Deep Brain Stimulation

If you have epilepsy-related seizures or a movement disorder, such as Parkinson’s disease or essential tremor, you may want to discuss a deep brain stimulation (DBS) system with your doctor. This approach places a series of electrodes in the parts of the brain that control movement. The electrodes emit electric pulses that can help control drug-resistant seizures and unwanted actions.

How DBS Works

A DBS system consists of three implantable parts:

• Pulse-generation device – This battery-powered, pacemaker-like device creates electrical pulses. It’s about the size of a stopwatch and is placed under the skin in your chest.
• Connecting wire – This electrode-containing wire connects the pulse-generation device to the neurostimulator. It’s placed under the skin and runs from the top of the head, behind the ear, down the side of the neck and to the chest.
• Neurostimulator – This wire with electrodes delivers the electric pulses to the brain. It’s implanted in the brain through a small hole in the skull and is attached to the connecting wire.

Doctors typically perform a DBS system implant procedure in two phases:

• Phase 1 – The doctor places the neurostimulator (electrodes) in your brain.
• Phase 2 – The doctor implants the pulse-generating device in your chest and the connecting wire underneath your skin, creating the connection between the pulse-generating device and the electrodes in your brain.

After the device has been implanted, your doctor will program it to generate electrical pulses at intervals specific to your condition.

Benefits

The DBS system’s benefits vary by condition:

• Epilepsy – In 2018, the FDA approved DBS for epilepsy based on a trial study in which patients’ median seizure frequency reduced by 75% after seven years.
• Parkinson’s disease – Research shows that 70% of Parkinson’s patients with DBS report improvement in slowness, tremor and rigidity. DBS also shows better results than medications for long-term Parkinson’s management, which means most patients can reduce their medications.
• Essential tremor – According to research, 80% of patients with DBS show an improvement in tremor and 70% experience improvement in handwriting.

Many people with a DBS system also report:

• Better sleep.
• More involvement in physical activity.
• Improved quality of life.

Side Effects

Complications from DBS are rare but do happen.

Possible surgery complications include:

• Bleeding
• Infection
• Blood clots
• Reactions to anesthesia

Possible DBS system complications include:

• Seizures
• Infection
• Small chance of bleeding in the brain.