Preparing for Deep Brain Stimulation (DBS) Surgery
If your doctor has prescribed deep brain stimulation (DBS) to help control your movement disorder symptoms, you will have surgery to have a DBS system implanted. Discuss any questions or concerns with your doctor. Having questions and concerns is normal and expected. Your doctor will be able to answer your questions or provide you with additional resources.
Before your procedure, you will go through a number of evaluations by your medical team to determine if you are a good candidate. This may include:
- An evaluation by a neurologist to determine if your symptoms are likely to respond to DBS
- An evaluation by a psychologist or psychiatrist to determine the status of your cognitive (thinking skills) and mental health
- An evaluation by a neurosurgeon to determine if you are a good surgical candidate
If you and your health care team decide you are indeed a good candidate for DBS, you will be scheduled for surgery.
Preparing for the procedure
As part of providing you with pre-surgery instructions, your doctor may:
- Tell you when to stop eating and drinking (usually a certain number of hours before the procedure)
- Explain what medicines you can take and what you need to stop taking
- Advise that you wear loose-fitting, comfortable clothing (for example, elastic waist pants and a button-down shirt) and shoes that you can slip on and off easily
- Instruct you to shower or bathe before your procedure because you may not be able to do so until your incisions are healed
- Suggest that you ask a family member or friend to drive you to the procedure and stay with you afterward; because of the medication you will receive, you likely will not be allowed to drive yourself home.
Tell your doctor about:
- Bad reactions you or your family members have ever experienced with any anesthesia
- Allergies you have to medications, food or other substances
- Medications you are using, including prescription and nonprescription medicines, paracetamol, aspirin, vitamins and herbal supplements
Tips to help you prepare for your surgery
- Check with your surgeon’s office to make sure you know exactly when and where you need to be on the day of your surgery.
- Ask friends and family to help care for any pets or personal affairs while you are in the hospital.
- If you are a student, make sure you have notified the appropriate contacts of your absence and make arrangements for your assignments to be completed after recovery.
- Pack a week’s supply of all of your medications in the original, labeled bottles for your hospital stay. Also, make a list of all of your medicines with dosages and times taken to provide to the hospital staff.
- Write down a list of names and phone numbers you might need, including emergency contacts.
- Pack a bag of items for your hospital stay, including personal toiletries, reading materials, and clothes to wear for your trip home. Include a shirt with buttons or a zip to make it easier to get dressed after surgery. In addition, consider packing a pair of socks to wear during surgery.
- For younger patients, pack a favorite toy or stuffed animal for comfort.
During the procedure
The DBS system is placed during surgery by a specially trained neurosurgeon. You will be required to stay in the hospital. Your doctor will determine how long you stay.
The procedure generally involves the following steps:
- Imaging: You will undergo CT or MRI scanning of your head, so the neurosurgeon can pinpoint the exact location in your brain to place the leads. Sometimes a frame will be put on your head before the images are taken.
- Lead placement: Once the images are complete, you will undergo the first part of the surgery to place the leads. You may be asleep during this part of the procedure; however, sometimes the surgery is performed while you are semi-awake. This is because your responses can help the neurosurgeon determine if the leads are placed in the right spot to help with your movement-related symptoms. If this is the case, you will be given some medicine to help you relax. A local anesthetic will also be given, so that you do not feel any discomfort at the surgery site.
- Device placement: Sometimes the device is placed in the chest cavity immediately following the lead placement. It may be placed several weeks afterward. You will be asleep during this part of the procedure, regardless of when it takes place.
As with any surgery or therapy, there may be some risks or complications with DBS therapy. Most effects of DBS surgery are temporary and correct themselves within 30 to 90 days. Some, however, may be more serious and/or permanent.
Ask your doctor about possible complications associated with the procedure and the therapy, as well as restrictions you will be asked to follow during your recovery and for the long term.
Immediately after the procedure
Following the operation you will be sent to a recovery area. You will then be transferred to a ward where you will begin your recovery process.