the DBS wire is implanted in the best location to obtain improvement of symptoms, the neurosurgeon uses advance imaging techniques to map the brain. The patient remains awake to report responses that will pinpoint the area to be treated. The patient will receive sedation or general anesthesia before the under-skin wire and the pulse generator are implanted.
DBS can be done on one or both sides of the brain, depending on the patient's needs. Most patients with Parkinson's disease will require the procedure on both sides of the brain.
The side effects of DBS are generally mild and reversible. Some patients experience a temporary tingling in the limbs. The sensation of slight paralysis, slurred speech and loss of balance are other possible side effects.
Living with Deep Brain Stimulation
Having DBS can dramatically improve the lives of people with uncontrollable movement and tremors, but follow-up care is necessary.
Battery life of the pulse generator varies, but typically the unit must be replaced about every five years. This can be accomplished under local anesthesia during an outpatient procedure.
While using electrical devices is usually not a problem for the implanted pulse generator, there are general precautions for DBS patients. Screening devices in airports, as well as theft detectors used in stores can cause the pulse generator to switch on or off. While this may only cause an uncomfortable sensation, carrying an identification card with you may help with bypassing those devices.