Table of ContentsView AllTable of ContentsWhat Is DBS?Who Can Get It?BenefitsComplications & Side EffectsWhat to ExpectTalking to Your Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is DBS?
Who Can Get It?
Benefits
Complications & Side Effects
What to Expect
Talking to Your Healthcare Provider
Frequently Asked Questions
Deep brain stimulation(DBS) is a therapy that may help reduce seizure activity in those with certain types ofepilepsy. This treatment is usually reserved for people whose seizures haven’t responded to other medications or therapies. DBS is a relatively new tool for epilepsy, and further studies may reveal additional uses.
This article discusses how deep brain stimulation is used, what the DBS device does inside your brain, how it’s implanted, and what to expect after starting treatment.
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What Is Deep Brain Stimulation?
Deep brain stimulation is a treatment tool for epilepsy that uses electrodes and a pacemaker implanted into the brain to help controlseizures. Its goal is to interrupt the brain’s abnormal electrical activity or signals that can lead to seizure activity.
The concept of deep brain stimulation goes back to the 1800s, but it was not studied and adopted in its current form until the 1970s and 80s.The Food and Drug Administration (FDA) approved deep brain stimulation as a treatment strategy for seizures in 2018, though this tool had already been used for several years in Europe and abroad.
How It Works
The location of the deep brain stimulation device can vary. In general, the device is used to target:
Targeted areas for direct deep brain stimulation typically include the following:
Indirect deep brain stimulation can target areas including:
The Anatomy of the Brain
Conditions and Symptoms DBS Can Treat
Recent research suggests deep brain stimulation is more effective in treating generalized epilepsy thanfocal seizures(seizures due to abnormal electrical activity).
Beyond seizures, deep brain stimulation has been used to treat conditions including:
Studies have also investigated the use of deep brain stimulation in treatingAlzheimer’s diseaseandmajor depressive disorder, but results in treating these conditions have been inconsistent.
Who Can Get DBS?
Deep brain stimulation is a relatively newtreatment for epilepsy, but it’s been used for some time to treat Parkinson’s disease and other conditions. If you have epilepsy and other treatments have failed to reduce seizure activity, you may be considered for DBS therapy.
Whether you are a candidate for this treatment depends on your specific type of seizure activity, your overall health, and whether you meet other criteria your surgeon may require.
Causes and Risk Factors of Epilepsy
Presurgical Testing
Before you are considered for deep brain stimulation, your healthcare provider will perform several examinations and tests. These include:
Your healthcare team will also review your symptoms and epilepsy history to determine if deep brain stimulation is a good fit for you.
Benefits of Deep Brain Stimulation
Generally, the benefit of deep brain stimulation is a reduction in seizure activity and an overall improvement in quality of life.
One report revealed around 69% of people who used DBS for epilepsy noticed a decrease in seizure activity five or more years after implantation of the stimulation device. About 6% said seizures had stopped entirely after DBS treatment.
How Common Are DBS Implants?The exact number of deep brain stimulators implanted specifically for epilepsy is difficult to estimate, but experts say around 230,000 have been implanted worldwide to treat various conditions.
How Common Are DBS Implants?
The exact number of deep brain stimulators implanted specifically for epilepsy is difficult to estimate, but experts say around 230,000 have been implanted worldwide to treat various conditions.
Complications and Side Effects
Data regarding complications and side effects of deep brain stimulation for epilepsy is limited since it was only approved in 2018. However, it’s been used longer for managing Parkinson’s disease, and side effects are believed to be similar.
Adverse effects that have been noted in studies specific to deep brain stimulation for epilepsy include:
Other possible complications observed with deep brain stimulation include:
Other side effects that can develop not from the surgery itself but from deep brain stimulation therapy include:
Will I Feel Different After DBS?DBS treatment aims to reduce symptoms of epilepsy, but other well-documented effects can impact how you feel.The following psychiatric side effects have been observed:DepressionSuicidal thoughtsApathyCognitive declineImpulse control disorders, like binge eatingBehavioral changesDelusions or psychosisBe sure to let the healthcare provider that manages your DBS treatment know if you develop any of these symptoms.If you develop suicidal thoughts while undergoing deep brain stimulation therapy, call 911 or contact the988 Suicide & Crisis Lifelineat988for support and assistance from a trained counselor.
Will I Feel Different After DBS?
DBS treatment aims to reduce symptoms of epilepsy, but other well-documented effects can impact how you feel.The following psychiatric side effects have been observed:DepressionSuicidal thoughtsApathyCognitive declineImpulse control disorders, like binge eatingBehavioral changesDelusions or psychosisBe sure to let the healthcare provider that manages your DBS treatment know if you develop any of these symptoms.If you develop suicidal thoughts while undergoing deep brain stimulation therapy, call 911 or contact the988 Suicide & Crisis Lifelineat988for support and assistance from a trained counselor.
DBS treatment aims to reduce symptoms of epilepsy, but other well-documented effects can impact how you feel.
The following psychiatric side effects have been observed:
Be sure to let the healthcare provider that manages your DBS treatment know if you develop any of these symptoms.
If you develop suicidal thoughts while undergoing deep brain stimulation therapy, call 911 or contact the988 Suicide & Crisis Lifelineat988for support and assistance from a trained counselor.
Deep brain stimulation devices are implanted under local orgeneral anesthesia. A team of surgeons and epilepsy experts are involved, and the entire implantation procedure can take as long as seven hours.
Preparing for Treatment
In addition to your preoperative testing, your healthcare provider may suggest the following to you before you are approved for surgery:
You will be given specific preoperative instructions for the day before your surgery, including when and where to arrive. This may also include instructions such as:
Preparing for Surgery
During DBS
You will first receive local or general anesthesia on the day of surgery. General anesthesia is usually used for children. If you are an adult, your healthcare provider may prefer to have you awake for at least a part of the procedure to monitor responses as electrodes are placed.
Next, your surgeon will prepare you for the procedure. They will shave and numb a section of your scalp and steady your head with a device and screws. Numbing medicine will be applied where the screws come into contact with your skin.
Brain Surgery for Parkinson’s Disease: Overview
Stage 1
Small holes are drilled into the skull where the electrodes will be placed. As they are inserted, your surgeon may ask you to move different parts of your body, respond to questions, or even read cards. Your responses in this stage will help your surgeon confirm the appropriate location of the electrodes.
Stage 2
In this stage, you will likely be placed under general anesthesia. A small incision is made below your collarbone or in your chest or belly. The device that will generate impulses—the neurostimulator—is implanted through this incision.
Once the neurostimulator is in place, your surgeon will connect it to the implanted electrodes through a long extension wire tunneled under your skin from your brain to the neurostimulator site.
Once these devices are connected and implanted, your surgeon will close the incision, and you will be taken to a recovery area while you wake up from anesthesia.
Recovery and Outlook
After surgery, you can expect to stay in the hospital for about three days. Your stimulation device will not be activated yet.
After your discharge, you will visit the healthcare provider managing your DBS therapy. The device will be turned on and adjusted to achieve the desired number and frequency of impulses. This procedure is called programming and does not require additional surgery.
Generally, people who begin treatment report an improvement in their symptoms with the device. The use of deep brain stimulation and the surgery to implant the device is riskiest in people over age 70. If needed, the procedure can be reversed.
Recovering From Surgery
Talking to Your Healthcare Provider About DBS
If you are interested in exploring deep brain stimulation therapy to treat seizure activity, speak with your healthcare provider to learn whether you are a candidate for it.
Not every type of seizure responds to DBS, and your healthcare provider may want you to try additional treatments or medications before undergoing the invasive procedure for DBS placement.
Summary
Deep brain stimulation is a therapy that delivers small impulses in your brain to interrupt the abnormal electrical activity that can trigger seizures or desensitize you to seizure activity.
The device to deliver these impulses can be programmed remotely, but implantation requires extensive invasive surgery. Not everyone with epilepsy is a candidate for DBS. Speak with your healthcare provider to determine whether DBS may be a promising treatment option.
Frequently Asked QuestionsDeep brain stimulation was only approved as a treatment for epilepsy in 2018. Still, studies indicate that as many as 70% of people treated with DBS report a decrease in seizures after five years.Learn MoreUnderstanding the Risks Involved When Having SurgeryMost health insurance plans cover FDA-approved uses of deep brain stimulation. Check with your insurance company before undergoing surgery to confirm your specific coverage.Learn MoreImportant Questions to Ask Before You Have SurgeryWhether or not you still need to take medication after starting DBS depends on how well you respond to treatment. Few people—only about 6%—have their seizures stop completely after DBS. How your remaining seizure activity after DBS is treated is a decision you will need to make with your healthcare provider.Learn MoreHow Epilepsy Is Treated
Deep brain stimulation was only approved as a treatment for epilepsy in 2018. Still, studies indicate that as many as 70% of people treated with DBS report a decrease in seizures after five years.Learn MoreUnderstanding the Risks Involved When Having Surgery
Deep brain stimulation was only approved as a treatment for epilepsy in 2018. Still, studies indicate that as many as 70% of people treated with DBS report a decrease in seizures after five years.
Learn MoreUnderstanding the Risks Involved When Having Surgery
Most health insurance plans cover FDA-approved uses of deep brain stimulation. Check with your insurance company before undergoing surgery to confirm your specific coverage.Learn MoreImportant Questions to Ask Before You Have Surgery
Most health insurance plans cover FDA-approved uses of deep brain stimulation. Check with your insurance company before undergoing surgery to confirm your specific coverage.
Learn MoreImportant Questions to Ask Before You Have Surgery
Whether or not you still need to take medication after starting DBS depends on how well you respond to treatment. Few people—only about 6%—have their seizures stop completely after DBS. How your remaining seizure activity after DBS is treated is a decision you will need to make with your healthcare provider.Learn MoreHow Epilepsy Is Treated
Whether or not you still need to take medication after starting DBS depends on how well you respond to treatment. Few people—only about 6%—have their seizures stop completely after DBS. How your remaining seizure activity after DBS is treated is a decision you will need to make with your healthcare provider.
Learn MoreHow Epilepsy Is Treated
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zangiabadi N, Ladino LD, Sina F, et al.Deep brain stimulation and drug-resistant epilepsy: a review of the literature.Front Neurol. 2019;10:601. doi:10.3389/fneur.2019.00601Epilepsy Foundation.Deep brain stimulation.Wu YC, Liao YS, Yeh WH, et al.Directions of deep brain stimulation for epilepsy and parkinson’s disease.Front Neurosci. 2021;15. doi:10.3389/fnins.2021.680938MedlinePlus.Deep brain stimulation.Foutz TJ, Wong M.Brain stimulation treatments in epilepsy: basic mechanisms and clinical advances.Biomed. Jour.2022;45(1):27-37. doi:10.1016/j.bj.2021.08.010Wong JK, Deuschl G, Wolke R, et al.Proceedings of the ninth annual deep brain stimulation think tank: advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, pain, interventional psychiatry, epilepsy, and traumatic brain injury.Front. Hum. Neurosci.2022;16. doi:10.3389/fnhum.2022.813387Medtronic.Getting DBS.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zangiabadi N, Ladino LD, Sina F, et al.Deep brain stimulation and drug-resistant epilepsy: a review of the literature.Front Neurol. 2019;10:601. doi:10.3389/fneur.2019.00601Epilepsy Foundation.Deep brain stimulation.Wu YC, Liao YS, Yeh WH, et al.Directions of deep brain stimulation for epilepsy and parkinson’s disease.Front Neurosci. 2021;15. doi:10.3389/fnins.2021.680938MedlinePlus.Deep brain stimulation.Foutz TJ, Wong M.Brain stimulation treatments in epilepsy: basic mechanisms and clinical advances.Biomed. Jour.2022;45(1):27-37. doi:10.1016/j.bj.2021.08.010Wong JK, Deuschl G, Wolke R, et al.Proceedings of the ninth annual deep brain stimulation think tank: advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, pain, interventional psychiatry, epilepsy, and traumatic brain injury.Front. Hum. Neurosci.2022;16. doi:10.3389/fnhum.2022.813387Medtronic.Getting DBS.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Zangiabadi N, Ladino LD, Sina F, et al.Deep brain stimulation and drug-resistant epilepsy: a review of the literature.Front Neurol. 2019;10:601. doi:10.3389/fneur.2019.00601Epilepsy Foundation.Deep brain stimulation.Wu YC, Liao YS, Yeh WH, et al.Directions of deep brain stimulation for epilepsy and parkinson’s disease.Front Neurosci. 2021;15. doi:10.3389/fnins.2021.680938MedlinePlus.Deep brain stimulation.Foutz TJ, Wong M.Brain stimulation treatments in epilepsy: basic mechanisms and clinical advances.Biomed. Jour.2022;45(1):27-37. doi:10.1016/j.bj.2021.08.010Wong JK, Deuschl G, Wolke R, et al.Proceedings of the ninth annual deep brain stimulation think tank: advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, pain, interventional psychiatry, epilepsy, and traumatic brain injury.Front. Hum. Neurosci.2022;16. doi:10.3389/fnhum.2022.813387Medtronic.Getting DBS.
Zangiabadi N, Ladino LD, Sina F, et al.Deep brain stimulation and drug-resistant epilepsy: a review of the literature.Front Neurol. 2019;10:601. doi:10.3389/fneur.2019.00601
Epilepsy Foundation.Deep brain stimulation.
Wu YC, Liao YS, Yeh WH, et al.Directions of deep brain stimulation for epilepsy and parkinson’s disease.Front Neurosci. 2021;15. doi:10.3389/fnins.2021.680938
MedlinePlus.Deep brain stimulation.
Foutz TJ, Wong M.Brain stimulation treatments in epilepsy: basic mechanisms and clinical advances.Biomed. Jour.2022;45(1):27-37. doi:10.1016/j.bj.2021.08.010
Wong JK, Deuschl G, Wolke R, et al.Proceedings of the ninth annual deep brain stimulation think tank: advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, pain, interventional psychiatry, epilepsy, and traumatic brain injury.Front. Hum. Neurosci.2022;16. doi:10.3389/fnhum.2022.813387
Medtronic.Getting DBS.
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