Before surgery
Your DBS center will provide instructions about medication, food and drink, skin preparation and arrival time. Follow those instructions, even if they differ from another person's experience. Some procedures are done while a person is awake for part of the operation; others use imaging-guided techniques under general anesthesia.
Plan practical support for transportation, meals, medication organization and wound checks. Ask who to call after hours and which symptoms require urgent attention.
The usual stages
- Planning: imaging helps the team identify the brain target and route.
- Lead placement: one or two leads are placed in the chosen target. The team may use imaging, brain recordings or symptom testing to confirm placement.
- Pulse generator placement: the battery-powered device is placed under the skin, usually near the upper chest, and connected by extension wires under the skin.
- Activation and programming: stimulation is often started at a later appointment after initial healing, though practices vary.
Lead placement and generator placement may happen on the same day or as separate procedures.
What are the risks?
DBS requires brain surgery. Risks include bleeding in the brain, stroke, infection, seizures, confusion, hardware movement or failure, and complications from anesthesia. Stimulation itself can cause side effects such as speech, balance, mood, vision or movement changes. Some stimulation effects may improve when settings are adjusted, but not every problem is reversible.
Risk depends partly on your health, procedure and team's experience. Ask your neurosurgeon for the center's complication rates and how they manage infections, bleeding and hardware problems.
Early recovery
Temporary swelling, discomfort, fatigue and changes around incision sites can occur. Your team should give you wound-care, activity and bathing instructions. Do not lift, drive, travel or resume strenuous exercise until your own team says it is safe.
Call the surgical team promptly for warning signs they identify, which may include fever, increasing redness or drainage, severe or worsening headache, new weakness, confusion, seizure, chest swelling or a sudden major neurological change. Use emergency services for urgent or severe symptoms.
Activation is the beginning of adjustment
DBS is not always turned on immediately, and the first settings are not necessarily the final settings. Programming may take multiple visits as the team balances symptom benefit with side effects and medication changes. Keep notes that describe specific activities and times of day instead of relying only on “better” or “worse.”
Long-term results also depend on thoughtful programming, medication management, device follow-up and clear communication with the clinical team.