24
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.