In DBS, once the desired site is detected, the surgeon replaces the recording electrode with the stimulating electrode, completing the first stage of the procedure. The following day the electrode is connected to an external stimulator which allows the surgical team to identify the best stimulation parameters. The patient then returns to the operating room where the programmable pulse generator is implanted below the clavicle. The deep brain stimulator functions like a cardiac pacemaker but, instead of pacing the heart, it suppresses the abnormal thalamic tremor generator. Most patients go home the following morning, after an overnight observation period to insure against brain hemorrhaging.
Total hospitalization is usually three to four days.
The stimulator is an unnoticeable, self-contained, watertight device. Patients are taught to control the stimulation by passing a small magnet over the generator. Because Parkinson's tremor generally ceases during sleep, turning the generator off at that time can save battery power. Although DBS has proven successful, it does have some drawbacks. Patients may need further surgery to replace worn out batteries or broken wires, or for other maintenance problems.