Deep Brain Stimulation

1 What is a Deep Brain Stimulation?

In deep brain stimulation procedure, electrodes are implanted within specific areas of your brain.

These electrodes are responsible for producing electrical impulses that regulate abnormal impulses. Or, the electrical impulses can affect certain cells and chemicals in the brain.

The quantity of stimulation in deep brain stimulation is controlled by a pacemaker-like device that is placed under the skin of your upper chest. This device is connected to your brain via a wire that travels under your skin.

Deep brain stimulation can be used in the treatment of several neurological conditions, such as:

Deep brain stimulation is also being studied as an experimental treatment or major depression, stroke recovery, addiction, and dementia.

Clinical trials for deep brain stimulation may be at candidate's disposal.

2 Reasons for Procedure

The main reason for deep brain stimulation has been developed is an option for the treatment of certain neurological conditions, such as Parkinson's disease, tremor and dystonia, and recently, obsessive-compulsive disorder.

This treatment is specific for individuals who are not able to control their symptoms with medications.

3 Potential Risks

Deep brain stimulation is generally safe. However, any type of surgery has risks of complication. In addition, deep brain stimulation may cause side effects.

Surgery risks. Deep brain stimulation involves creating small holes in the skull to implant electrodes, and surgery to implant the device that contains the batteries beneath the skin in the chest.

The following complications may accompany surgery:

  • Bleeding in the brain.
  • Stroke.
  • Infection.
  • Nausea.
  • Seizures.
  • Heart problems.
  • Breathing problems.
  • Possible side effects after surgery.

The possible side effect that might occur following deep brain stimulation include:

  • Seizure.
  • Infection.
  • Headache.
  • Confusion.
  • Stroke.
  • Hardware complications, such as an eroded lead wire.
  • Temporary pain and swelling at the site of the implantation.

A few weeks after surgery, the device will be turned on and the process of finding the best settings for you begins.

Some settings can lead to side effects, but these often improve with further adjustments of your device.

Possible side effects of stimulation:

  • Numbness or tingling sensations.
  • Muscle tightness of the face or arm.
  • Speech complications.
  • Balance problems.
  • Lightheadedness.
  • Unwanted mood changes, such as mania and depression.

4 Preparing for your Procedure

In preparing for your deep brain stimulation, you must follow your doctor’s orders. This can include:

First, weigh the pros and cons. Deep brain stimulation is a serious procedure that carries its own risks.

Even if you might be eligible for deep brain stimulation, you and your doctor must thoroughly compare the risks and potential benefits of the procedure.

Next, preparing for surgery. Prior to surgery, you will need some tests to make sure that deep brain stimulation is safe and appropriate for you.

You will also need brain-imaging studies, such as an MRI, before the surgery, to map the areas of your brain to implant the electrodes.

5 What to Expect

Read on to learn more about what to expect before, during, and after your deep brain stimulation.

This a general method of how surgery for deep brain stimulation works:

Brain surgery. For the brain surgery fraction, your health care team fits you with a special head frame to keep your head still during the procedure (stereotactic head frame).

Then, the make use of magnetic resonance imaging (MRI) to map your brain and identify an area in your brain where they will be able to implant the electrodes.

You will be given local anesthesia to numb your scalp before the surgery commences. You will not, however, need an anesthetic in your brain itself, as the brain has no pain receptors.

Your surgeon will implant a thin lead wire with a number of contacts (electrodes) at the tips within a particular area of your brain. Or, one lead is implanted into each side of your brain (for a total of two leads).

A wire runs underneath your skin to a pulse generator (neurostimulator) implanted near your collarbone.

In the majority of cases, you will remain awake and alert during the whole procedure to make sure that the appropriate areas of your brain are being stimulated.

Your responses help your health care team place the lead in the correct location while minimizing the side effects.

During surgery, both the neurologist and surgeon will carefully track your brain to ensure correct electrode placement.

Chest wall surgery. During the second fraction of the procedure, which can occur on the same day or at a later time, the surgeon implants the part of the device which contains the batteries (pulse generator) under the skin in your chest, near the collarbone.

General anesthesia will be used during this portion of the procedure. Wires from the brain electrodes are placed under your skin and guided down to the battery-operated pulse generator.

This generator is programmed to send a continuous array of electrical impulses to your brain. You control the generator, and you turn it on or off by using a special remote control.

After the procedure. The pulse generator will be activated in the doctor's office a few weeks after surgery. Your doctor can easily program the pulse generator from outside your body by using a special remote control.

The amount of stimulation is customized to your condition. Stimulation may be constant, 24 hours a day, or your doctor may advise you to turn your pulse generator off at night and back on in the morning, depending on your condition.

You can turn stimulation on and off with a special remote control that you will be able to take home with you. In some case, your doctor may program the pulse generator to let you make minor adjustments a home.

The battery life of your generator varies with the usage and settings. The batteries can be replaced, if necessary, by a doctor during an outpatient procedure.

6 Procedure Results

If you do not understand your deep brain stimulation results, consult with your doctor.

Deep brain stimulation will not provide a cure for your condition, it will, however, help reduce your symptoms.

If deep brain stimulation works effectively, your symptoms will significantly improve, but they usually do not completely disappear.

In certain cases, medications may still be required for particular conditions. Deep brain stimulation will not be successful for every individual who tries it.

There are a number of variables involved in the success of deep brain stimulation.

It is important to talk with your doctor prior to surgery about what type of improvement you can expect for your condition.

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