DBS

[Jocee]

How many of you who have had DBS would recommend it, and how many would say it didn't help?

My neuro tells me I should have it done while I still can, but I really am nervous about it.

[12stargate]

Good mornig Jocee;

I wish I could tell you, but I have no idea.

I am ceertain you will get some ideas from the others in

the group during the day.

Make this an kind day!

Hugs from Eva

[Hidden]

Dear Nervous,

quote MJF webpage: "Deep brain stimulation is a game-changer for some patients, alleviating the motor symptoms of Parkinson’s disease without the fluctuations that medications can bring. However this type of treatment isn’t for everyone and has limitations and side effects of its own."

paraphrase my Neurologist at the time of my Dx: ...do not recommend DBS. As example, caused more problems than good for MJF...

[enjoysalud in reply to Hidden]

What kind of problems did it cause for MJF? I google that topic but get no information.

[Hidden in reply to enjoysalud]

Neurologist said only caused more problems than good

[fwes]

IT TAKES A LITTIE EFFORT, BUT IT'S YOUR HEAD !

I GOOGLED "DBS RISKS":

MAYO CLINIC

Risks

By Mayo Clinic Staff

Although deep brain stimulation is generally safe, any type of surgery has the risk of complications. Also, the brain stimulation itself may cause side effects.

Surgery risks

Deep brain stimulation involves boring small holes in the skull to implant the electrodes, and surgery to implant the device that contains the batteries under the skin in the chest. Complications of surgery may include:

Bleeding in the brain (hemorrhage)

Stroke

Infection

Breathing problems

Nausea

Heart problems

Incision scarring

With deep brain stimulation, surgery isn't a one-time procedure. The batteries that are implanted in the chest have a limited life span, and when they run out, your symptoms may quickly return. Replacing the batteries requires another surgery. It's also possible for a wire connecting the batteries to an electrode to break or for other malfunctions to occur.

Possible side effects after surgery

Side effects associated with deep brain stimulation may include:

Seizure

Infection

Headache

Insomnia

Memory problems

Temporary pain and swelling at the implantation site

A few weeks after the surgery, the device will be turned on and the process of finding the best settings for you begins. This process may take several months. Some settings may cause side effects, but these often improve with further adjustments of your device.

Possible side effects of stimulation

Numbness or tingling sensations

Muscle tightness of the face or arm

Speech problems

Balance problems

Lightheadedness

Unwanted mood changes, such as mania and depression

FROM PUBMED

Abstract

J Neurosurg. 2014 Jan;120(1):132-9. doi: 10.3171/2013.10.JNS131225. Epub 2013 Nov 15.

Risks of common complications in deep brain stimulation surgery: management and avoidance.

Fenoy AJ1, Simpson RK Jr.

Author information

Abstract

OBJECT:

Deep brain stimulation (DBS) surgery is increasingly prominent in the treatment of various disorders refractory to medication. Despite the procedure's efficacy, the community at large continues to be hesitant about presumed associated risks. The main object of this study was to assess the incidence of various surgical complications occurring both during and after DBS device implantation in a large population of patients with movement disorders in an effort to better quantify patient risk, define management plans, and develop methods for risk avoidance. A second aim was to corroborate the low procedural complication risk of DBS reported by others, which in light of the procedure's efficacy is needed to promote its widespread acceptance.

METHODS:

All patients who had undergone new DBS device implantation surgery between 2002 and 2010 by a single surgeon were entered into a database after being verified by cross-referencing manufacturer implantation records. All surgical records and charts were reviewed to identify intraoperative, perioperative, and long-term surgical complications, including any characteristics predictive of an adverse event.

RESULTS:

Seven hundred twenty-eight patients received 1333 new DBS electrodes and 1218 new internal pulse generators (IPGs) in a total of 1356 stereotactic procedures for the treatment of movement disorders. Seventy-eight percent of the patients had staged lead and IPG implantations. Of the 728 patients, 452 suffered from medically refractory Parkinson disease; in the other patients, essential tremor (144), dystonia (64), mixed disease (30), and other hyperkinetic movement disorders (38) were diagnosed. Severe intraoperative adverse events included vasovagal response in 6 patients (0.8%), hypotension in 2 (0.3%), and seizure in 2 (0.3%). Postoperative imaging confirmed asymptomatic intracerebral hemorrhage (ICH) in 4 patients (0.5%), asymptomatic intraventricular hemorrhage in 25 (3.4%), symptomatic ICH in 8 (1.1%), and ischemic infarction in 3 (0.4%), associated with hemiparesis and/or decreased consciousness in 13 (1.7%). Long-term complications of DBS device implantation not requiring additional surgery included hardware discomfort in 8 patients (1.1%) and loss of desired effect in 10 (1.4%). Hardware-related complications requiring surgical revision included wound infections in 13 patients (1.7%), lead malposition and/or migration in 13 (1.7%), component fracture in 10 (1.4%), component malfunction in 4 (0.5%), and loss of effect in 19 (2.6%).

LOOK UP THE BIG WORDS

Abstract

Clin Sci (Lond). 1991 Nov;81(5):575-86.

The vasovagal response.

van Lieshout JJ1, Wieling W, Karemaker JM, Eckberg DL.

Author information

Abstract

The vasovagal response is the development of inappropriate cardiac slowing and arteriolar dilatation. Vasovagal responses reflect autonomic neural changes: bradycardia results from sudden augmentation of efferent vagal activity, and hypotension results from sudden reduction or cessation of sympathetic activity and relaxation of arterial resistance vessels. Two different neural pathways are thought to be involved, one originating in the hypothalamus, the other in the heart. Direct hypothalamic activation of the medullary cardiovascular centres triggered by emotional stress or pain causes a vasovagal response (central type). The combination of a reduced central blood volume secondary to venous pooling or blood loss, and an increased inotropic state of the heart, may stimulate ventricular mechanoreceptors and provoke vasodilatation and bradycardia (peripheral type). Cardiovascular afferents originating from stretch receptors in various parts of the vascular tree sometimes induce opposite reflexes when compared with those from ventricular afferents. The depressor reflex involved in the peripheral type of vasovagal response originates in the heart itself and overrides normal baroreflex circulatory control; an antagonism between the control of volume and pressure on the filling side of the heart and the control system of arterial pressure becomes apparent. Vasovagal responses are not necessarily abnormal; the neural pathways involved in the vasovagal response are probably present in all healthy subjects who individually mainly differ in susceptibility.