Steady Hands Devoted to Helping You Find Relief
Your brain is one of the most important and interconnected parts of your body. So, it only makes sense to find a care team with renowned expertise in a variety of specialties — all working together to help you regain control of your body and your life.
Within the AdventHealth Neuroscience Institute network, our trusted physicians and specialists in deep brain stimulation are ready to help you or a loved one regain control and feel like yourself again.
What to Know About Deep Brain Stimulation
Your nervous system (which includes your brain and spinal cord) allows you to feel, communicate and move around. But in some instances, it may become impaired through injury, infection or from medication side effects. Severe impairment can lead to movement disorders that cause uncontrolled physical movements or tics. Medication can be helpful, but sometimes, it’s not enough. That’s where deep brain stimulation, or DBS, can make a big difference. Learn more about this procedure and the different types.
- Deep Brain Stimulation 101
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Deep brain stimulation is a surgical procedure that uses advanced technology, carefully implanted under your skin near your chest, to help you regain movement control. In this procedure, your surgeon will gently enter your skull and insert electrodes that send electrical impulses throughout your body. These impulses affect your abnormal nerves and help improve your movement.
The pacemaker-like device implanted near your chest controls the electrodes and is programmed by your surgeon. Deep brain stimulation has proven so effective that many people who undergo the procedure to improve their movement can reduce their medication dose — or eliminate it — with their care team’s guidance.
Deep brain stimulation is a highly effective and advanced procedure that involves an expertly trained group of providers across many specialties. Your care team will consist of a neurologist, neurosurgeon, physical therapist, speech-language pathologist and a social worker who can help tend to your unique needs.
- Types of Deep Brain Stimulation
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Unlike many surgical procedures where you’d be under anesthesia, brain surgery can be especially effective if you are awake for some of it. Your neurologists and neurosurgeons will recommend “asleep” or “awake” deep brain stimulation, based on your unique needs.
“Asleep” Deep Brain Stimulation
While you’re under general anesthesia, your surgeon will use imaging techniques like computerized tomography (CT) or magnetic resonance imaging (MRI) as a guide to insert electrodes into your brain. This type of procedure may be an option if you have symptoms that are controlled only by medication, or if you’re anxious about being awake during surgery.
“Awake” Deep Brain Stimulation
In some cases, you benefit most when you’re awake for the procedure. Images from a computerized tomography (CT) scan guide your surgeon inside your skull. A specialist will administer anesthesia to ensure you’re comfortable and don’t feel anything but are alert enough to answer questions. This interaction helps your surgeon identify where to place the electrodes.
Conditions We Treat Through Deep Brain Stimulation
Deep brain stimulation helps treat a variety of movement disorders, including dystonia, essential tremor and Parkinson’s disease. In addition to helping with movement control, deep brain stimulation can also help treat addiction, depression, stroke and traumatic brain injury.
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Dystonia
Dystonia can cause muscle contractions and twisting or repeated movements in the neck or hands. Deep brain stimulation can help you find relief, but it may not be immediate.
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Essential Tremor
Deep brain stimulation can help relieve the shaking movements that essential tremor can cause in the hands, head and voice.
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Parkinson’s Disease
If you have Parkinson’s, deep brain stimulation can improve movement control and speed, easing the shakiness and stiffness that this condition can cause.
How DBS Helps Relieve Movement Disorder Symptoms
We know how physically and emotionally challenging it can feel to live with tremors and other movement-related challenges. Explore how we can use deep brain stimulation as part of your treatment plan for dystonia, essential tremor or Parkinson’s disease to help you find relief.
- Deep Brain Stimulation for Dystonia
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This is a condition that makes your muscles contract, twist or repeat movements throughout your body, often affecting your neck or hand control. Dystonia can be mistaken for a seizure, but there is no loss of consciousness.
If you’re living with dystonia and the uncomfortable muscle contractions associated with the condition, deep brain stimulation may be an effective therapy option for you. While it’s difficult to predict who will benefit and to what degree, deep brain stimulation may help with dystonia when:
- Medications and other treatments aren’t providing you with adequate relief
- Symptoms are negatively affecting your quality of life
Your body’s response to deep brain stimulation for dystonia may take longer than for Parkinson’s disease and essential tremor, potentially six months to a year.
- Deep Brain Stimulation for Essential Tremor
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A genetic mutation is usually the cause of essential tremor. It happens when your nervous system loses proper control over your body, causing you to shake. If you’re diagnosed with essential tremor and experience tremors of the hands, head or voice, deep brain stimulation therapy is a treatment option you can consider at any time.
Deep brain stimulation has been used for over 20 years in the treatment of essential tremor. It is considered an effective treatment option with the potential to improve symptoms even more effectively than the best medical therapy.
In fact, with this therapy, most essential tremor patients can stop taking medication. Patients often choose deep brain stimulation for essential tremor when:
- Medications are not adequately controlling symptoms
- Medications may be causing significant side effects
- Other treatments are not effective
- The tremor is impacting your quality of life and daily activities
- Deep Brain Stimulation for Parkinson’s Disease
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Parkinson’s disease can cause shakiness or stiffness, among other symptoms. Over time, this disease tends to become more severe and can progress to difficulty walking and speaking. If you’re seeking deep brain stimulation for Parkinson’s disease, it’s important to understand what symptoms it can treat and what symptoms it won’t improve.
Deep brain stimulation can address the motor symptoms associated with Parkinson’s disease, including:
- Bradykinesia (slowness)
- Dyskinesia (involuntary movements)
- Dystonia (involuntary spasms)
- Rigidity (stiffness)
- Tremor (shakiness)
Deep brain stimulation can provide the best “on” time that you experience with your medications for Parkinson’s disease, and a smoother therapy over time that reduces motor fluctuations between “off” and “on” periods throughout the day.
It can also benefit patients with medication-induced dyskinesia (involuntary movements), as well as with medication-refractory tremor, rigidity and slowed movements. Many patients who cannot tolerate higher doses of medication due to side effects may benefit from deep brain stimulation.
In addition, if your doctor has recommended higher doses of medication, but you cannot tolerate higher doses due to side effects (such as sedation or lightheadedness), you may benefit from this treatment.
Deep brain stimulation does not benefit non-motor symptoms of Parkinson’s disease, including:
- Constipation
- Mood
- Memory
- Sleep difficulties
- Urinary symptoms
If you don’t experience any benefits from your Parkinson’s medication, deep brain stimulation may not be helpful for you. However, you should be evaluated by a movement disorder neurologist to determine if you’re receiving the correct medications at enough doses.
After deep brain stimulation surgery, most people will continue taking their medications for Parkinson’s disease. However, with ongoing programming, the amount of medication can likely be reduced.
Request a Consultation With a Specialist
Whether you’re experiencing new symptoms or were recently diagnosed, the compassionate neurological care you need is close to home. Request a visit with one of our experienced specialists to begin a personalized treatment plan that supports your whole health.
Performing Surgery for the Entertainer
A professional ventriloquist, Mark Wade relied on his voice tricks and puppet control to make people laugh. When his movement disorder started to interfere with his performance, Mark sought our help.
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Your healing is our whole focus. From clinical trials that develop new treatments to leading-edge technologies that mean a smoother recovery, we’re dedicated to raising the bar for neurological care with your whole health in mind. Explore how we’ll support you and your loved ones with the most advanced care and the utmost compassion.
Resources
From support groups and educational guides to caregiver support, financial assistance and more, we offer a range of resources to help you and your loved ones better understand and manage your condition.
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Innovative care starts with medical research. See how we’re developing new treatments and procedures, leading concussion and brain injury-related studies, conducting clinical trials for stroke care and more.
Technology
Explore how we use robotic technologies, precise therapies and leading-edge techniques to care for epilepsy, eliminate masses with less pain, treat brain tumors in a matter of hours and much more.
Answering Your Questions About Deep Brain Stimulation
If deep brain stimulation is the next best step in your care plan, we want you to feel as informed, comfortable and confident as possible. Explore our answers to these frequently asked questions about DBS, and rest assured that your care team will sit down with you to fully answer all your questions in depth before and after your surgery.
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Q:Question: What are the risks and possible side effects of deep brain stimulation surgery?
A:Answer:The potential risks and side effects of deep brain stimulation surgery can include:
- Allergic reactions to implanted materials
- Balance difficulties
- Behavioral changes
- Bleeding, tissue swelling and infection at the surgery site (rare side effects)
- Changes in mood, memory or cognition, including temporary confusion
- Headaches
- Numbness, dizziness or tingling sensations (often temporary)
- Seizures
- Temporary pain after surgery
- Trouble talking
Always call 911 right away if you or a loved one experiences a seizure after deep brain stimulation surgery. For any non-life-threatening side effects, talk with your surgeon about adjusting the settings of the deep brain stimulation hardware.
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Q:Question: What should I expect during recovery, programming and follow-up after DBS surgery?
A:Answer:Immediately after deep brain stimulation surgery, you’ll likely stay in the hospital for several days. As you continue recovering in the weeks following surgery, you’ll be scheduled for programming visits, in which your care team will activate the implanted device and adjust the stimulation settings to best manage your symptoms. This initial programming typically takes several appointments as your care team finds the best settings for you.
Continue ReadingCollapse AnswerOngoing programming appointments and follow-up care after deep brain stimulation will vary depending on your unique symptoms, side effects and treatment goals and how they change over time. Expect ongoing follow-up care (monthly, in some cases), as your neurologist and care team will continue to adjust your stimulation settings and medication dosage over time. As you get into a good rhythm with your therapy, you may only need a handful of follow-up visits per year.
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Q:Question: Is DBS done on one side or both sides of the brain, and how do doctors decide?
A:Answer:During deep brain stimulation, electrodes may be placed in specific areas of the brain that control movement on one or both sides of the brain. Surgeons determine whether a unilateral (one side) or bilateral (both sides) approach is best for each patient after weighing many factors, including the:
- Patient’s diagnosis, current symptoms and treatment goals
- Patient’s dominant hand
- Results of pre-surgical brain-mapping imaging scans
- Risk of side effects, like cognitive effects
- Side of the body that’s most affected by movement disorder symptoms
In some cases, surgeons initially target only one side of the brain and may adjust to treat both sides in a follow-up procedure.
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Q:Question: Can DBS be adjusted if I have side effects like speech, balance or mood changes?
A:Answer:Yes, deep brain stimulation devices, hardware and settings can be adjusted to reduce some side effects. Your surgeon can adjust the electrical signals sent by the system (without the need for another procedure), and they can also remove the device’s battery pack to stop treatment right away, if needed. A patient programmer system may also allow you to adjust your treatment yourself, under your surgeon’s guidance.
Continue ReadingCollapse AnswerTalk with your healthcare team about what can and can’t be updated in your unique case and how to best manage your symptoms.
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Q:Question: Will DBS let me reduce my Parkinson’s or tremor medications?
A:Answer:With your surgeon’s guidance, you may be able to lower the dose of your tremor medications after deep brain stimulation, but you’ll likely still need to take them for the long term, as movement disorder symptoms can change with time. For your health and safety, any reductions in your tremor medication must be approved by your surgeon first, so talk with your care team about the best plan for you.
Find Minimally Invasive Brain Surgery Care Near You
Your faster, safer recovery is our whole focus. That’s why our experts across the AdventHealth Neuroscience Institute network use a full array of minimally invasive procedures and techniques for brain surgery whenever possible, helping you heal with less pain and a quicker return to the life you love. Explore your options for care close to home with the guidance of our dedicated team. We’ll help you find the right fit, so you’re in the best setting to get the care you need.
