Deep Brain Stimulation for Movement Disorders
If medication does not adequately control the symptoms of essential tremor or dystonia and the unwanted movements disrupt your daily activities significantly, your NYU Langone doctor may recommend a procedure called deep brain stimulation. It’s similar to a pacemaker, but it’s used in the brain instead of the heart.
In deep brain stimulation, NYU Langone neurosurgeons at the Center for Neuromodulation implant a small electrode in the brain that uses electrical stimulation to block the nerve signals that cause movement disorders.
NYU Langone neurologists, neurosurgeons, and psychiatrists perform a thorough evaluation to choose the best candidates for this procedure.
Surgery to Implant the Device
NYU Langone neurosurgeons perform more than 100 deep brain stimulation procedures each year. Before surgery, your doctor uses MRI and CT scans to determine the exact location in the brain to implant the electrode.
When the surgeon determines the appropriate location, he or she makes a small opening in the skull and inserts the electrode through a thin, insulated wire. The tip of the electrode is positioned in the area mapped by the surgeon. The wire is then passed under the skin of the head, neck, and shoulder.
Surgery to implant the device and wire takes several hours and is performed under general anesthesia. It requires an overnight hospital stay so your doctor can monitor your recovery.
During a second surgery the next day, the wire is connected to a pulse generator—a small battery pack that sends electrical impulses to the electrode in the brain. The pulse generator is implanted under the skin near the collarbone. Most people can return home on the day of this second procedure.
Several days after surgery, you visit your neurosurgeon and neurologist, who program the pulse generator. With the push of a button on an external remote control, electrical impulses are sent to the electrode in the brain.
People receiving deep brain stimulation are able to adjust the strength of the electrical impulses on their own. They work with a neurologist to determine the combination of settings that best controls their symptoms.
After this adjustment period, most people require only occasional maintenance visits. Depending on the settings used, deep brain stimulation can significantly reduce involuntary movements in people with movement disorders.