Deep Brain Stimulation: Treatment, Procedure, Cost and Side Effects

DBS

Deep brain stimulation refers to implanting electrodes in certain areas of the brain. Abnormal impulses of the brain are regulated due to the electrical impulses produced by these electrodes. These impulses affect the chemicals and certain cells within the brain. A pacemaker is used for deep brain stimulation. The pacemaker is placed in the upper chest, under the skin. There is a wire that travels under the skin and it connects the pacemaker to the brain. This treatment is used to treat many neurological conditions such as Obsessive compulsive disorder (OCD), chronic pain, Tourette syndrome, epilepsy, Dystonia, Parkinson’s disease and essential tremor. Many doctors and researchers believe that deep brain stimulation can also cure dementia, addiction, stroke recovery and depression.

Deep brain stimulation is ideal for people who cannot control their mental health condition even with the help of medications. The device used in Deep brain stimulation contains three components which are an extension, the lead and the pulse generator. The battery powered neurostimulator is kept in a titanium housing which sends signals to the brain that interferes with neurological activity. This treatment has been very effective in controlling the symptoms of Parkinson’s, OCD, Tourette syndrome and chronic pain.

Deep brain stimulation starts with the brain surgery, the doctor first fits your head in a head frame, so that your head does not move during the procedure. Then, a MRI (Magnetic resonance imaging) takes place to identify and map the area of your brain where the electrodes will be placed. Local anesthesia will be given to you so that your scalp area is numb. The brain however does not contain any pain receptors, so your brain won’t need any anesthesia. The surgeon then implants a very thin wire which contains electrodes at the tip. This is placed on the specific area of the brain, one lead is placed on each side of your brain. The wire then runs under the skin into a neurostimulator (pulse generator) placed near the collarbone. During the procedure, the surgeon and the neurologist monitor the brain to ensure if the electrode has been placed in the correct area or not.

The second part of the surgery can occur at the same time after the brain surgery or some other day. After the electrodes are placed in the brain, the surgeon places the other part of the device which contains the pulse generator (batteries) under the skin of your chest, near the collarbone area. Wires from the electrodes placed on the brain are guided down to the pulse generator and placed under the skin. The generator is usually programmed to send electrical pulses to the brain which are continuous. You can switch the generator on or off using a special remote which will be provided after the surgery. General anesthesia is used during this procedure.

This treatment is ideal for patients who cannot control their impulses due to certain mental health conditions. These conditions include epilepsy, Dystonia, Parkinson’s disease, Essential tremor, OCD, Chronic pain and Tourette syndrome. It can also be helpful in dealing with dementia, addiction, stroke recovery and depression. Deep brain stimulation has proved beneficial for patients who find it difficult to control their impulses with just medication.

If medicines or therapy fail to work for patients who are suffering from impulse control disorders, only in such cases Deep brain stimulation surgery is recommended. People who have extreme uncontrollable symptoms of mental health disorders are eligible for this procedure.

Deep brain stimulation surgery is usually safe but can have certain complications or risks. Brain stimulation itself can also cause few side effects. This procedure involves creating tiny holes inside the skull so that electrodes can be implanted. The second part of the procedure involves placing devices that contain batteries neat the collarbone. Certain complications can arise such as bleeding in the brain, stroke, infection, breathing problem, nausea, heart problems, and seizures. Side effects which are associated with this procedure include temporary pain in the area of the implant, eroded lead wire, stroke, confusion, headache, infection and seizure. Possible side effects can include lightheadedness, balance problems, speech problems, muscle tightness, tingling sensations, numbness, etc. Most people also experience unwanted mood swings such as depression or mania.

After Deep brain stimulation surgery, the pulse generator which rests on your chest is usually activated in your surgeon or doctor’s office. Anyone can program this pulse generator outside your body by using a special form of remote control. The magnitude of stimulation is customized keeping your condition in mind. The stimulation you receive from the pulse generator can either be constant (24 hours a day) or your health professional can recommend you to switch it off at night and turn it back on during the morning. You will have to take the special remote along with you to your home and you will also be taught how to use it. The doctor might also program the device so that you can make minor adjustments at your home. The battery life of the pulse generator varies with settings and usage. When the battery has to be replaced, the doctor generally performs an outpatient procedure.

After the surgery, your doctor will advise you to regularly take certain medicines for a period of few weeks. Ample rest should be taken right after the surgery for faster recovery. You can continue with your daily activities a few days after Deep brain stimulation surgery.

The price of the treatment is India is anywhere between Rs.9,70,125 to Rs.19,40,250.

Deep brain stimulation surgery doesn’t really treat the disease, but can help to reduce your symptoms. If the surgery is successful, the symptoms of the disease will improve significantly. They don’t usually disappear completely, but reduce with time. In certain cases, medicines are still necessary along with Deep brain stimulation surgery to improve the symptoms of the disease. This procedure is not successful for everyone, there are many variables involved in the treatment of the disease.