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Types of DBS

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UW Health neurologists and neurosurgeons in Madison, Wisconsin, offer deep brain stimulation (DBS) to adults and children as young as seven years of age. This procedure is offered as a treatment for selected patients with Parkinson’s disease, essential tremor and dystonia.
 
During the DBS procedure surgeons, neurologists, neurophysiologists, electroneurodiagnostic specialists and nurses work together to implant a DBS lead (electrode) which contains four electrical contacts into target areas in the brain. The lead from the electrodes is connected to an impulse generator located beneath the skin near the chest, which then delivers electrical impulses to target areas of the brain. The entire system is beneath the skin and not exposed.
 
Advantages of Deep Brain Stimulation (DBS)
  • General:
    • Proven as more effective and safer than ablative (during which tissue is removed) surgical procedures
    • Long-term complications are fewer than with traditional surgery because traditional surgery involves destroying small parts of the brain, while DBS does not
    • Stimulator is adjusted to the needs of patient
    • DBS is reversible, leaving open the option of future alternative surgical approaches
  • For Parkinson's disease:
    • Often more effective than best medical therapy
    • Often succeeds when all manner of pharmacological interventions have failed
    • Increased "on time" (the number of hours without involuntary movement)
    • Very effective in relieving involuntary movements (dyskinesia) that often occur with medications
    • Most patients are able to significantly reduce their medications, often reducing or eliminating medication-related side effects
  • For essential tremor:
    • Often succeeds when medications fail
    • Many patients experience upwards of 80 percent reduction in tremor
  • For dystonia:
    • Often effective for a wide range of dystonias when medications not very effective
    • In children, early DBS or EMCS can help prevent many of the skeletal, emotional or psychological complications of dystonia

Risks of Deep Brain Stimulation (DBS)

 

There is a 2-3 percent chance of a significant and/or long-term complication due to the DBS surgery. These include bleeding in the brain and infection. Patients with implanted DBS systems do have to exercise caution when potentially exposed to strong electromagnetic fields.

 

Deep Brain Stimulation (DBS) Candidates

 

The selection process for candidates is complex. Patients with a movement disorder who have not achieved a satisfactory control of symptoms should consult with a movement disorders neurologist.