What type of follow-up is needed after surgery?

Patients normally leave the hospital two days after surgery. Patients then return a week later for suture removal and check of the incisions by a DBS nurse, and approximately 4 weeks later to see the surgeon and neurologist. The initial programming session is usually performed at the surgical center, and varies from center to center from one to four weeks after surgery. Some patients may have temporary disorientation or sleepiness for a few days after surgery due to temporary brain swelling, and if this occurs programming is deferred until the mental state completely returns to baseline. For subsequent programming needs after the initial stimulator activation, the patient may choose to return to the surgical center or be programmed by their local neurologist.

In the first month or two following DBS implantation, some patients may develop an infection of the device or of the skin over the device. This would present as drainage, increasing redness, increasing swelling, or increasing pain starting a few days to a few weeks post-surgery. It is very important to let your primary care doctor, neurologist or neurosurgeon know IMMEDIATELY if such signs are noted, since early wound care may be effective at salvaging the device. If such symptoms are ignored for even a few days, however, the patient will usually have to have all of the hardware removed.

Patients will typically require replacement of the pulse generator after 3-4 years, depending on the exact settings of the device (for non-rechargable neurostimulators). This is an outpatient procedure that takes about 45 minutes. Since 2009, a rechargeable pulse generator is available, which lasts much longer than the other pulse generators (about 9 years).