DBS surgery risks & Deep Brain Stimulation side effects, Side Effects of DBS For Essential Tremor – Drkharkar

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.

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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.

Keywords – best hospital for dbs surgery, deep brain stimulation cost, long term side effects of dbs, life after dbs surgery, how long does deep brain stimulation last, deep brain stimulation dystonia success rate, deep brain stimulation surgery, side effects of dbs for essential tremor

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

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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

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    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
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    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
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    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
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    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
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    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
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    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you
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    We have visited the hospital and meet the Dr. S. Kharkar. And my personal experience is very much better and exilent. My father is very well recover as … More we thought. Thanks to Nanavati Hospital and Dr. S. Kharkar.
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    Had very Severe migraine attacks for years and suddenly my migraine had triggered for continuous 5 days thats when I contact Dr Siddharth and was fortunate … More to have a effective medication which help me reduced my triggers and headaches..Lucky in few months I have very less days of headache in a month and can do my Daily life with much ease.
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    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.
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    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!!!
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    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.
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    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.
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    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
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  • Avatar Sharmila Kumawat ★★★★★ a year 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.

2 thoughts on “DBS surgery risks & Deep Brain Stimulation side effects, Side Effects of DBS For Essential Tremor – Drkharkar”

  1. Sir …what is the cost of replacement of the pacemaker (IPG).
    Diagnosis : advance Parkinson ‘ s disease
    age : 60 as on 2021
    Operated case of left pallidotomy followed by bilateral STN DBS with IPG insertion was done in 2007 followed by IPG change in 2012 and 2017.

    Reply
    • It varies between 5 to 10 lakh. Will add it to the article also.

      Reply

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