Deep Brain Stimulation (DBS) Surgery

Deep brain stimulation (DBS) surgery is a surgical procedure used to treat neurological conditions by implanting one or more electrodes in the brain. DBS Surgery uses the process of electrical stimulation to treat movement disorders associated with certain neurological conditions. A device is placed under the patient’s chest to monitor this electrical stimulation. Some of the conditions treated by this DBS procedure are as follows:

. Parkinson’s disease

. Dystonia

. Essential tremor

. Epilepsy

. Obsessive-compulsive disorder

How is the Deep Brain Stimulation (DBS) surgery performed?

First, a special head frame called a stereotactic head frame is fitted on the patient’s head to keep the head still for the procedure. An MRI or CT Scan determines the appropriate brain targets where the electrodes need to be implanted. A local anesthetic is used to numb the scalp. The surgery is performed while the patient is awake. In certain cases, general anesthesia can also be given. A wire runs under the skin to connect to the pulse generator placed in the chest. General Anaesthesia is used for the second part of the surgery. The surgeon places the pulse generator under the skin of the chest near the collarbone. The wires from the implanted electrodes are guided down to the pulse generator. The pulse generator is battery-operated and is controlled using a special remote.

Preparation for Deep Brain Stimulation Surgery

. Preoperative evaluation: The patient should inform the doctor about their past and current medications and the dosage and frequency of these medications. Any current vitamin or supplement intake should also be reported.

. Diet: The patient should not eat or drink anything after midnight the night before the surgery.

. Medications like Aspirin, Ibuprofen, Advil, and others should be discontinued seven days before the surgery.

. Medications taken currently to treat the existing neurological condition, such as Parkinson’s or dystonia, should also not be consumed after midnight before the surgery.

. The patient needs to be admitted to the hospital a day before the surgery.

Follow-Up after DBS Surgery

After the DBS surgery, the patient is typically discharged within one or two days. Before discharge, a set of instructions are provided to the patient for post-operative care at home. The patient must visit the hospital for a follow-up approximately 10 days after surgery. The staple/suture removal procedure takes place on this day. An initial programming appointment is also scheduled for the patient after 2-3 weeks of the surgery. At this appointment, the electrical stimulation is turned on. The patient is provided with a list of necessary instructions to help speed up the recovery process and avoid any risk of complications.

Risks Factor of Deep Brain Stimulation Surgery

Deep brain stimulation surgery is generally a low-risk surgical procedure. However, some complications can occur from person to person. Risks of the surgery may include:

. Nausea

. Trouble breathing

. Infection

. Stroke

. Leaks in sutures

. Brain bleeding

. Heart problems

. Seizure attacks

. Pain and swelling at the implanted site

. Difficulty in concentration

. Confusion

. Dizziness

. Complications with the implanted wire such as erosion

. Problems balancing

. Occurrence of double vision

. Problems with speech

. Tingling sensations

Recovery From DBS Surgery

Full recovery after the Deep Brain Stimulation (DBS) surgery can take at least two weeks and up to two months. The patient is advised to keep all wounds clean and dry for the first two days after surgery. The patient should not lift any weight heavier than 20 lbs for the first four to six weeks after surgery. No strenuous activity should be performed for about two weeks. The patient should avoid swimming or hot baths for up to two months after surgery. Driving is not permitted for a minimum of two weeks. Hair coloring and perming solutions are strictly prohibited for six weeks following surgery. If the patient experiences any alarming complications during the recovery period, they should immediately report to the doctor.

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