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Deep Brain Stimulation​

What is Deep Brain Stimulation​ ?

Deep brain stimulation is a surgical process of implanting one or more electrodes in specific regions in the brain to deliver continuous high-frequency electrical impulses to the brain. These electrodes produce impulses which regulate abnormal impulses. The strength of the stimulation, length of each pulse and the number of the pulses per second may be adjusted to individualize the stimulation so that you achieve best results possible. Each electrode is attached to an extension wire that runs under the skin behind the ear and down the neck to an implantable pulse generator (IPG/ pacemaker) which is usually placed under the skin of the upper chest.

Deep brain stimulation is indicated for Parkinson's disease, OCD, and Dystonia. It is performed while you are awake, reducing the risk of damaging critical brain areas that control speech and other skills.

DBS for Parkinson's disease

Before the procedure, neuro-navigation MRI protocol is done and the same is used to identify the concerned area of the brain to be stimulated.

You would be given local anesthetic on the scalp and thereafter a stereotactic frame is placed on a skull. You would then go to the CT scanner with the doctor with a frame being in place. From there you would be shifted to OT for the procedure.

What symptoms of PD are treated through DBS

  • DBS helps to improve the motor symptoms of PD such as Tremors, rigidity, and bradykinesia.
  • DBS also helps to relive the motor complications of the PD, often related to medications: Dyskinesia, Dystonia and “On/Off” fluctuations
  • DBS will also help in non-motor functions such as Mood, energy level and the general sense of well-being.

Are you a candidate for DBS? Yes if you have:-

  • Had PD for at least 5 years
  • “On /off” fluctuations, with or without dyskinesia
  • Good response to levodopa (though the duration of response is insufficient)
  • Tried various PD medications –without beneficial results.
  • PD symptoms that interfere with daily activities.


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Course In Hospital

Previous to getting admitted into a hospital, you would undergo several investigations on OPD basis. You would require prolonged neurological monitoring. This help to distinguish between Parkinson's disease and Parkinsonism.

Day 1

Your surgery shall be planned. You and/ or your relative has explained the procedure in detail and consent is undertaken. Pre-anaesthesia checkup (PAC) is done. The intravenous line (IV) is given to provide fluids. You are shifted to OT for a procedure. You are given anesthesia before surgery. You medications for PD would be withheld one night before the procedure. Post-procedure, you will be moved to the normal room.

Day 2

Pre-anaesthesia checkup (PAC) is done. The intravenous line (IV) is given to provide fluids. You are given local anesthesia. The frame is placed in the morning and you are taken to CT scanner. Once CT scan is over, you would be shifted to Operation theatre for the procedure. You are sedated for the first part of the procedure and thereafter you would be awake during the whole procedure. Once the procedure is over you would be sedated again to close the scalp and incision. Post-procedure, you will be moved to Post Anaesthesia Care Unit (PACU) and once fully awake, you will be moved to the normal hospital room. Here you medications for PD would be immediately resumed.

Day 3

You are monitored for any seizures or a headache and shall be given appropriate medication including pain relievers. Discharge process is undertaken. You will be explained about the discharge medication and follow up. You will be discharged in stable condition.

Follow up

In the follow-up process, your stimulator would be programmed multiple times over next few visits to individualize it as per your condition. During these visits, your PD medications would also be adjusted.

The Life expectancy of the stimulator battery varies with the output settings; however, it ranges between 5-8 years. The same can be checked by the patient using the handheld device or same can be done at Neurologist’s office.

You should see improvements in your symptoms after programming has started. Some would appreciate the improvement immediately while for others it may take over 3-4 weeks to appreciate the same. It often requires about 3-6 months to before a comfortable balance is reached and a patient does not need much of follow up appointments. You may return to normal activities within 3-6 days after the surgery.

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