Deep Brain Stimulation (DBS) is a type of epilepsy surgery that involves implanting an electrode into the brain and a neurostimulator into the chest, usually just below the left collarbone.
DBS is a type of ‘neuromodulation’, similar to vagus nerve stimulation (VNS). It has been used for both epilepsy and is also widely used for Parkinson’s Disease, although that targets a different area of the brain with essentially the same procedure.
The aim of DBS is to reduce the frequency and severity of seizures, but not necessarily stop them. It has been helpful for some people where seizures can not be controlled with the use of other treatment options, but as it’s relatively new its effectiveness is still being researched. DBS may not prove an effective option for everybody.
A battery-powered device, called a neurostimulator, is implanted into the chest (or less commonly the abdomen) and connected to the brain. The device sends electrical impulses directly to the brain via leads and electrodes that are placed in the anterior nucleus of the thalamus. This is part of the brain that is commonly involved in the spread of seizures.
Although it’s showing promising results, DBS is still fairly new and as such, there is currently no NHS funding. As with all new treatments, DBS is currently being rigorously researched to assess its suitability in different cases. The National Institute for Health and Care Excellence (NICE) is currently assessing DBS to ensure that it’s a reliable and safe treatment option, although NICE does not make the ruling on whether there should be NHS funding.
However, in some cases, individual specialist doctors are able to make special arrangements in exceptional cases if they want a patient to be offered DBS therapy.
NICE’s initial report into DBS outlined some of the risks that could be associated with the therapy. These include:
Of course, these risks may be treatable or reduced as the therapy is refined and grows in stature amongst the medical community.
The neurostimulator will be programmed to work by a doctor or nurse post-surgery via a small handheld computer. The amount of electrical stimulation will be set here automatically, although it may take some months to adjust to the correct therapeutic level.
Also, some people have an ‘aura’, which is a focal aware seizure (formerly known as a simple partial seizure) that alerts them to future seizure activity. In this case, the programmer can be used to activate DBS therapy and increase electrical impulses to hopefully prevent further seizure activity.