Deep Brain Stimulation Surgery (DBS)
Deep Brain Stimulation (DBS) is a surgical procedure used to treat a variety of disabling neurological symptoms—most commonly the debilitating symptoms of Parkinson’s disease (PD), such as tremor, rigidity, stiffness, slowed movement, and walking problems. The procedure is also used to treat essential tremor, a common neurological movement disorder. DBS does not damage healthy brain tissue by destroying nerve cells. Instead the procedure blocks electrical signals from targeted areas in the brain.
At present, the procedure is used only for patients whose symptoms cannot be adequately controlled with medications. Deep Brain Stimulation (DBS) uses a surgically implanted, battery-operated medical device called a neurostimulator similar to a heart pacemaker and approximately the size of a stopwatch—to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms. DBS is often described as a brain “pacemaker” because constant pulses of electrical charge are delivered at settings that are thought to restore normal brain rhythms, allowing the restoration of more normal movements.
Before the procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) scanning to identify and locate the exact target within the brain where electrical nerve signals generate the PD symptoms.Some surgeons may use microelectrode recording also to identify the precise brain target that will be stimulated.
Although most patients still need to take medication after undergoing DBS, many patients experience considerable reduction of their PD symptoms and are able to greatly reduce their medications. The amount of reduction varies from patient to patient but can be considerably reduced in most patients.
Candidates for DBS
DBS is a surgical option that is known to improve quality of life for movement disorder patients, so when one’s quality of life is dramatically affected by the disease or by medication side effects, it’s time to consider DBS. Following are the conditons where Deep Brain Stimulation Surgery can be performed:
Parkinson Disease: DBS surgery offers important symptomatic relief in patients with moderate disability from Parkinson's disease who still retain some benefit from antiparkinsonian medications and who are cognitively intact. Patients who fluctuate between "ON” and “OFF” medication states are usually good surgical candidates, as are those who have troublesome dyskinesias.
Dystonia: DBS surgery does not cure dystonia but can decrease the abnormal movements and postures of dystonia. The degree of benefit appears to vary with both the type of dystonia and the duration of the symptoms. Adolescents and young adults with inherited forms of primary dystonia appear to get very significant benefit. For patients with secondary dystonia due to stroke or head trauma, the benefit may be mild. Adults who have had dystonia for many years probably have less improvement than those with more recent onset of symptoms.
Essential Tremor: DBS is a highly effective therapy for patients with essential tremor, often resulting in an 80% decrease in tremor that lasts for several years. Patients with a tremor secondary to stroke, traumatic brain injury or multiple sclerosis are less likely to benefit from DBS.
Is Age a Factor in Deep Brain Stimulation?
Deep brain stimulation has been successful in treating people of different ages. However, each person should be assessed individually as to their stamina and overall health before considering surgery.
What Should I Expect After Deep Brain Stimulation?
You may feel tired and sore but will be given medication and kept comfortable after your deep brain stimulation procedure. The average hospital stay for deep brain stimulation surgery is 24 to 48 hours.
Dr Arun Saroha
Dr Arun Saroha is one of the best brain and spine surgeons in India. He has more than 15 years of experience of working at hospitals like Vimhans, Paras, Artemis and Max. He specializes in brain and spinal tumours, spinal instrumentation, decompression, fusion and fixation surgeries. He is presently associated with GNH Hospital and Max Hospital, Delhi and Gurgaon
Dr Vikas Kathuria
Dr Vikas Kathuria specialized in Neurosurgery from PGI Rohtak and has been doing all kinds of complex Brain Tumour and Spine Surgeries. He is Consultant Neurosurgeon at GNH Hospital Gurgaon and Max Hospital Gurgaon. He also specializes in all kinds of Head Injuries and management of critically injured patients.