Stimulation Side Effects

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Deep brain stimulation should bring significant benefit but like medication, can be associated with side effects. Stimulation side effects can occur even with perfect placement in the brain and vary depending on the proximity to structures outside the intended brain target and intensity of stimulation. Stimulation side effects are reversible and can be avoided with proper use of stimulation settings. Within a common brain target called the subthalamic nucleus are emotional and cognitive areas that can also cause negative changes in mood and thinking that is also reversible with modification of stimulation settings. (see Physiology)

The following are the most common side effects when stimulating in or near the typical brain targets for PD, tremor and dystonia:

  • overactive muscle contraction that causes slurred speech, facial muscle contraction, choking or swallowing problems, eye blinking, lip or chin twitching, leg dragging, abnormal hand or arm posture, imbalance, gait freezing, double vision
  • stimulating sensation areas may include numbness, tingling, thick or heavy feeling in the face, tongue, hand, leg, warmth, sweating
  • other side effects may include slowness of movement, muscle cramps or pain, dizziness, blurred vision, anxiety, depression, mental fog, falling, sleepiness

Most importantly, stimulation problems caused by side effects are reversible within a few minutes up to a few months. Adequate stimulation adjustments can avoid or eliminate side effects. If the electrodes are misplaced, side effects may persist and cause problems that were not present before DBS surgery. The most common misconception after DBS is confusing side effects with disease progression. Worsening walking, balance, speech and swallowing can occur with disease progression but can also be a side effect of stimulation. Skilled DBS experts can distinguish between disease factors and stimulation induced problems. Seeking a second opinion about DBS side effects can provide a fresh look at the problem and potentially a solution after failed attempts to maximize stimulation benefits. (See Walking and Balance and Troubleshooting Data  or story about corrective surgery for more information)

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