Frequently Asked Questions

Your evaluation will depend on what condition you are being treated for. Generally, one of our neurologists will meet with you and review your case. They may refer you for an MRI or other imaging tests. They may also want you to be evaluated by other specialists. The whole DBS team will then discuss your case, come up with a treatment plan, and make a recommendation for surgery. You will have as much time as you need to ask questions and discuss your options with your neurologist and neurosurgeon.

No. Temple offers all of our patients “asleep” DBS surgery. This allows us to perform your surgery without the need to wake you up in the operating room, resulting in a less stressful experience. Research and our own experience has shown that “asleep” DBS is just as effective as standard “awake” DBS.

No. We may clip a small area of hair but do not need to shave your head. Often, we can do the entire procedure without clipping any hair.

It's important to us that you have a good cosmetic outcome after surgery. We take care to make sure that you can see and feel the DBS system as little as possible. DBS brain electrodes are generally invisible, except in people who are bald or balding. You may be able to see and feel the extension wires as they come over the collarbone. Although you can feel it, the stimulator will be hidden by most shirts. We can place stimulators away from the chest if needed for specific cosmetic concerns.

There is no age limit for DBS surgery as long as you are healthy enough to have anesthesia. 

Whatever your age, if medications no longer work for your condition, it may be time to consider DBS. The earlier in your disease that you have DBS surgery, the more time you will have to benefit.

No surgery is without risks, especially brain surgery that lasts a number of hours. Major complications, such as bleeding in the brain, are very rare. More often, some patients experience side effects like confusion, balance problems, fatigue and soreness after surgery. These usually go away within a few weeks. Infection can happen in about 1 out of 50 cases but can usually be managed with antibiotics alone. 

Before surgery, you will meet with your neurosurgeon, discuss the treatment plan, and have the chance to ask questions or make any requests you need. You'll have special MRI and CT scans done to plan the procedure. You will also meet with your anesthesiologist, and have blood tests. Some patients may need to take other steps to prepare for surgery, like obtaining clearance for surgery from their other physicians, or stopping certain medications.

In stage 1 of DBS surgery, the electrodes will be placed in your brain. You will be completely asleep under general anesthesia. One or two incisions will be made in the front part of your scalp, behind your hairline, and one or two small holes will be made in your skull. Each hole is about the size of a nickel. Using special computer software and equipment, the tip of the electrodes will be placed to the exact position in your brain that is needed to treat your symptoms. The electrode wires will then be wrapped carefully and placed below the scalp so that they lie underneath your skin. The incisions will be closed with dissolving stitches. This procedure takes between 4 and 8 hours to complete. Most patients stay in the hospital for 1 or 2 nights before going home to recover.

Stage 2 is an outpatient surgery and is usually done 1-2 weeks after stage 1. It is also done under general anesthesia. During surgery, the stimulator will be placed under the skin of the upper chest. The extension wires will be passed down the side of your neck below the skin and will connect the brain electrodes to the stimulator. This procedure takes about 2 hours and you will go home the same day.

About two weeks after surgery, you will see your neurologist to have the DBS system turned on for the first time. For symptoms such as tremor, you may notice some benefits right away. For most patients, it takes several visits over a few months to “fine tune” the stimulation and adjust your medications. After the first period of frequent visits for DBS adjustments, you will go back to your regular schedule of seeing your neurologist. You will see your neurosurgeon at 2 weeks, 3 months, 6 months and 1 year after surgery to make sure that you are recovering well and that your treatment is working to your satisfaction.

Everyone is different, but most people need about a month to fully recover from the entire process of stage 1 and stage 2 surgery. However, there are no activity restrictions during that time, and we encourage you to be as active as you like. If you are ready to return to work or normal activity sooner, you may do so.

You will still need to be on some medication. However, some people are able to reduce their dose or take fewer medications.

The benefits of DBS can last for many years. However, diseases like Parkinson’s disease and essential tremor usually get worse over time, so DBS can become less effective at controlling symptoms as time goes on.

DBS batteries typically last about 4 years. Replacing the battery requires a short outpatient surgery that lasts about 1 hour. Rechargeable batteries are available that can last up to 15 years before needing to be replaced.

No. DBS devices are safe for airport scanners and all everyday activities. Most DBS systems are safe for MRI scanners, with some restrictions depending on the manufacturer.