Deep Brain Stimulation

About Deep Brain Stimulation

Deep brain stimulation (DBS) is a surgical treatment for dystonia, a movement disorder that causes muscles to contract involuntarily and hold abnormal postures. Dystonia is different from spasticity: spasticity is a continuous, velocity-dependent stiffness, while dystonia causes twisting, repetitive movements or sustained postures that the child can't control. 

How it works

The surgeon implants thin electrodes into a specific area deep in the brain using a precise, minimally invasive robotic arm. The electrodes are connected by thin wires under the skin to a small battery-powered device (pulse generator) placed in the chest. The device sends continuous electrical signals to the brain that disrupt the abnormal activity causing the dystonia.

The surgery is done in two stages. First, the electrodes are placed in the brain using image guidance, robotic assistance, and intraoperative brain recordings. Then the pulse generator is implanted and connected. Both stages may happen on the same day or may be separated by a short interval.

Who is a candidate

DBS is most effective for primary (genetic) dystonia, where children often see substantial improvement. It is also used for secondary dystonia, including dystonia related to cerebral palsy, though the response is more variable and typically more modest. Your child's neurosurgeon and neurologist will evaluate whether DBS is likely to help based on the type of dystonia, its severity, and your child's overall condition.

What to expect after surgery

DBS does not work immediately. The device is programmed over a series of clinic visits in the weeks and months after surgery. The settings are adjusted gradually to find the combination that gives the best result with the fewest side effects. Most families begin to see improvements within the first few months, but it can take up to a year to reach the full benefit.