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Deep Brain Stimulation and Parkinson ’ s way to sleep . You ’ ll hear the surgeon drill a small opening in the skull , which some say is similar to the sound of a dentist drilling .
The brain does not feel pain , so you should not feel discomfort . Some people have neck pain from lying in one position for a long time . Your surgical team can help you reposition carefully , if needed , to keep you as comfortable as possible .
When the lead is positioned , you are awake so that you can describe what you feel and whether you have side effects . Your doctors test your symptoms and listen to the electrical activity of your brain cells . This is called “ microelectrode recording .” It ’ s another way to help get leads precisely to the target area .
Many people feel an immediate lessening of symptoms when the lead is placed . This is the result of minor , expected swelling around the end of the brain wire . As swelling fades , this response fades , too . But that same feeling of benefit returns when the device is turned on and programmed several weeks later . Once the leads are properly positioned and tested , you go to sleep for the last 30 to 45 minutes of the procedure .
Lead placement takes , on average , about two to three hours for one side and three to four hours for both sides . But the whole procedure , from start to finish , can take six hours or more . Most people spend one or two nights in the hospital for recovery and monitoring .
You may notice a small bump behind one or both ears after lead placement . These are the brain wires , simply being held there until they are later connected to the battery .
Some centers offer DBS while a person sleeps under general anesthesia , using real-time brain MRI to see and place brain wires . This may be an option for someone with significant anxiety or other symptoms that make it difficult to temporarily hold medication or to be awake . Both awake and asleep surgery have pros and cons .
Battery Placement
Once leads are placed , the next step is getting the DBS battery . This typically happens a week or so after both leads are placed .
The battery usually goes below the collarbone or in the abdomen . Depending on the device and surgeon preference , some people get two batteries , one on each side . Each brain wire connects to the battery via an extension wire that runs behind the ear and down the neck . DBS batteries vary slightly in size , but you ’ ll likely see and feel a small bump .
Movement disorders neurologist Jun Yu , MD , MS , carries out DBS programming and works in the operating room to perform testing during DBS .
Battery placement typically is done under general anesthesia , while you are asleep . It takes about two hours . It ’ s an outpatient procedure , meaning you go home the same day .
When you leave the hospital , you get a temporary DBS device card , while a permanent one is mailed . Keep this card with you at all times . You also may want to confirm where and how many incisions you have so you can watch them carefully . Typically DBS requires incisions on the scalp for the lead ( s ), behind the ear for the lead connections , and in the chest or abdomen for the battery . But each surgeon and center have their own preference and protocol .