A Parkinson's care team consisting of a neurologist,
neurosurgeon , neurophychologists and team of nurses is involved in caring for
DBS patients. The DBS system is implanted by a functional
stereotactic neurosurgeon, that is, a neurosurgeon who specialises in
treating central nervous
system function disorders using stereotactic
techniques. This means that a stereotactic head frame is used to keep the
patient's head still during surgery and the neurosurgeon uses special imaging
techniques such as magnetic
resonance imaging (MRI) or computerised
tomography (CT) to map the brain and locate the site to be stimulated -
either the STN or GPi.
There are two parts to the
surgery: the procedure to implant the leads, and the surgery to implant
the neurostimulator(s)
and extensions.
The duration of the procedure and the specific steps involved can vary. The surgery will last several hours.
Although the prospect of surgery
can be scary, there is some comfort in knowing that patients who have the DBS
system usually describe the surgery as demanding and exhausting, but not
painful. Fortunately, the brain itself has no pain receptors and feels no pain.
The hospital stay is usually a
few days for the pre-operative tests, implant surgery and recovery.
Follow up: programming the DBS
system
After surgery, follow up visits
are necessary. This is because the computer chip inside the neurostimulator
must be programmed to send the electrical pulses to help control Parkinson's
disease symptoms.
The physician uses a programmer
to non-invasively program (transmit instructions to) the DBS system. People
respond to deep brain stimulation in their own way and the program for the
neurostimulator is customised to each patient's needs.
Visits to the clinic for initial
programming after surgery and periodic adjustments are a routine part of DBS
therapy. It will take more than one visit to adjust the stimulation and
medication before the right combination is determined. As the patient becomes
accustomed to DBS therapy and the body fully heals, further adjustments will be
needed. Over time as the disease progresses, further adjustments may be
necessary. Ongoing, periodic visits are a routine part of the process.
