What are the Risks of DBS?

By University of Florida Health Physicians Michael S. Okun, M.D., Hubert H. Fernandez, M.D., and Kelly D. Foote, M.D.

DBS, like any brain surgery, has significant risks(16-18).  The most serious and worrisome risk occurs during the surgical procedure when “probes” called microelectrodes are inserted into the brain to determine the best target location.  If a microelectrode, or alternatively the DBS lead, punctures a blood vessel it can lead to a stroke or stroke-like syndrome which may result in weakness, numbness, sensory loss, visual difficulties, or a host of other neurological problems.

Additionally, patients with cognitive dysfunction may worsen following DBS, and the surgery may affect one of many mood and cognitive circuits leading to changes such as depression, laughter, memory problems, or other psychiatric and/or behavioral features.  Additionally, there is a chance the lead may migrate, or the electrode, connecting wire, or impulse generator may break and need to be replaced.  Any time a foreign body is implanted into a human there is a risk for infection, both at the skin level, and in the brain.  The batteries in the device will have to be changed requiring additional surgery, with the average time to battery replacement differing based on the underlying disorder, as well as the stimulation settings.  As with all surgical procedures, there is a small chance of infection, and death from the procedure.

Perhaps the biggest risk of surgery is that for patients and families the surgery will not meet perceived expectations.  It is for this reason that we strongly suggest an in depth consultation with a movement disorders neurologist.  This discussion should address individual symptoms and be as specific as possible.

We offer a mneumonic device for PD patients interested in DBS (Table 1) to help educate them and alter their perceptions to more closely match what is known about anticipated benefits of surgery.

If you have questions or would like a consultation to see if you are a candidate please call Chris Baughman at 352-294-5431 or email at Christopher.baughman@neurology.ufl.edu.