Deep Brain Stimulation (DBS)
A reversible, adjustable procedure that quiets the abnormal brain signals behind tremor, rigidity and involuntary movement — when medication alone no longer holds the day together.
Treatments
Surgical and non-surgical, across seven clinical areas, in the order they are usually considered — not in the order that would be most profitable to sell.
A reversible, adjustable procedure that quiets the abnormal brain signals behind tremor, rigidity and involuntary movement — when medication alone no longer holds the day together.
The same deep brain stimulation, planned and guided by a surgical robot instead of a traditional stereotactic frame.
Tremor treated through the intact skull with focused sound waves — no incision, no implanted hardware, and in most cases a result the patient can see on the treatment table.
A thin, implanted tube system that continuously drains excess cerebrospinal fluid from the brain to the abdomen — the standard treatment for normal pressure hydrocephalus.
A procedure that permanently reduces spasticity in the legs by dividing a portion of the abnormal sensory nerve fibres that drive it.
An implanted, adjustable pump that delivers a muscle relaxant directly to the spinal cord, at a fraction of the dose tablets would require.
A lesioning alternative to deep brain stimulation for a small number of patients with severe, treatment-resistant OCD.
An investigational, incisionless technique — available mainly through research studies and specialised programmes rather than as routine treatment.
Thin leads placed near the spinal cord deliver controlled stimulation that changes abnormal pain signalling within the nervous system.
A lesioning procedure for a small number of patients with severe facial or cancer-related pain that has not responded to other treatment.
A pacemaker-like device that stimulates the vagus nerve at regular intervals, used for drug-resistant epilepsy.
Mild, adjustable electrical stimulation of the nerves that help control the bladder and bowel.
A minimally invasive way to obtain a precise tissue diagnosis, guided by stereotactic imaging rather than open surgery.
Before anyone discusses surgery, the medication has to be right. A surprising number of patients arrive with symptoms that are not resistant to treatment — only under-treated.
The treatment that continues after everyone else has finished. Surgery and medication change what the body can do; rehabilitation decides how much of it you actually get back.
The first-line treatment for focal dystonia — and one where the difference between a poor result and a good one is usually which muscles were injected, not which drug.
Every decision that follows depends on this one being right. A tremor named correctly is half of it treated.
The part of medical travel that most often goes missing. Your care does not end when you board the flight home.
The same procedure can serve more than one condition. Each is described once, in full, on its own page.
Deep brain stimulation appears three times above. It is one operation with one set of hardware; what changes is the brain target, chosen for the condition being treated. The DBS page covers all of its indications together.
| Clinical area | Procedures |
|---|---|
| Movement disorders | DBS, robotic-assisted DBS, MRgFUS, VP shunt surgery |
| Spasticity | Selective dorsal rhizotomy, intrathecal baclofen pump |
| Psychiatric neurosurgery | DBS, capsulotomy, LIFU |
| Pain surgery | Spinal cord stimulation, stereotactic thalamotomy |
| Epilepsy | Vagus nerve stimulation, DBS |
| Bladder and bowel dysfunction | Sacral nerve stimulation |
| Diagnostics | Stereotactic brain biopsy |
| Supporting care | Medication management, rehabilitation, botulinum toxin, neurological evaluation, remote follow-up |
Almost every patient starts with medication management and rehabilitation, and a substantial number need nothing more. Surgery enters the discussion when medication is working but no longer lasting, or when a tremor has stopped responding to it altogether.
Between the two surgical options, the deciding factors are usually whether one side or both need treating, whether symptoms beyond tremor are present, and how much the patient values being able to adjust or reverse the treatment later.
| If… | The usual answer |
|---|---|
| Symptoms are controlled but the dose keeps rising | Medication review first |
| Medication works but wears off, with dyskinesia | Deep brain stimulation |
| Disabling tremor on one side, resistant to medication | MRgFUS |
| Neck, eyelid or hand dystonia | Botulinum toxin injections |
| Balance, gait or freezing is the main problem | Rehabilitation — surgery helps these least |
| The diagnosis itself is uncertain | Neurological evaluation before anything else |
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