Deep Brain Stimulation (DBS)

Deep brain stimulation surgery is a three-part procedure: Installation, activation, and programming. It’s typically completed over a month to six weeks. DBS installation involves two procedures:

• You’ll be admitted to the hospital to have electrodes implanted in your brain. You won’t feel any pain, but you’ll be awake and alert for most of the procedure so neurosurgeons and neurologists can ask you questions and monitor your reactions. You’ll recover in the hospital for a few days under the supervision of your care team.
• About a week later, you’ll have an outpatient procedure to place the stimulator behind your collarbone or in your chest or abdomen. You’ll get full anesthesia for this surgery and you’ll go home the same day.

After these procedures, you’ll have another visit where the neurologist will program your device. Most patients notice improvement in motor symptoms within a few months. As your condition changes over time, your neurologist will reprogram your device to effectively manage symptoms.

Medication is the first line of treatment for movement disorders. Your care team will guide you through a thorough trial of medications and extensive follow-up before recommending surgery. Prior neurosurgeries such as pallidotomy or thalamotomy do not exclude you as a candidate for DBS. In fact, if you benefited from these procedures, you’re likely to have success with DBS as well.

MedStar Health offers DBS for certain movement disorders.

Parkinson's disease & dyskinesias

DBS can help minimize the tremors, slow movements, stiffness or rigidity of Parkinson’s disease and the involuntary, uncontrolled spasms of dyskinesia. But some Parkinson's symptoms are not treated by DBS, including cognitive problems, speech and swallowing difficulties, and imbalance. And difficulty walking may have a variable response to DBS. Patients with dementia are not eligible for DBS.

You might benefit from DBS if you've seen at least some improvement with medication, such as carbidopa-levodopa. You'll likely still need to take medication at a lower dose after DBS surgery.

Dystonia

Dystonia is involuntary muscle contractions that cause abnormal posture, repetitive movements, or twisting. DBS has been shown to reduce the severity of symptoms and the level of disability symptoms cause.

Essential tremor

DBS targeting the thalamus can improve the involuntary movement of the arms, hands, and head that is associated with essential tremor. It's a viable option if medicine is no longer effective or not tolerated.