Brief Answer:
Secondary effects from DBS

Detailed Answer:
Good afternoon. I'm sorry for the problems you're experiencing following DBS placements and even more so for the point that in order to best help you would need to provide much more information on your lead placements into the brain, medications that you have been prescribed and how those doses were changed or modified following DBS lead placement, how the leads were placed in their designated locations to begin with and how they were verified to be in the proper places as well as the neurosurgeon's opinion on whether the leads could be potentially misplaced, poorly placed, or simply causing too much collateral or overflow stimulation to surrounding areas having to do with cerebellar control relay circuits which would appear the most likely affected elements causing almost a TRUNCAL type of ataxia or imbalance in truncal muscle stability by causing motor contractions on one side of the body without compensating on the other.

Bilateral DBS electrode leads is always a tricky type of procedure. I will give you just the following general information about DBS complications which hopefully will STIMULATE (no pun intended) a discussion between yourself and your neurosurgeon so that a plan of action can be formulated to see how things can be ameliorated.

First of all, I would recommend a good NEUROLOGICAL EVALUATION by a neurologist in order to rule out any other coincidental problems that could be causing this uncomfortable issue separate and apart from lead placement. If the neurologist can determine a separaate cause to what's going on then, it is logical to assume that an underlying etiology can be addressed and fixed without having to implicate any changes to the DBS lead placement.

In general, some of the more common problems we see following DBS lead placement include suboptimal placement, suboptimal programming, device malfunction (though this is probably not the case if they've reviewed everything already), Over-reduction in medicatons? Remember, DBS therapy almost never guarantees that patients do not need ANY medication and perhaps in some cases they may even require MORE medication but the point is that DBS adjunct therapy can add much more "bang for the buck"....or should I say, "ZAP for the buck...?"

Is titrated voltage too HIGH seeing as how this is a bilateral placement for a multifocal problem. Again, I'm sure the surgeons have contemplated this...but perhaps, someone needs to ask for the actual numbers and a program titration should be redone starting at the very minimum and escalating up....very very slowly until just the right amount of juice is flowing....not too much....not too little.

As far as commonly misplaced leads are concerned....when patients experience an overcontraction, pulling, or pushing effect of the muscles or motor system....one common problem if there is lead placement in the SUBTHALAMIC NUCLEUS is that it or they are too LATERALLY PLACED in the capsule. That means they are too much to the outside ON THE OPPOSITE SIDE from where the pulling is coming from. And so in your case if you're going to the right ask your surgeon about the possibility of placing your leads that may be in the STN on the LEFT a bit more "medially....or even deeper."

Another thing that can happen and cause problems of over or undercorrection is a SHORT CIRCUIT in play. In other words, 2 closely placed lead wires may actually be touching...is that a possibility in your case? Is there what we call a fractured circuit which refers to a broken lead wire? If there is a broken wire on the same side that your body is pulling then, there may not be sufficient counteractive forces to neutralize the rightward pull.

If I've adequately addressed your concerns could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating to our encounter if you feel my suggestions have helped? Again, many thanks for posing your question.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 27 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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