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Specialized Therapy Helps You Regain Control

Life with a movement disorder can be challenging. When medication alone can’t bring relief, the AdventHealth Neuroscience Institute offers deep brain stimulation (DBS) to treat your symptoms.

What is Deep Brain Stimulation?

If you’re living with a movement disorder like Parkinson’s disease, essential tremor or dystonia — and your symptoms aren’t manageable with medications alone — deep brain stimulation can improve your quality of life. 

While it isn’t a cure, DBS can significantly improve quality of life, including allowing you to cautiously return to hobbies, sports and other activities. It can also help you manage your symptoms as your disease changes or progresses.

By implanting electrodes, your doctors can stimulate the specific areas of your brain associated with your unique condition through electrical impulses that regulate signals, cells and chemicals within your brain.

A pacemaker-like device implanted under the skin of your chest controls the amount of stimulation you receive, and a wire connects the device to the electrodes in your brain.

Stimulation is adjusted by your doctor based on your needs.


To learn more, or talk with the Brain Services Care Coordinator, call: 407-303-7944

The Ventriloquist

 

Mark Wade is a well-known ventriloquist who went under Deep Brain Stimulation surgery at AdventHealth Celebration to treat an essential tremor. Learn more about his story by watching the video.

The Relief You Seek

Parkinson’s Disease

If you’re seeking DBS therapy for Parkinson’s disease, it’s important to understand what symptoms DBS can treat and what symptoms it won’t improve. 
DBS therapy can address the motor symptoms associated with Parkinson’s disease including:

  • Bradykinesia (slowness)
  • Dyskinesia (involuntary movements)
  • Dystonia (involuntary spasms)
  • Rigidity (stiffness)
  • Tremor (shakiness)

DBS can provide the best “on” time that you experience with your medications for Parkinson’s disease, and a smoother therapy over time that reduces motor fluctuations between “off” and “on” periods throughout the day.
It can also benefit patients with medication-induced dyskinesia (involuntary movement), as well as medication-refractory tremor, rigidity and slowness of movements. Many patients who are not able to tolerate higher doses of medications due to side effects may benefit from DBS. 

In addition, if your doctor has recommended higher doses of medication, but you cannot tolerate higher doses due to side effects (such as sedation or lightheadedness), you may benefit from DBS.
DBS does not benefit non-motor symptoms of Parkinson’s including:

  • Constipation
  • Mood
  • Memory
  • Sleep difficulties
  • Urinary symptoms

If you don’t experience any benefits from your Parkinson’s medication, DBS may not be helpful for you. However, you should be evaluated by a movement disorder neurologist to determine if you’re receiving the correct medications at enough doses. 
After DBS surgery, most people will continue taking their medications for Parkinson’s disease. However, with DBS programming, the amount of medication can likely be reduced.

Essential Tremor

If you’re diagnosed with essential tremor and experience tremors of the hands, head or voice, DBS therapy is a treatment option you can consider at any time.
DBS therapy has been used over 20 years for essential tremor and is considered an effective treatment option with the potential to improve symptoms even more effectively than the best medical therapy. 
In fact, with DBS therapy, most essential tremor patients can stop taking medication. Patients often choose DBS therapy for essential tremor when:

  • Medications are not adequately controlling symptoms
  • Medications may be causing significant side effects
  • Other treatments are not effective
  • The tremor is impacting your quality of life and daily activities
Dystonia

If you’re living with dystonia and the uncomfortable muscle contractions associated with the condition, DBS may be an effective therapy option for you. While it’s difficult to predict who will benefit and to what degree, DBS may help with dystonia when:

  • Medications and other treatments aren’t providing you adequate relief
  • Symptoms are negatively affecting your quality of life

Your body’s response to DBS for dystonia may take longer than for Parkinson’s disease and essential tremor, potentially six months to a year. 

Choosing the Right DBS Procedure

At AdventHealth, our expert neurosurgeons perform two types of DBS surgical procedures: “Awake” and “Asleep.” After assessing your condition, updating your treatment plan and understanding your unique challenges, our neurologists and neurosurgeons can help you decide which DBS procedure is right for you.

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                        “Awake” Deep Brain Stimulation

“Awake” Deep Brain Stimulation

In “Awake” DBS (the most common) your head is placed in a frame and a CT scan is performed. You’ll undergo light anesthesia and be awake for part of the surgery, experiencing little to no pain and interacting with your surgical team to help ensure the electrodes are placed in the best location. 

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                        “Asleep” Deep Brain Stimulation

“Asleep” Deep Brain Stimulation

In “Asleep” DBS, your surgeon uses a CT or MRI to guide the electrode placement while you are under general anesthesia.
There is no testing done at the time of the implant. This procedure is typically reserved for patients who are symptomatic off medications or too anxious to undergo the “Awake” procedure.
 

A Multidisciplinary Evaluation Provides the Assurance You Need

As part of the DBS evaluation at AdventHealth, you’ll be asked to complete evaluations by a neurologist, neurosurgeon, neuropsychologist, physical therapist and speech-language pathologist.

Once the evaluations are complete, our multidisciplinary team will review them to determine the best treatment plan for you. 

We have treated many DBS patients who would be glad to speak to you about their journey. 

If you’ve been diagnosed with Parkinson’s disease, you will meet with an AdventHealth movement disorder neurologist or their physician assistant to undergo an “ON-OFF” evaluation. 

For patients with essential tremor or dystonia, an “ON-OFF” evaluation may not be completed. 

During your initial consultation, your neurosurgeon will explain the surgical DBS procedure, review the potential risks and benefits of surgery and evaluate your candidacy for surgery.

This consultation doesn’t require you to commit to DBS surgery. Rather, it’s an opportunity for you to have your questions answered by the surgeon and to get to know the team.
 

During your neuropsychological evaluation, your memory will be tested, as will facets of language. Plan for a 3 to 4 hour testing period. You should take your medications as normally scheduled prior to this evaluation.

DBS requires brain imaging and a review by your neurosurgeon and neurologist. This is an MRI of the brain.

A physical therapist is available to evaluate your gait and motor function prior to DBS surgery, if needed. We may also recommend that an occupational therapist evaluate your ability to perform your daily tasks prior to DBS surgery.

It may also be recommended that you meet with a speech-language pathologist for an evaluation of your speech and swallowing prior to DBS surgery.

To discuss your personal needs pertaining to DBS surgery, you may meet with a social worker prior to or following DBS surgery and during DBS programming.

We invite you to watch our free pre-surgical information video to better prepare you for your upcoming procedure, discharge and recovery. We recommend viewing it with your coach, the person who will be at home with you when you are discharged and support you throughout your health journey.

Watch the Video

Neuro specialist going over medical charts.

Your Health Ally All the Way

Your compassionate and knowledgeable Care Coordinator is available to help schedule appointments, thoroughly explain every treatment option and put you in touch with the right resources. You’ll never wonder what’s next, because we’ll be with you every step of the way.

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