Deep brain stimulation
We offer advanced surgical treatment options, including deep brain stimulation (DBS), to people with movement disorders in the Commonwealth of Virginia. With innovative treatments like these, our highly skilled team can more effectively treat symptoms — and improve the quality of life for many.
What is deep brain stimulation?
DBS is a type of surgery for movement disorders that may be an option if other treatments, including medication, are no longer as effective in controlling the motor symptoms of Parkinson’s disease, essential tremor, or dystonia.
During the DBS procedure, a neurosurgeon will place an adjustable “on/off” device that’s similar to a pacemaker. The wire or DBS lead is placed within a specific location in the brain and a battery pack or generator is placed just under the skin on the chest. The DBS system delivers an electrical current that disrupts the brain signals responsible for abnormal movements. It is adjustable and reversible so the system can be turned off or even removed. Thus, if the motor symptoms get worse over time, the stimulation can be adjusted to continue to treat symptoms.
What to expect
If DBS is right for you, our team will work with you to create a personalized treatment plan that meets your unique needs, including deciding whether to clip or preserve your hair, whether the surgery requires testing while awake, which manufacturer to use and the type of batteries (rechargeable or non-rechargeable) would be best for your situation.
Evaluation
If you’re interested in DBS, the next step is to schedule an evaluation with our care team to determine if you are a good candidate for surgery.
The evaluation may include:
- An evaluation of your mood and memory
- An appointment with a physical and speech therapist to evaluate your gait, balance and speech
- MRI and CT scans
- Specific examinations to characterize your movement disorder
Your neurosurgeon will coordinate with your neurologist and other specialists to create the best treatment plan for you. This careful evaluation process for DBS can take a couple of months to complete.
Surgery
DBS surgery can be performed under sedation that is paused for awake testing or under general anesthesia without the need for test stimulation. Your surgeon will help you decide which option is best for you.
Postoperative Care
The surgery requires 1 or 2 nights in the hospital on average, though some patients will require a second procedure for battery placement as an outpatient procedure.
Before you go home, we’ll make sure you have care instructions and information on any limitations after surgery.
About two weeks after surgery, you will see your surgeon for a wound check, to perform a head CT and activate your DBS. Then, an additional appointment is scheduled approximately 1 month later for further optimization of your DBS.
Your neurosurgeon will communicate with your neurologist about next steps, so your whole care team is informed at every step of your surgery and recovery.
Conditions treated with deep brain stimulation
We treat several different movement disorders with DBS, including these common conditions:
- Essential tremor: We perform DBS as part of essential tremor treatment to stimulate the ventral intermediate nucleus of your thalamus (VIM), which is part of the tremor circuit in your brain. You will be sedated during this procedure, but we will wake you up to test the tremor and check for side effects.
- Parkinson’s disease: DBS can be an effective Parkinson’s disease treatment since it can help improve tremor, slowness, stiffness and walking, and reduce dyskinesia, the extra movements that can occur as a medication side effect. During DBS, we target the globus pallidus (GPI) or the subthalamic nucleus (STN).
- Dystonia (including Meige syndrome): We use DBS to target the globus pallidus (GPI), which can ease the symptoms of dystonia.
DBS can also be used to treat other conditions including Tourette’s syndrome and epilepsy.
Meet our team
Our care team includes specialists with specific experience and expertise treating patients with movement disorders. Your care team may include:
- Neurosurgeons
- Neurologists
- Neuropsychologists and psychologists
- Deep brain stimulation programming nurses
- Occupational therapists
- Physical therapists
- Speech therapists
- Care coordinators or nurse navigators
Our team collaborates directly with your regular care providers including neurologists and primary care providers, to coordinate ongoing follow-up and support.
Access helpful resources
We believe it’s important to connect you with patients who’ve had deep brain stimulation and are willing to share their experiences.
Make an appointment with our care team
Contact VCU Health Neurosurgery at (804) 828-9165 to schedule an evaluation with our care team.