What type of follow-up is needed after surgery?

Patients normally leave the hospital two days after surgery. Most patients are asked return to the clinic one week later for suture removal and check of the incisions by a trained nurse, and approximately 4 weeks later to see the surgeon and neurologist in the Movement Disorders Surgery Clinic. The initial programming is done at the movement disorders clinic one to four weeks after surgery, depending on the specific center. Some patients may have temporary disorientation 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. Subsequent programming needs after the initial stimulator activation depend on the specific center. For patients who live at a distance from the implanting center, further programming is performed by local neurologist. In the first month following DBS implantation, some patients may develop 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 the surgeon or neurologist 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 2-3 years, depending on the exact settings of the device. This is an outpatient procedure that takes about 45 minutes. Since 2009, a rechargeable pulse generator is available, which will last much longer than the existing pulse generators.