Functional Neurosurgery is a specialized branch of neurosurgery that focuses on restoring or improving the function of the nervous system rather than removing or repairing tissue. One of its most advanced and effective procedures is Deep Brain Stimulation (DBS), primarily used to treat Parkinson’s disease, essential tremor, dystonia, and other movement disorders that do not respond adequately to medication.

• Purpose: The goal of DBS is to modulate abnormal electrical activity in specific deep brain structures responsible for motor control, helping to relieve symptoms such as tremor, rigidity, slowness of movement (bradykinesia), and involuntary muscle contractions.
• Mechanism: In DBS, thin electrodes are implanted into targeted brain areas—commonly the subthalamic nucleus (STN) or globus pallidus internus (GPi)—which are connected via wires to a small pulse generator (like a pacemaker) implanted under the skin of the chest. This device sends continuous electrical impulses to the brain to normalize its activity.
• Preoperative Evaluation: Patients undergo neurological assessment, MRI brain imaging, neuropsychological testing, and sometimes intraoperative microelectrode recording to ensure precise electrode placement.
• Surgical Procedure: The surgery is typically performed under local or general anesthesia. Stereotactic guidance and intraoperative imaging are used to achieve millimeter-level accuracy. The pulse generator is then implanted subcutaneously in the chest.
• Postoperative Management: Device settings are customized post-surgery through programming sessions. Medication doses are often reduced but not completely stopped. Regular follow-up is essential for adjustment and battery replacement.
• Outcomes: DBS significantly improves motor symptoms and quality of life in most patients, allowing greater independence and smoother movement. It is reversible and adjustable, unlike lesioning procedures such as thalamotomy or pallidotomy.
• Risks: Possible complications include infection, bleeding, hardware malfunction, and temporary speech or balance problems, though these are rare with modern techniques.