Refuse to Surrender

Common Questions About Medtronic Deep Brain Stimulation

Will the neurostimulator show through my clothes?

Depending on your body build, the neurostimulator may be noticeable as a small bulge under the skin. However, your doctor will try to place the neurostimulator in a place that is most comfortable and cosmetically acceptable.

How long will it take for the DBS Therapy to work after the implant procedure?

Typically, a Medtronic DBS Therapy system is not activated until you've healed from the surgery. Your symptoms may decrease at that time. Optimal results are usually achieved after the doctor or nurse who programs your device has gone through multiple programming sessions with you. This process may take several months.

Is this a new type of treatment for essential tremor?

Medtronic DBS Therapy for Essential Tremor was developed by Medtronic in the 1980s and approved for use in the United States in 1997. It has been proven to reduce tremors associated with essential tremor.1

Is this a permanent procedure?

Medtronic DBS Therapy is a reversible procedure. It is also adjustable, which means that the stimulation can be adjusted to match changes in your symptoms. The system can also be deactivated or even removed. Removal would require additional surgery.

What are the risks associated with this type of treatment?

DBS Therapy requires brain surgery. Risks of brain surgery may include serious complications such as coma, bleeding inside the brain, seizures and infection. Some of these may be fatal. Once implanted, the system may become infected, parts may wear through your skin, and the lead or lead/extension connector may move. Medtronic DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause your symptoms to return.

Medtronic DBS Therapy may cause worsening of some motor symptoms associated with your movement disorder, and may cause speech and language impairments. Stimulation parameters may be adjusted to minimize side effects and attain maximum symptom control. In patients receiving Medtronic DBS Therapy, depression, suicidal thoughts and suicide have been reported.

Talk to your doctor about the risks that may be applicable to your specific situation.

What does the stimulation feel like?

Most people don't feel the stimulation at all as it reduces their symptoms. However, some people may feel a brief tingling sensation when the stimulation is first turned on.

Higher levels of stimulation have been described as uncomfortable, jolting, or shocking. If the stimulation changes or becomes uncomfortable, contact your doctor immediately.

Does the brain stimulation system make any noise?

No.

Will I be able to increase or decrease the strength of stimulation?

In most cases, only your doctor can change the strength of stimulation. Depending on the type of neurostimulator you have, you may be able to choose from a range of stimulation settings that your doctor has programmed for you.

Will I be able to resume my normal daily activities?

For the first few weeks after surgery, you should avoid strenuous activity, and arm movements over your shoulder, and excessive stretching of your neck. You may gradually want to try activities that were difficult before your surgery.

Talk about this with your doctor first, and be sure to follow all of your doctor's instructions.

How long will the neurostimulator battery last?

On average, and depending on programmed settings, an Activa SC neurostimulator battery lasts 4 to 6 years, and an Activa PC neurostimulator battery lasts 3 to 5 years. The rechargeable neurostimulator lasts for 9 years.

What happens when my neurostimulator needs a new battery?

Before your battery runs out, you'll need to replace the neurostimulator through a surgical procedure. The DBS Therapy leads and extensions can typically stay in place and be reconnected to the new neurostimulator.

Can stimulation be used during pregnancy?

The safety and effectiveness of this therapy have not been established for patients who are pregnant.

Is it safe to have medical tests with the system implanted?

Consult your doctor before engaging in any medical treatment or diagnostic test (for example, MRI, mammograms, electrocautery, or heart defibrillation). Diathermy (deep heat treatment) should not be permitted under any circumstances.

What should I do if the stimulation changes or becomes uncomfortable?

Contact your doctor immediately.

What happens if the neurostimulator stops working?

Your symptoms will return. If you can't determine the possible cause and correct the problem, contact your doctor.

Will my insurance cover DBS Therapy?

Medicare Coverage

The current national policy provides coverage for Medicare beneficiaries who qualify as candidates for DBS. (Medicare does not require prior approval before an implant, although you must meet Medicare's criteria in order for the procedure to be covered.) You will still pay deductibles, coinsurance, and copayments.

Insurance Coverage

Typically, your doctor will work with private insurance companies to obtain prior approval. This process normally requires that your doctor send a letter of medical necessity to the insurance company. This letter explains why DBS is appropriate for you. It also describes the other treatments that have been attempted and failed.

It is not uncommon for an insurance company to deny a request for prior approval if they are unfamiliar with the treatment. If you receive a denial and wish to appeal, we're here to guide you and your doctor through this process.

Next: When to Consider Deep Brain Stimulation

References

  1. Medtronic DBS Therapy for Parkinson's Disease and Essential Tremor Clinical Summary, 2009.
Last updated: 13 Aug 2012