After Deep Brain Stimulation (DBS) Surgery

On a thin person, the batteries or pulse generators might be visible as large bumps (about half the size of a deck of cards) underneath the skin in the chest. In addition, special caps (roughly the size of two stacked quarters) on the skull keep the electrodes in place. They may be visible if you have little or no hair covering the area.

A thin, flexible wire runs from your scalp to your chest under the skin in your neck. You may be able to feel it, but probably not see it. There are no visible metal parts in the entire DBS system.

Pain from the DBS Devices

You may notice small bumps on either side of your head at the surgical sites. There is a small amount of discomfort just after we place these devices in your body. We can typically control this with mild pain medication. After a few days, you shouldn’t have any discomfort from either the brain electrodes or the electrical devices in your chest.

When we activate the electrodes in the operating room or at any time in the clinic, you may feel a tingling or pulling sensation in your legs, arms or face. This sensation should subside within a few moments. If not, we will change the settings of your electrodes to correct the sensation.

Your electrodes continuously stimulate the targeted brain region. However, once we turn them on and set them correctly for you, you shouldn’t feel any sensation from them.

You can play any sport that doesn’t have a significant risk of these issues:

• Extreme twisting of the head and neck
• Falls
• Hard impacts

The goal is to avoid breaking the DBS equipment that runs from your skull, through your neck and into your chest.

For your safety, you should have a swimming buddy when going swimming for the first time after your DBS surgery. Most people remain capable swimmers after DBS surgery.

You can travel by airplane after DBS surgery. At the airport or at any security checkpoint, please inform security officials that you have DBS. Show them your DBS ID card and ask to be inspected with a hand wand.

With the new generation of batteries, there is very little risk of security scanners activating your DBS.

You should understand which medical imaging tests are safe and not safe for people with DBS.

X-Rays, EKG and CT scans

X-Rays, electrocardiograms (EKG) and CT scans are safe for you. However, DBS can interfere with the quality of the EKG.

If you have your device with you, you can inactivate your DBS for several minutes for the EKG technician. You then should be able to reactivate it without negative side effects (other than a temporary increase in tremor if you have DBS for tremor).

MRI

Because MRI uses a powerful magnet to make images, the imaging team will need to avoid damaging the hardware or any tissues that are in contact with the DBS. If you need a brain MRI for any reason, let the radiologist know that you have a DBS system in place.

You may need to turn off the DBS system during the scan. Alternately, you may need to place the DBS into an MRI safe mode. (This capability depends on the type of DBS you have.)

Besides brain MRI, you cannot safely have any other type of MRI. Your care team will need to offer you safe imaging tests, including X-Ray, ultrasound and CT scan.

Diathermy (Deep Tissue Ultrasound)

As a part of physical therapy, some therapists may recommend deep tissue ultrasound to heal inflamed soft tissues. This is not safe for people with DBS due to concerns of transmitting too much energy to the DBS system.

Antibiotics Before Dental Cleanings or Procedures

DBS doesn’t cause you to need antibiotics before dental procedures. Care teams typically recommend antibiotics before dental procedures for people with specific heart valve problems. Please check with your primary care provider to confirm your specific situation.

Colonoscopy Special Precautions

Most colonoscopies don’t require the use of a procedure to remove abnormal tissue. However, in the event that your doctor needs to use a device called electrocautery to remove abnormal tissue, we recommend you turn off your DBS before the colonoscopy.

Mammogram Special Precautions

Mammography is safe to perform in people with DBS. The technician may need to take special care to avoid twisting the DBS battery while they compress your breast for the test. Let the technician know that you have DBS before they begin mammography.

Pacemaker or Cardiac Defibrillator

If the need arises for you to have an implanted cardiac pacemaker or defibrillator, you can safely do so. You need to let your cardiologist know that you have DBS.

Emergency Defibrillator for Cardiac Arrest

There is a risk of damage to the DBS system and to the brain with anything that uses powerful electrical shocks, such as with cardiac defibrillators. However, we strongly recommend using cardiac defibrillation as a potentially life-saving measure. People should use them when appropriate, regardless of whether or not you have DBS.