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Deep Brain Stimulation

If you have a movement disorder, such as tremors or Parkinson’s disease, you know living with the symptoms can be a challenge.

Your doctor may prescribe medications to treat these symptoms. But medications may not always work well. They can become less effective over time and may interfere with your normal activities. Deep-brain stimulation (DBS) is an alternative if medications and other treatments don’t provide the symptom relief you need.

Experts in DBS Treatment

Neurosurgeons at Baystate Medical Center are the only providers to offer Deep Brain Stimulation treatment in western Massachusetts. Baystate is also one of the few places in the country to use a frameless technique during DBS surgery.

During traditional DBS surgery, surgeons attach a large, metal halo device (frame) to the patient’s skull and secure it to the surgical table. The frameless technique uses several small bone screws instead of the heavy frame. This approach keeps the patient much more comfortable during the procedure. It also significantly reduces the length of the surgery.

The goals of treatment with deep brain stimulation:

  • Fewer movement-related symptoms from your neurological condition
  • Improved quality of life
  • Fewer medications and/or smaller dosages to control symptoms

What Is DBS?

Deep brain stimulation is a neurosurgical procedure. We use it to improve control for people with a variety of movement disorders. During DBS, neurosurgeons place permanent electrodes in the brain so we can continuously stimulate specific parts through a small electrical unit, similar to a pacemaker. The unit is under the skin of the chest and connects by wires also under the skin.

DBS helps us control abnormal brain activity of brain cells without actually damaging the brain. We can also adjust the unit and change the treatment over time.

Am I a Candidate for DBS?

Deep brain stimulation is a treatment alternative when medications don’t control tremors caused by a movement disorder. To qualify, you must:

  • Be significantly disabled by your disorder
  • Be healthy enough for surgery
  • Have tried medication therapy without success
  • Not have a medical condition that requires routine MRI scans

A referral from your doctor is required. Next steps then include:

  • An evaluation by one of our neurologists
  • A physical therapy assessment
  • Neuropsychological testing
  • A neurosurgical evaluation
  • Insurance approval

What is involved in the DBS Procedure?

Deep brain stimulation requires multiple steps:

Before Your Surgery

Two to three weeks before surgery, you will come in to the neurosurgery department at Baystate Medical Center for an MRI of your brain. Then about ten days before your surgery, you will come in again so that we can place four tiny screws into your head while you are under local anesthesia. The screws are small enough to hide under your scalp.

Then you will go to our radiology department for a CT scan of your head. The MRI and CT scan will be fused and used to create a customized plan to specifically manufacture the platform that we will use to accurately place the electrodes.

Your Surgery

About a week later, you will come in for your surgery. We will make you as comfortable as possible. Because we use the frameless technique, you will have greater freedom of movement and the surgery will take less time than the traditional approach.

The neurosurgeon will implant the electrodes into your brain through a tiny incision in your skull about the size of a dime. You will be awake during the procedure, but your head will be numb so you aren’t in any pain.

Next, your neurosurgeon will attach a stimulator to the wires. The team will ask you to perform different functions, like speaking or making hand motions. This helps the team make sure the electrodes are in the right location.

After Your Surgery

About a week after your surgery, you will come back to the hospital. Our team will implant the small stimulator device (similar to a pacemaker), usually under the skin on your chest. They will connect the wires under your skin to the electrodes in your brain.

Follow-up Appointments

You will then have multiple follow-up appointments:

  • one with the neurosurgeon within two weeks to check on your healing;
  • one with your neurologist to program the device a week or two after surgery; and
  • regularly scheduled follow-up visits every 3-6 months with your neurologist to monitor your progress and make any necessary adjustments. Sooner appointments can be scheduled if you need further fine tuning of the device program.

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