DBS surgery risks & Deep Brain Stimulation side effects

DBS surgery risks & Deep Brain Stimulation side effects are relatively low.

It is very easy to think only about the risks of the surgery itself. But the DBS surgery risk is relatively minor, and described below.

A few weeks after the DBS surgery, the DBS electrical current is switched on. The current decreases Parkinson’s Disease symptoms. But sometimes, Deep Brain Stimulation side effects are seen.

Stimulation can increase certain symptoms such as depression, thinking problems and rarely, falling.

There is a small risk of DBS failure as well (10-15%). Although not a DBS risk as such, it is worthwhile to discuss it here.

Let us learn more.

What are the DBS surgery risks (risk of the actual DBS surgery)?

Although this is surgery on the brain, as compared to other surgeries, it is relatively minor. Therefore the DBS surgery risks are low. But they are not non-existent.

Surgeon e1573663930144
The DBS surgery takes a few hours but is quite safe.

Let us look at one of the largest studies on this topic, to know the DBS surgery risk.

A group of German researchers studied 1,183 patients who had Deep Brain Stimulation (DBS) surgery. This series included patients with Parkinson’s disease as well as with other diseases. These were their findings.

  1. The risk of death was less than 1%. 
  2. About 2% of patients had bleeding inside their head that caused weakness on one side of the body. In many patients, this weakness resolved by itself within 30 days.
  3. A few patients (0.6%) had uncommon problems such as infection.
  4. A few patients (0.6%) had somewhat unrelated problems such as pneumonia.

In short:

  • More than 95% of patients did not have any complications.
  • The risk of death or permanent problems was minimal (about 1%).

Overall, as previously mentioned DBS surgery risks are modest. They are on the lower side of those expected from a major surgery.

Perhaps more important is to consider the long-term side effects of the electrical stimulation itself.

[Click here for the entire study]

What is the risk of long-term Deep Brain Stimulation Side-effects?

A few weeks after the surgery is done, the DBS current (stimulation) is switched on. Most people have marked relief from their Parkinson’s symptoms at this time.

Many people do not have any Deep Brain Stimulation side effects.

But sometimes, the stimulation can cause some characteristic problems.

deep brain stimulation surgery 7964267472492663133
A few weeks after surgery, the DBS device is switched on. This may cause worsening of some side effects.

Deep Brain Stimulation side effects include possible worsening of 3 symptoms of Parkinson’s disease:

  • It can worsen Depression, if you already have uncontrollable depression.
  • It can worsen Thinking & Memory problems, especially if you already have them.
  • It can worsen falling, if your falling is caused mostly due to instability.

Depression and Memory:

The first two problems usually happen only if you have these problems before DBS as well. This risks can be reduced by making sure you are a good DBS candidate. [Read “Am I a good DBS candidate?”]

If you have uncontrolled deprssion or thinking/memory problems, these need to be controlled before you can have DBS. Also your doctor may recommend DBS of a different brain part called GPi. [Read about DBS targets].

DepressionParkinsons
If you have uncontrolled depression, it needs to be treated before you have DBS.

Instability and rarely, falling

Let us think about two things that can cause you to fall if you have Parkinson’s:

  • Imbalance – increases in 1/3rd of patients after DBS.
  • Freezing – decrease in most patients after DBS.

Overall, the beneficial effects outweigh the increased imbalance. So, usually patients fall less often after DBS. 

But if the most important reason for you falling is that you are unstable, you should pause.

And think.

You should ask your doctor these 3 questions, BEFORE DBS.

  1. Why am I falling? Is it because of Freezing or Instability?
  2. Do I have a “Parkinson’s Plus Syndrome”?
  3. Is another problem (for example, B12 deficiency) causing my falls?

If instability is the cause of your falls, proceed only after understanding the pros & cons.

If you have a Parkinson’s plus syndrome, consider not getting DBS.

Falling e1574089012814
If you are falling very often, you need to stop and think BEFORE you have DBS.
In summary
DBS improves most symptoms of Parkinson’s disease. But it may worsen three symptoms:

1. Falling: If you are falling because of instability.

2. Thinking/memory: If you already have these problems.

3. Depression: If you already have uncontrollable depression.

No one is perfect. Most patients with Parkinson’s have these symptoms, in greater or lesser severity. This does not mean nobody can get DBS. 

But if you have very severe/uncontrollable problems with any of these three symptoms, you should discuss the pros/cons of DBS in detail with your doctor before proceeding.

What is the risk of DBS failure?

10-15%

Few patients do not get any benefit after DBS. Proper selection of the DBS candidate helps to reduce this risk.

DBS Success rate

But, even if you don’t improve initially after DBS surgery, there is still hope. A initial DBS failure can be converted into a success.

For example, the University of Florida & Harvard university studied patients who had not improved after DBS.

This study included both Parkinson’s patients and some patients with other diseases.

The most common reasons for failure were:

  • Misdiagnosis. [read more]
  • Incorrectly placed electrode. [read more]
  • Incorrect DBS programming. (the DBS settings needed to be changed)
  • Improper medication adjustment

With optimized care such as changing medication doses and reprogramming the DBS, more than half these patients improved. 

Therefore the DBS risk of failure can be lowered.

You can click here for the entire study.

 

In summary, DBS surgery risks are low. Deep Brain Stimulation side effects are uncommon, provided the evaluation is done carefully, BEFORE DBS.

Ont the other hand, the chances of DBS success are very high. They are described in another article.

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

Send Message


NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

4.7 57 reviews

  • Avatar JAIKUMAR MANI ★★★★★ in the last week
    My experience with Dr Siddharth Kharkar was really awesome. It’s always great to be in the presence of someone who is a renowned expert in his field & … More it brings peace of mind that the advice will obviously be the correct one. In addition, his ability to convey complex workings of the human brain in such simple terms that a layman like me could easily understand was something I really appreciated. I heartily Thank Dr Kharkar for his astute advice & gladly recommend him to anyone who needs a neurologist.
  • Avatar Rohit shetye ★★★★★ 3 weeks ago
    Best Dr. we have ever meet. Dr. Listened to us patiently and gave us the proper solution. No unnecessary test or didn’t frighten us. Thank you so much … More Dr.
  • Avatar Ashish Patil ★★★★★ 4 weeks ago
    Great doctor!! Really appreciate.The doctor diagnosed me correctly and start treatment that will help me a lots to improve my condition. The doctor is … More really good, calm and his nature is down to earth, gives confidence to patient!!! Thank you!!!
  • Avatar Bianca D'silva ★★★★★ in the last week
    We had been looking for a specialist in parkinsons for a while now, for my father and when we found Dr. Siddharth Kharka's details on Google, we were … More partly relieved. Partly because, we were all very anxious not knowing how would our visit turn out. I appreciate Dr. Kharkar and his team. He was very clear in his explanations, his knowledge about parkinsons. He took the time to answer the questions we had, went over the diagnosis and started necessary treatment immediately. The only drawback we experienced was the waiting time. Overall, we left the clinic satisfied, knowing much more than when we walked in. We would highly recommend him to anyone looking for a specialist.
  • Avatar Neelam Satghare ★★★★★ 4 weeks ago
    I have visited the doctor clinic for the first timeBut he gave good advice and helped me overcomeMy doubts and queries. It was a good experience.I am very … More thankful for cooperation.
  • Avatar Nitin Ghotge ★★★★★ 4 weeks ago
    Dr.Sidharth Kharkar is one of the best neurologist i came across ....He is really genuine and focused .....We really satisfied after consultancy...
  • Avatar Krishna kumari Radhakrishnan ★★★★★ 2 months ago
    Hi Sharing my experience with Dr KharkarI had consulted with dr regarding my husband’sProblems of tremors. Dr immediately diagnosed on video consultation … More and could help him to control the tremors s of Parkinson’s disease.I found him genuinely polite and free to talk n patiently listening to the patients problem.Now my husband regained his balance n tremors controlled. Many many thanks to Dr Kharkar
  • Avatar a kumar ★★★★★ 4 weeks ago
    Dr kharkar is very nice doctor, sir explained each and every thing very nicely, and i am thankful for Dr kharkar for his treatment .
  • Avatar Nidhi Sonawane ★★★★★ 3 months ago
    I had a positive experience with the doctor. He was very sympathetic. His communication skills were good and listened with patience.
  • Avatar Ujwala Sawant ★★★★★ 4 weeks ago
    Because of Dr.kharkar sir my husband got new life. Tnx sir.
  • Avatar Mythili Balasubramanian ★★★★★ 4 months ago
    Consultation with the doctor was a very satisfying experience. Was empathetic in his approach, and responded positively to all the queries we had. Thank … More you doctor!
  • Avatar Govind Patel ★★★★★ 2 months ago
    Doctor explained very Good nice person give length time to check body
  • Avatar Sharmila Kumawat ★★★★★ 6 months ago
    Dr Siddharth is one of the best Dr I have ever met. He is kind, polite, helpful and very selfless person. I have migraine and I am his patient since more … More than 2 years. The staff is always helpful and Dr Siddharth is just beyond words for me. Thank you for ur selfless service and kindness u give to all ur patients.

Leave a Comment

India Today Magazine - 2021Noted as one of the Best Neurologists in Mumbai