Patient Journey
Deep Brain Stimulation is far more than a single surgery. The 10-stage roadmap below transparently lays out everything patients experience at our Neuromodulation Center — from first enquiry to battery replacement.
The patient's first contact with the center
Coordinator and movement-disorders neurologist review
Coordinator collects diagnostic history, medications, and chief complaints; shares the list of required documents.
Movement-disorders neurologist reviews comprehensive records, imaging, and treatment history; performs an initial suitability assessment.
First decision point: is DBS appropriate?
After the first clinical evaluation, potential suitability is assessed. This step is not binding — the final decision is made after the multidisciplinary team review.
→ Medication is optimized; a roadmap is set with rehabilitation and scheduled follow-up.
The patient is referred to a multidisciplinary evaluation requiring roughly 3 days of inpatient assessment.
Four parallel assessments + team meeting
The patient is assessed simultaneously by four specialist teams; all findings are consolidated in a single meeting.
UPDRS motor scoring (on/off medication), L-Dopa responsiveness testing, gait analysis, tremor measurement.
Memory, attention, and executive-function assessment; dementia screening (MoCA, MMSE).
Depression severity, psychosis screening, anxiety, and suicide-risk assessment.
Stereotactic MRI for surgical planning; anaesthetic risk stratification and structural imaging.
All findings are presented together; the decision is the team's consensus — not a single physician. Approval or rejection is documented with reasoning.
Testing and patient education run in parallel
Two-phase surgery; awake or general anaesthesia
The surgery can be performed in two ways depending on the patient and center experience; both rely on high-precision stereotactic planning.
Patient is conscious; microelectrode recording (MER) identifies the target tissue and test stimulation confirms symptom response in real time.
In patients for whom awake surgery is unsuitable, electrodes are placed under general anaesthesia with MER guidance.
Stereotactic frame application; bilateral electrode placement into STN, GPi, or VIM targets.
The implantable pulse generator is placed under the clavicle; cables are tunneled under the skin.
From ICU to ward under controlled progression
Control CT for haemorrhage or electrode position; low-voltage activation or delayed activation; medication revision and neurological assessment.
Initial IPG parameter programming; wound care; start of physical therapy; discharge education and DBS identification card.
Serious-complication risk <3%
Overall serious-complication rate: under 3% at modern centers; the risk profile is shared transparently.
Accessible emergency line; nurse hotline as first contact, escalation to neurology or neurosurgery when needed.
Prevention: Comprehensive preoperative screening, MER precision, intraoperative monitoring, strict sterile technique, and discharge education.
From monthly visits to yearly follow-up
Comprehensive IPG parameter adjustment; start of medication dose reduction; final wound check; UPDRS repeat and satisfaction assessment.
Fine-tuning of stimulation settings (typical stabilization point); meaningful medication reduction; cognitive reassessment and psychiatry review.
Semi-annual to annual neurology visits; ongoing review of IPG and medication; symptom control is maintained as the disease progresses.
Non-rechargeable and rechargeable options
Average lifespan 3–5 years. As depletion approaches, symptoms reappear; timely replacement is required.
20–30 year lifespan; requires weekly home charging. Reduces the number of future replacement surgeries.
Replacement Procedure: A short procedure under local anaesthesia lasting about 15–20 minutes. The electrode hardware is not touched; risk is minimal.
Send your reports before travelling to Istanbul
Share your MRI, medical reports and symptom videos on WhatsApp. Our team will review your information and guide you on whether an in-person DBS evaluation may be appropriate.
Start with a remote case review.
