Deep Brain Stimulation (DBS) is a treatment for many movement disorders (particularly for Parkinson's Disease, dystonia, tremor and other involuntary movements) that can help patients when medication do not work well enough. DBS cannot cure these conditions or change the progression of the disease, but it can relieve symptoms and improve quality of life.
At the DBS clinic, we begin the evaluation process to confirm your eligibility to undergo DBS surgery and we continue to follow and monitor those patients that have had DBS surgery.
Eligibility and pre-op assessments for Parkinson's disease patients involves appointments with Neuropsychology, Neuropsychiatry, a Levodopa Challenge and the DBS Neurology team. The assessments for other conditions vary depending on clinical needs.
As a large multidisciplinary team, you can expect a Fellow Doctor, a Nurse Practitioner or a Nurse Coordinator to evaluate you before you see the main Neurologist.
What Makes Us Special
After 30 years from its launch, deep brain stimulation (DBS) has become an established and successful treatment for many movement disorders, such as Parkinson's disease (PD), dystonia and tremor. As a consequence of its growing worldwide use, surgical indications, selection of candidate, clinical and surgical management are continuously changing and often challenge clinicians in their clinical decisions. A part of these challenges rely on the ongoing development of new devices and software guiding the neurologist and neurosurgeon across the multiple steps of DBS. All of these aspects are seriously taken into consideration by us. We are constantly exploring new opportunities (e.g., novel technologies) for our patients.
The Toronto Western Hospital (TWH) has a long-standing tradition in movement disorders and neurofunctional surgery and it is world renowned as one of the top centres in this field. A part of TWH's fame relies on the success of all the different subspecialties related to DBS. As such, TWH is an attractive place for all the physicians interested in learning or perfecting DBS.
DBS is an outstanding example of multi-disciplinary approach, as it needs the close collaboration of multiple professional figures (neurologist, neurosurgeon, neuroradiologist, neurophysiologist, psychiatrist, neuropsychologist, PD nurse, physiotherapist, etc.). In order to promote the knowledge on DBS, we publish guidelines, train international fellows and host intensive courses on DBS.
Tests & Services
How to Prepare
Appointment #1 – Neuropsychology
- The neuropsychological evaluation describes strengths and weaknesses in your memory and thinking abilities. It can identify changes in your abilities linked to brain dysfunction and disease.
- Specific abilities such as memory, problem solving, reasoning, understanding, concentration, perception and language will be examined.
- This test may take up to 6 hours and you should take all your medication as usual
Appointment #2 – Neuropsychiatry
- This assessment is required to assess whether you might be at risk for any psychiatric complications as a result of DBS surgery.
- The appointment will be 1 hour long and you should take all your medications as usual
Appointment #3 – Levodopa Challenge
- For this appointment, we ask patients
NOT to take any Parkinson's related medication after midnight the night before their appointment. For example, if you appointment is Monday morning, you will not take any medication the after midnight on Sunday.
- The purpose of this assessment is to test your Parkinson's symptoms before and after taking Levodopa.
- The appointment will be approximately 2 hours.
Learn more about
what you can expect when you have a clinic appointment.
