DBS is when we place a device called a "brain pacemaker" into your brain. The pacemaker delivers electrical signals that excite the brain. By stimulating specific areas of your brain, we can manage symptoms related to movement, pain, and mood disorders.

The DBS system consists of these main components:

• A lead (electrode) that we implant in your brain through a small opening in the skull
• Anchors fix the lead to the skull
• An extension wire connects the lead to the implantable pulse generator (IPG)
• The IPG, a battery-powered device typically implanted under the skin near the collarbone

Once connected, the IPG sends electric pulses along the wire to the lead and into the brain. These tiny pulses interfere with and block the nerve signals that cause symptoms of some movement disorders.

DBS can help regulate abnormal brain activity by stimulating specific areas. This signal can reduce tremors, stiffness, and involuntary movements. It can be helpful in Parkinson's disease, essential tremor, dystonia, and epilepsy.

DBS may be an option for you if your symptoms are not well controlled with medicine. They also need to impact your quality of life significantly.

DBS can treat disabling symptoms of several neurological disorders. It's an option to treat movement disorders or epilepsy when other treatments haven't worked. These include:

• Parkinson's disease: To treat motor symptoms like rigidity, slowed movement, tremors, stiffness, and walking difficulties
• Essential tremor: To improve involuntary movements of the arms, hands, and head
• Dystonia: To reduce involuntary muscle contractions, which cause abnormal posture, repetitive movements, and twisting
• Epilepsy: To treat focal epilepsy and reduce the frequency and severity of seizures

DBS won't be a good option for everyone. Making sure that you're a good candidate is crucial. How well it works depends on your health issue and response to other treatments.

If your doctors think you're a good candidate for DBS, they'll start the testing process. At Carilion, you'll work with a nurse navigator to help you plan visits and tests.

Before

Before your implant, you'll consult multiple experts. These include neurologists, brain surgeons, and psychologists. These doctors will work together to ensure you're a good candidate for DBS with the best chance of success.

All patients getting a DBS implant will go through a series of tests, including a physical exam, blood tests, and brain scans. These tests help your care team find the exact area of the brain causing your symptoms.

Your doctors may use microelectrode recording to help locate the precise brain area causing symptoms. This test involves inserting a tiny wire that monitors the activity of nerve cells.

During

Your neurosurgeon will place the DBS system in 1 or 2 stages. You may be awake or put to sleep for one or both surgeries.

During the first surgery, the doctors will numb just the outer layers of your head. They'll shave a small portion of your scalp and secure your skull using a special frame.

The surgeon then makes an incision in your scalp, drills a small hole in your skull and inserts the leads into your brain. They'll test the leads by sending impulses and check they placed them correctly.

The surgeon may use a surgical robot for precision and speed during your surgery.

In the second stage, they'll put you to sleep. The surgeon will implant the IPG, usually below your collarbone. They'll connect it to the lead and sew you up.

After

After surgery, you'll receive care tailored to you and your health. You'll stay in the hospital for about 3 days and get antibiotics to prevent infection.

Once you heal, your neurologist will program the DBS device during follow-up visits. They'll work to adjust the signal to ensure your symptoms are well controlled without more surgeries.

Although less-invasive, DBS is brain surgery and carries some risks. There's a low chance of bleeding, swelling, or infection in the brain.

Side effects of the stimulation may include numbness or tingling, behavior changes, and balance or speech problems. Other risks include headaches, seizures, and temporary pain following surgery. You may experience a decrease in neurocognitive functioning.

Over time, the hardware may erode or break down. You may need to have surgery again to replace parts of the device.