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Deep Brain Stimulation Surgery

What Is Deep Brain Stimulation?

Deep brain stimulation (DBS) is a surgical treatment administered to improve quality of life in patients with

  • movement disorders such as Parkinson’s disease
  • chronic pain including conditions such migraines that are not alleviated by non-surgical treatments, and
  • obsessive-compulsive disorders.

DBS surgery is performed by inserting a device called a neurostimulator to target specific brain areas. The revolutionary device delivers tiny electrical signals to the neurocircuitry of the brain that is associated with the condition.

Deep Brain Stimulation was approved by the US Food and Drug Administration (FDA) in 1997. Since then, numerous patients worldwide have had a DBS implant surgery.

There is great success for patients that are unable to control their symptoms through medication and are candidates for DBS implantation. On average, 66% of patients reported a marked improvement in symptoms – allowing for an enhanced quality of life. Even more encouraging, patients with tremor can expect approximately 90% improvement, and those with Parkinson’s Disease can see up to 80% improvement. The reduction in symptoms also allowed some patients to reduce their medications.

When patients aren’t doing well-enough on current treatments, they should be re-evaluated for treatment with DBS.

What Conditions Does Deep Brain Stimulation Treat?

Patients that have been helped by DBS treatments include those with:

Chronic Pain including conditions such migraines that are not alleviated by non-surgical treatments

Obsessive-Compulsive Disorders that are not improved my pharmacologic measures or other conservative measures

Movement Disorders:

  • Parkinson’s disease with unacceptable medication side effects
  • Medication-resistant Essential Tremor
  • Dystonia resistant to medication, or unmanageable with Botox or requiring multiple injections
  • Disabling tremor, rigidity, akinesia or bradykinesia not helped by medications

What Happens During Deep Brain Stimulation Surgery at NSPC?

Deep brain stimulation (DBS) leads can be placed on one side or both sides of the brain. A battery is placed within the chest wall pocket on one or both sides of the chest, depending on the location of the leads.

Surgery is typically performed in stages:

  • During the first stage, which is performed under local anesthesia, the neurosurgeon places the electrodes in the brain.
  • About one week later, under general anesthesia, the electrodes are tunneled and the batteries are implanted. The patient is partially awake, so that certain activities can be performed and the reduction in symptoms can be observed. The patient does not feel any pain.
  • A few weeks after surgery, patients return to the doctor so that the stimulator can be turned on and the amount of stimulation can be properly adjusted, as needed. This is an easy process referred to as programming.

For this very specific type of functional neurosurgery, it is best to work with a physician that has in-depth experience in movement disorders and DBS implantation. Dr. Snyder is one of a handful physicians on Long Island that performs deep brain stimulation surgery. To date, he has conducted this surgery on over 150 patients in both his Long Island and Toronto practices.

What To Consider Before Surgery

•Has the disease or symptom progression become debilitating and is it interfering with quality of life, including daily functioning and activities?
•Have you and your physician discussed all potential, non-surgical, therapeutic treatment options?
•What do you need to consider for preparatory or post-surgery care needs?
•Is there a location that will make pre/post and day-of surgery convenient for you and your caregivers?

When you meet with the neurosurgical team, ask additional questions, such as:

•Are you a surgical candidate?
•What are the potential benefits and risks of a surgery?
•What will specifically happen during the procedure?

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