What to expect during deep brain stimulation surgery

What to Expect During Deep Brain Stimulation Surgery

TBS Surgery: A Two-Stage Process

Deep Brain Stimulation (DBS) surgery is typically completed in two separate stages. Here’s a comprehensive look at what you can expect during this procedure.

Phase One: DBS Lead Placement

During the first phase of the surgery, patients with Parkinson's disease are usually asked not to take their Parkinson's medications. Upon arrival in the operating room, a head frame is positioned onto your head. You will then undergo a CT scan while sedated. A small dime-size opening will be made to access the brain, depending on your medical condition and safety requirements.

Listening to Brain Cells

The surgeon places testing electrodes in the brain to listen to your brain cells. Nerve cells sound different in varying parts of the brain, which helps the surgeon determine the best location to place the lead.

Here is an example of what these sounds may resemble:

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The surgery lasts about four to six hours, and you'll be awake for much of it to ensure your brain cells remain active. Don’t worry; your brain lacks nerve endings that feel pain. However, remaining still and attached to a head frame for this duration may be uncomfortable. During the procedure, you will be asked to move various parts of your body and respond to stimuli, including feeling numbness or muscle pulling. This is normal and temporary.

After this phase, you’ll be moved to a post-surgery recovery area and closely monitored in a hospital room overnight. If everything progresses without complications, you will go home the following day.

Phase Two: System Connection

About a week after your first surgery, the second phase is conducted. You can continue to take medications for Parkinson's disease, tremor, or dystonia as usual.

Surgical Procedure

During this phase, the surgeon makes a small incision behind your ear and creates a pathway under the skin of your neck to another small incision in your chest. An extension wire is placed from the electrode in your head to the battery in your chest. Once everything is connected, the system is tested, and the incision is closed with dissolvable sutures. The DBS system will not be turned on immediately but will be activated several weeks later.

This surgery lasts about 90 minutes, during which you will be sedated. You can expect to go home the same day, experiencing tenderness or stiffness that should subside within a few days. Prescription pain medication will be provided if needed.

Potential Risks and Complications

As with any surgery, DBS surgery comes with associated risks, including:

• Bleeding in the brain
• Seizures
• Infections
• Incorrect lead placement
• Lead movement or breakage

Serious adverse events are rare, occurring in about 1-2% per lead, but it’s crucial to be aware. In extremely rare cases, death has been reported. Other possible risks include worsening of cognitive, mood, balance, or speech problems, as well as issues with DBS system parts. Expectation management is key as symptoms may not always be alleviated to the degree anticipated.

Always discuss with your surgeon any potential risks and their personal experiences.

Keyword

• DBS Surgery
• Parkinson's disease
• Phase One
• Lead Placement
• CT scan
• Brain Cells
• Test Stimulation
• Phase Two
• Extension Wire
• Post-surgery Recovery

FAQ

Q: What should I expect when preparing for Phase One of DBS surgery? A: You may be asked to refrain from taking Parkinson's medications and will undergo various preparatory steps, including positioning a head frame and getting a CT scan.

Q: Is the surgery painful? A: While you will be awake during much of the surgery, the brain itself does not have pain-sensitive nerve endings. You may feel some discomfort from being in the head frame and from test stimulations.

Q: What are the main risks associated with DBS surgery? A: Potential risks include bleeding in the brain, seizures, infections, incorrect lead placement, lead movement, and very rare cases of death. Discuss these with your surgeon for detailed insights.

Q: How long does each phase of DBS surgery take? A: Phase one lasts about four to six hours, while phase two requires around 90 minutes.

Q: When will the DBS system be activated? A: The DBS system is typically turned on several weeks after the second phase of surgery.

Q: Will I need pain medication post-surgery? A: You might experience tenderness or stiffness and can be prescribed pain medication as needed.

By knowing the stages, risks, and what to expect after the surgery, you are better prepared for your DBS surgical journey. Consult your surgeon for more personalized information.