Deep Brain Stimulation (DBS)

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Deep brain stimulation refers to a procedure in which one or more electrodes are implanted in the brain. The electrodes are powered by a battery and, depending on their location, can stimulate different areas of the brain. Deep brain stimulation is a procedure that is usually offered only at large specialized hospitals, as the care of these patients requires not only specialized neurosurgery but also neurologists.

Indications

The indications for DBS are very diverse; deep brain stimulation is most commonly used for Parkinson’s disease. However, DBS is also used for a number of other disorders in the neurological and psychiatric spectrum.

Implantation

Implantation of a DBS system can be performed under local or general anesthesia, depending on the surgeon’s and hospital’s preference. For the procedure, a stereotactic frame is attached to the patient’s head to enable use of the precise electrode trajectory previously determined by the neurosurgeon. In addition to the electrodes, a battery system must also be implanted to supply power to the DBS system.

Surgical Risks

  • Infection: As with any surgery, DBS procedures also carry a risk of infection. Since a DBS system is foreign material, depending on the severity of the infection, there is a risk that surgical revision with subsequent removal of the system may be required. The risk of this is approximately 1-2%​ 1
  • Hardware breakage: The electrodes and cables of the DBS system can become damaged and break over time. The risk of this is likewise approximately 1%​ 2​
  • Malposition: Malpositioning of the electrodes can occur during implantation of the DBS system, potentially making repeat surgery necessary. The risk of malposition is 1-2%​ 3
  • Lack of effect: Depending on the indication, the desired effect of the DBS system may not occur or may diminish over time, making removal of the system advisable. The risk of this is approximately 2%​ 4 ​.
  • Epileptic seizures: The risk of experiencing epileptic seizures directly postoperatively as a result of electrode implantation is less than one percent​5​.
  • Postoperative hemorrhage: The risk of symptomatic bleeding after or during surgery is approximately 1%​6

References

    1. Fenoy AJ, Simpson RK. Risks of common complications in deep brain stimulation surgery: management and avoidance. JNS. January 2014:132-139. ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩

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    Edit · Alaric Steinmetz ·

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    Edit · Alaric Steinmetz · (+11 −11)
    • Text changed: “Deep brain stimulation is a procedure in which one or more electrodes are implanted in the brain. The electrodes are powered by a battery and, depending on their location, can stimulate different areas of the brain. Deep brain stimulation is a procedure that is usually offered only at large, specialized clinics, as caring for these patients requires not only specialized neurosurgery but also neurologists.”“Deep brain stimulation refers to a procedure in which one or more electrodes are implanted in the brain. The electrodes are powered by a battery and, depending on their location, can stimulate different areas of the brain. Deep brain stimulation is a procedure that is usually offered only at large specialized hospitals, as the care of these patients requires not only specialized neurosurgery but also neurologists.”
    • Text changed: “The indications for DBS are highly varied; deep brain stimulation is most commonly used for Parkinson’s disease. However, DBS is also used for a range of other disorders within the neurological and psychiatric spectrum.”“The indications for DBS are very diverse; deep brain stimulation is most commonly used for Parkinson’s disease. However, DBS is also used for a number of other disorders in the neurological and psychiatric spectrum.”
    • Text changed: “Implantation of a DBS system can be performed under local anesthesia or general anesthesia, depending on the surgeon’s and clinic’s preference. For the operation, a stereotactic frame is attached to the patient’s head to enable use of the precise electrode trajectory previously determined by the neurosurgeon. In addition to the electrodes, a battery system must also be implanted to supply power to the DBS system.”“Implantation of a DBS system can be performed under local or general anesthesia, depending on the surgeon’s and hospital’s preference. For the procedure, a stereotactic frame is attached to the patient’s head to enable use of the precise electrode trajectory previously determined by the neurosurgeon. In addition to the electrodes, a battery system must also be implanted to supply power to the DBS system.”
    • Text changed: “### Surgical risks {#operationsrisiken}”“### Surgical Risks {#operationsrisiken}”
    • Text changed: “* **Infection**: As with any operation, DBS surgery also carries a risk of infection. Since a DBS system is foreign material, depending on the severity of the infection, there is a risk that surgical revision with subsequent removal of the system may be required. The risk of this is approximately 1-2%​ [^1] * **Material breakage**: The electrodes and cables of the DBS system can become damaged and break over time. The risk of this is also approximately 1%​ [^1]​ * **Malposition**: Malpositioning of the electrodes can occur during implantation of the DBS system, potentially making repeat surgery necessary. The risk of malposition is 1-2%​ [^1] * **Lack of effect:** Depending on the indication, the desired effect of the DBS system may not occur or may diminish over time, making removal of the system advisable. The risk of this is approximately 2%​ [^1] ​. * **Epileptic seizures**: The risk of experiencing epileptic seizures immediately postoperatively as a result of electrode implantation is less than one percent​[^1]​. * **Hemorrhage**: The risk of symptomatic hemorrhage during or after the operation is approximately 1%​[^1]”“* **Infection**: As with any surgery, DBS procedures also carry a risk of infection. Since a DBS system is foreign material, depending on the severity of the infection, there is a risk that surgical revision with subsequent removal of the system may be required. The risk of this is approximately 1-2%​ [^1] * **Hardware breakage**: The electrodes and cables of the DBS system can become damaged and break over time. The risk of this is likewise approximately 1%​ [^1]​ * **Malposition**: Malpositioning of the electrodes can occur during implantation of the DBS system, potentially making repeat surgery necessary. The risk of malposition is 1-2%​ [^1] * **Lack of effect:** Depending on the indication, the desired effect of the DBS system may not occur or may diminish over time, making removal of the system advisable. The risk of this is approximately 2%​ [^1] ​. * **Epileptic seizures**: The risk of experiencing epileptic seizures directly postoperatively as a result of electrode implantation is less than one percent​[^1]​. * **Postoperative hemorrhage**: The risk of symptomatic bleeding after or during surgery is approximately 1%​[^1]”
    Edit · Alaric Steinmetz · (+12 −12)
    • Text changed: “Deep brain stimulation is a procedure in which one or more electrodes are implanted in the brain, supplied by a battery, and able to stimulate different areas of the brain depending on their location. Deep brain stimulation is a procedure that is usually offered only at large specialized clinics, as the care of these patients requires not only specialized neurosurgery but also neurologists.”“Deep brain stimulation is a procedure in which one or more electrodes are implanted in the brain. The electrodes are powered by a battery and, depending on their location, can stimulate different areas of the brain. Deep brain stimulation is a procedure that is usually offered only at large, specialized clinics, as caring for these patients requires not only specialized neurosurgery but also neurologists.”
    • Text changed: “The indications for DBS are very diverse; deep brain stimulation is most commonly used for Parkinson’s disease. However, DBS is also used for a number of other disorders within the neurological and psychiatric spectrum.”“The indications for DBS are highly varied; deep brain stimulation is most commonly used for Parkinson’s disease. However, DBS is also used for a range of other disorders within the neurological and psychiatric spectrum.”
    • Text changed: “Implantation of a DBS system can be performed under local anesthesia or general anesthesia, depending on the surgeon’s and clinic’s preference. For the procedure, a stereotactic frame is attached to the patient’s head to enable use of the precise electrode trajectory previously determined by the neurosurgeon. In addition to the electrodes, a battery system must also be implanted to supply the DBS system with power.”“Implantation of a DBS system can be performed under local anesthesia or general anesthesia, depending on the surgeon’s and clinic’s preference. For the operation, a stereotactic frame is attached to the patient’s head to enable use of the precise electrode trajectory previously determined by the neurosurgeon. In addition to the electrodes, a battery system must also be implanted to supply power to the DBS system.”
    • Text changed: “* **Infection**: As with any surgery, DBS procedures also carry a risk of infection. Since a DBS system is a foreign body, depending on the severity of the infection, there is a risk of revision surgery with subsequent removal of the system. The risk of this is approximately 1-2%​ [^1] * **Material breakage**: The electrodes and cables of the DBS system can become damaged and break over time. The risk of this is likewise approximately 1%​ [^1]​ * **Malposition**: Malpositioning of the electrodes may occur during implantation of the DBS system, making repeat surgery necessary. The risk of malposition is 1-2%​ [^1] * **Lack of effect:** Depending on the indication, the desired effect of the DBS system may fail to occur or may diminish over time, making removal of the system advisable. The risk of this is approximately 2%​ [^1] ​. * **Epileptic seizures**: The risk of experiencing epileptic seizures directly postoperatively as a result of electrode implantation is less than one percent​[^1]​. * **Postoperative hemorrhage**: The risk of symptomatic bleeding after or during surgery is approximately 1%​[^1]”“* **Infection**: As with any operation, DBS surgery also carries a risk of infection. Since a DBS system is foreign material, depending on the severity of the infection, there is a risk that surgical revision with subsequent removal of the system may be required. The risk of this is approximately 1-2%​ [^1] * **Material breakage**: The electrodes and cables of the DBS system can become damaged and break over time. The risk of this is also approximately 1%​ [^1]​ * **Malposition**: Malpositioning of the electrodes can occur during implantation of the DBS system, potentially making repeat surgery necessary. The risk of malposition is 1-2%​ [^1] * **Lack of effect:** Depending on the indication, the desired effect of the DBS system may not occur or may diminish over time, making removal of the system advisable. The risk of this is approximately 2%​ [^1] ​. * **Epileptic seizures**: The risk of experiencing epileptic seizures immediately postoperatively as a result of electrode implantation is less than one percent​[^1]​. * **Hemorrhage**: The risk of symptomatic hemorrhage during or after the operation is approximately 1%​[^1]”

    Article created on · Alaric Steinmetz

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