What is the difference between awake and asleep Deep Brain Stimulation surgery?
During “asleep” DBS surgery, general anesthesia is used and you are asleep through your surgery. You may find this more comforting. Intraoperative imaging provides accurate photos that allow the neurosurgeon to target the brain, without the need for your feedback. Parkinson’s patients can take their medicine on the day of their surgery.
During “awake” DBS surgery, you are kept alert during the operation. You may find this discomforting. The neurosurgeon uses cellular recordings to map the cells in the target region of your brain and relies on your feedback to determine accurate placement of the DBS electrodes. Parkinson’s patients cannot take their medicine.
DBS has dramatically changed the lives of many patients with uncontrollable tremors. Patients often can resume normal activities, such as feeding and dressing themselves, and can have active and fulfilling lives. The need for anti-tremor medications is often reduced or eliminated.
The future: DBS is reversible and adjustable
DBS blocks electrical signals from targeted brain areas. Thus, if newer, more promising treatments develop in the future, the DBS procedure can be reversed. The IPG is easily adjustable, without further surgery, if an individual patient’s condition changes.
Benefits of DBS:
- DBS surgery can be performed on both sides of the brain
- DBS surgery effects are reversible thus patients have the option of other treatments such as stem cell or gene therapy when they become available
- IPG adjustments can be made to meet individual needs to minimize any side effects and improve efficacy
- 24 hour symptom control
What are the risks?
In carefully selected and screened patients, DBS is quite safe and effective, but as with any surgery, there are some risks. There is an estimated 2-3 percent risk of brain hemorrhage; there is a small risk of leakage of cerebrospinal fluid, which can lead to headaches or meningitis. There is a risk of infection, erosion, lead fractures, hardware breakage and IPG failure.
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