At Mayo Clinic, a team of doctors with training in brain conditions (neurologists), brain surgeons (neurosurgeons) and other specialists work together to care for you before, during and after deep brain stimulation (DBS). Doctors first will determine if you're a candidate for DBS and, if so, perform an examination and offer patient education prior to surgery. Your doctor will review with you possible results before surgery.
In DBS, your surgeon implants a thin wire lead with four contacts (electrodes) at the tips into a specific area of your brain. A wire runs under your skin to a generator (neurostimulator) implanted near your collarbone. A nurse with specialized training in DBS programs the generator to send continuous electrical pulses to your brain. You control the generator, and you can turn it on or off when you swipe a special magnet over it.
To implant the electrodes, your care team fits you with a special head frame to keep your head still during the procedure (stereotactic head frame). Then, they use magnetic resonance imaging (MRI) to map your brain and identify the area in your brain where they'll place the electrodes. They anesthetize your scalp before the procedure. During surgery, you'll remain awake to report any side effects and talk to doctors while they place the electrodes. Your responses help your surgeon place the lead in the correct place while minimizing side effects. During surgery, your doctor carefully monitors your brain to help ensure correct electrode placement. After the electrodes are implanted, you'll receive general anesthesia so that you're unconscious when your surgeon implants the generator in your chest and guides the wire lead from your brain to the generator.
After your surgery, doctors will perform an MRI to confirm correct placement of your device and leads. You'll usually need to stay in the hospital for a night after your surgery, and you may return to your normal activities after several days. Usually you'll return to the hospital in two weeks to have the device programmed.
The battery life of your generator varies with usage and settings. The battery should last about five years, if it's used 16 hours a day. When the battery needs to be replaced, your surgeon will replace the generator during an outpatient procedure.