The DBS Evaluation Process and Procedure: What to Expect
The DBS evaluation process and then surgery is typically performed in the following stages:
- Pre-Surgical Evaluation
You will meet with a multidisciplinary team that includes a Movement Disorders neurologist, neurosurgeon, and neuropsychologist. This stage involves clinical exams, MRI or CT scans, and an in-depth cognitive assessment to ensure DBS is safe and likely to be beneficial. - Surgical Implantation
The electrodes are precisely placed in targeted areas deep in the brain using advanced imaging, navigation systems, recordings of the brain activity, and intraoperative testing with stimulation. A Movement Disorders neurologist (Dr. Afshari) will be in the operating room to help the neurosurgeon and a neurophysiologist to ensure the most precise and optimal placement of the electrodes. This procedure is typically performed with the patient awake at our institution. In awake implantation, real-time patient feedback is used to help guide and confirm accurate electrode placement. The neurostimulator “pacemaker” device is then implanted under the skin, typically near the collarbone, during a separate surgery under general anesthesia
. - Device Programming and Adjustment
After recovery, your Movement Disorders neurologist will work closely with you to program the stimulator about a month following the electrode implantation. This process may take several visits as your neurologist fine-tunes the stimulation for optimal symptom control while minimizing side effects.
