New Logo

 

OUR MISSION

"The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives."

 

Deep Brain Simulation (DBS)

Quiz

What is deep brain stimulation?

Deep brain stimulation (DBS) is

A device used to help control seizures. Surgery is done to place the device, then it is programmed in the outpatient clinic by an epilepsy specialist.

A type of neuromodulation therapy. This means, DBS therapy is designed to change (modulate) how brain cells work by giving electrical stimulation to brain areas involved in seizures.

Used together with seizure medications.

DBS therapy for the treatment of seizures was approved by the U.S. Food and Drug Administration (FDA) in 2018. It has been approved in Europe, Australia, and Canada for several years.

DBS therapy has also been used to treat other neurologic conditions, including Parkinson’s disease, chronic pain, and Tourette’s syndrome.

Who can use DBS?

DBS may be used to treat people 18 years and older with uncontrolled focal seizures when medicines don’t work. Uncontrolled seizures, also called drug resistant seizures, are seizures that do not respond to appropriate trials of seizure medicines.

DBS is an option for people whose seizures are not able to be treated with other types of epilepsy surgery.

How does DBS work?

The DBS device is placed by a neurosurgeon during an operation. Thin wires (called electrodes) carry electrical impulses from the neurostimulator device directly to the brain to stop brain signals that causes seizures.

The neurostimulator device is battery operated. It can be programmed like a tiny computer (similar to a cardiac pacemaker).

The device is programmed by your doctor or nurse to deliver tiny electrical impulses.

These electrical impulses help to stop seizures from beginning or spreading to different areas of the brain.

How helpful is DBS?

DBS does not cure epilepsy but can decrease the number and severity of seizures in many people. In general, results of clinical studies show

About half of people who have DBS have less seizures with this treatment.

For others, DBS therapy may reduce their seizures. It may not help in a small number of people.

The positive effect of DBS therapy may not be seen right away. It can take up to two years for DBS therapy to show its full benefit.

DBS is always used together with seizure medication. Like other devices used to treat epilepsy, if seizure control improves with DBS, seizure medicines may be lowered to lessen side effects.

How do I know if I am a candidate for deep brain stimulation?

Everyone who has seizures that are not well controlled after trying two or more antiseizure medicationsshould talk with their epilepsy doctor about whether treatment with a device or surgery could help them. An epilepsy specialist or an evaluation at an epilepsy center can help you explore all treatment options. 

Presurgical Testing

Determining if a person may benefit from DBS therapy starts with a number of diagnostic tests to see if any type of surgery or device could help. If a person cannot have surgery to remove the area of brain causing the seizures, then a device such as responsive neurostimulation (RNS)vagus nerve stimulation (VNS), or DBS may be possible.

Testing for DBS therapy takes into consideration:

A person’s seizure type

The best way to limit risks from surgery and provide the most benefit from DBS

Some tests are done in the outpatient setting. For other tests, people are admitted to an epilepsy monitoring unit (EMU) at a comprehensive epilepsy center. The testing will involve EEG (electroencephalogram) monitoring, MRI (magnetic resonance imaging) or other imaging tests, and cognitive neuropsychology testing. Other tests may be needed depending on the person’s situation.

Although the testing can feel like it is taking a long time, careful evaluation is important. This time gives you a chance to ask your epilepsy team questions and share any concerns about DBS therapy.

Resources

The DBS® System is manufactured by Medtronic. Additional information for patients and physicians is available on their website.

Authored By: 
Elaine Kiriakopoulos MD, MSc
on
09/2018