Deep Brain Stimulation for Epilepsy

If your epilepsy isn't getting better with the treatments you get now, you may want to try deep brain stimulation (DBS). In this treatment, your doctor places small electrodes into your brain to help control your seizures.

How It Works

Your brain has billions of nerve cells called neurons. Electrical impulses carry messages from neuron to neuron. When you have epilepsy, abnormal bursts of electrical activity in these brain cells set off seizures.

When you get DBS, the tiny electrodes that your doctor puts into your brain deliver an electric current. This interrupts the abnormal electrical signals and helps prevent seizures. It's kind of like having a pacemaker for your brain.

Who Can Get Deep Brain Stimulation

Most people try medicines first to control seizures, but anti-seizure drugs don't work in about 30% of people. Another treatment is surgery to remove the small piece of your brain that's causing the seizures. But not everyone with epilepsy should get this procedure.

DBS is an option if other epilepsy treatments don't work or your doctor doesn’t recommend them. It won't destroy your brain tissue or cause many of the memory and language problems that can be a side effect of other types of surgery.

How to Prepare

Your doctor will give you tests to make sure DBS is the right treatment for you. You'll also have magnetic resonance imaging (MRI) or computed tomography (CT) scans to make images that let your surgeon find the right place in your brain to put the electrodes.

What to Expect

DBS is usually done while you're awake. You'll get medicine to relax you and prevent pain. Your doctor will attach a metal frame to your head to keep you still during the surgery. He'll shave your hair in the part of your head where the procedure will be done.

The surgeon will place one or two very thin metal wires called leads into the part of your brain where your seizures start. The electrodes are attached to another wire that goes down your neck. The wire is connected to a small device called a pulse generator or neurostimulator that's put under the skin just below your collarbone, or under the skin of your belly. Electrical signals will travel from the neurostimulator to the leads in your brain.

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After your surgery, your doctor will turn on the DBS device with a small computer called a programming unit. He'll use it to adjust the speed and intensity of the electrical signals to control your seizures. You'll also get a programming unit to take home, so you can adjust your device and track any seizures you get.

DBS might not stop your seizures completely, but it should cut down how many you get. In one study, people who got DBS had 56% fewer seizures by their second year with the device.

After you get your DBS device, you'll need to return to your doctor for regular follow-up visits. You'll need to get the battery replaced every 3 to 4 years.

Risks

DBS is generally safe, but the device and the surgery to put it in can cause side effects. 

Risks from DBS surgery can include things like:

  • Stroke
  • Bleeding in the brain
  • Infection
  • Breathing problems
  • Heart problems
  • Headaches
  • Seizures

Side effects from using the device include:

  • Numbness or tingling
  • Speech problems
  • Balance issues
  • Tight muscles in your face or arm
  • Dizziness
  • Mood changes, depression

Deep brain stimulation is just one possible treatment for hard-to-control epilepsy. Talk to your doctor about all your options. Make sure you know how DBS might help your epilepsy and what the risks are before you have the procedure.

WebMD Medical Reference Reviewed by Neil Lava, MD on April 08, 2019

Sources

SOURCES:

Clinical Neurology and Neurosurgery: "Clinical efficacy of deep brain stimulation for the treatment of medically refractory epilepsy."

Epilepsia: "Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy."

Epilepsy Foundation: "What is a Seizure?"

Epilepsy Society: "Deep Brain Stimulation."

Mayo Clinic: "Deep brain stimulation: Overview," "Deep brain stimulation: Risks," "Epilepsy: Treatment."

Neurosurgical Focus: "Deep brain stimulation targets for treatment of epilepsy."

NHS: "Epilepsy and deep brain stimulation."

University of Pittsburgh: "Deep Brain Stimulation for Movement Disorders."

UpToDate: "Patient education: Seizures in adults (Beyond the Basics)."

Young Epilepsy: "Deep Brain Stimulation."

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