The surgery required to implant a DBS device is an expensive and potentially risky procedure that doctors will recommend only for certain patients. First of all, the patient must be in healthy physical condition and able withstand the stresses caused by a major surgery.
It's also important to ensure that DBS therapy will have a good chance of producing effective results. One indication that DBS will be an effective treatment is if the patient's symptoms are responding to drug therapy. Drug therapies act on some of the same brain pathways as DBS, so if the drugs are having a good effect, deep brain stimulation might be beneficial as well.
So at what stage should deep brain stimulation be considered? Most specialists agree that DBS implantation should occur after drug therapies begin to produce their negative side effects but before the patient begins to experience a major decrease in quality of life. Quality of life is sometimes measured by the patient's ability to perform activities of daily living.
The patient must also have realistic expectations regarding the outcomes of DBS therapy. It must be clear to the patient that DBS is not a cure for his or her condition, but rather a treatment that might alleviate the condition's symptoms. Of course, the patient should also be fully aware of the risks and possible side effects involved with DBS implantation.
Although DBS is generally recognized as a very safe treatment, any major surgery -- especially brain surgery -- carries certain risks. One of the major risks is hemorrhaging, or excessive bleeding caused by damage to blood vessels. Brain tissue is very delicate, and navigating through the brain to implant a device can be challenging. The probability of major damage due to hemorrhaging is low, but if hemorrhaging occurs, the resulting complications can be severe and permanent.
Infection is another risk associated with DBS implantation surgery. The problems caused by infection are usually mild and treatable, but sometimes infections can cause serious problems. One more risk worth mentioning is breakage of the device. Breaks in the extension wire or movement of the stimulating electrode are two of the major causes of device failure.
The side effects caused by the electrical stimulation from the DBS electrode vary from patient to patient and commonly include minor sensory or motor control problems. Psychological side effects might include mood changes or feelings of depression. Fortunately, all of these side effects are usually temporary or can be reversed by turning off the stimulation. In most cases, the doctor can adjust the device's electrical stimulation patterns to minimize side effects.
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