Brain

Deep Brain Stimulation (DBS)

More than 150,000 patients have undergone DBS. The present day techniques make it a very safe procedure.

Risks and Complications

DBS is overall considered a relatively safe neurosurgical procedure with low mortality. However, akin to other surgical procedures, DBS surgeries can be complicated by intraop­erative and postoperative complications such as intracranial bleeding, seizure, stroke, hardware malfunction, infection, prolonged length of hospitalization, and postoperative confusion.

A study by Dr. Doshi in 2011 with a longer mean duration of follow-up showed confusion in 3.9%, hardware infection in 4.5%, and malfunction of the implantable pulse generator (IPG) in 1.4%. The most serious complication of haemorrhage was only 1.2%, one of the lowest in the world. Hardware failure can occur as a result of blunt force trauma or the electromagnetic pulses from medical devices such as mag­netic resonance imaging and defibrillators. Patients may get suboptimal response in case of poor electrode positioning or problems with programming. These all problems can be fixed.

One of the common issues of DBS complication is the erosion or thinning of the skin over the implants. This occurs due to various reasons, ageing, superficial pocket, weight of the implant etc. Patient should maintain good hygiene and care of the implant sites, right from the scalp to the pacemaker site. One should also watch out for the extension wire connector site as it is another common area of erosion; this is located behind the ears.

Many times, patient develop stimulation related side effects. The most common being speech, and gait disturbances. Sometimes patient also develop paraesthesia and that is tingling and numbness in the areas of stimulation.   This problem can be related to adjustments of this medication and others can be because of the stimulation induce side effects careful programming and understanding of this problem helps to minimise or eliminate most of them.