DBS surgery for dystonia is performed under general anesthesia: the targets are planned on MRI, two thin electrodes are placed precisely into the globus pallidus (or subthalamic nucleus) through small openings in the skull, and a stimulator is implanted under the skin below the collarbone. At our center the hospital stay in the standard program is about six days, followed by a hotel stay in Istanbul while programming continues.
Recovery from the operation itself is quick, but improvement of dystonia is gradual: jerky movements and pain often ease in the first weeks, while fixed postures improve over months. Programming is adjusted step by step, in person and, for compatible systems, remotely by video call.
Before surgery
- Remote review of videos and reports, then a video consultation
- In Istanbul: assessment by neurosurgery, neurology, psychology, cardiology, anesthesiology, physiotherapy and nutrition
- Blood tests, chest X-ray and other tests as needed
- 3 Tesla MRI under general anesthesia, so dystonic movements do not blur the images
The operation, step by step
- Frame and imagingUnder general anesthesia, a stereotactic frame (Leksell Vantage or Inomed) is fixed and imaging is merged with the MRI.
- Trajectory planningThe electrode path is planned on contrast-enhanced MRI to stay away from blood vessels.
- Electrode placementThrough two small openings, the electrodes are guided to the target. Microelectrode recording (Alpha Omega or FHC systems) can be used to confirm the target.
- Position checkA CT scan confirms the electrode position.
- Stimulator implantationThe extension wires are tunnelled under the skin to the pulse generator below the collarbone. Prof. YILMAZ closes the wounds himself.
After surgery
- Most patients sit up and walk within a day or two
- Daily wound care, DBS system checks and programming during the hospital stay
- Physiotherapy and rehabilitation begin in hospital
Programming: the most important part in dystonia
In dystonia, programming is a gradual process. Settings are increased step by step over weeks and months, and the benefit grows as the brain network adapts. This is why we include long-term programming support in the package: 3 to 5 years of free remote programming depending on the package, then paid follow-up without limits. Systems such as Abbott Liberta with NeuroSphere Virtual Clinic allow adjustments by video call wherever you live.
Recovery timeline for dystonia
| Time | What usually happens |
|---|---|
| Days 1–6 | Hospital stay, first programming, wound care, mobilisation |
| Weeks 1–3 | Hotel stay in Istanbul, daily programming and physiotherapy; return home |
| Months 1–3 | Pain and jerky movements usually improve; settings adjusted remotely |
| Months 3–12 | Fixed postures loosen; most of the benefit is reached |
| Years | Benefit maintained; battery checks or recharging; occasional fine-tuning[1] |
Safety measures at our center
- Contrast-enhanced MRI planning to keep the electrode path away from blood vessels
- CT after electrode placement to confirm position
- Effective antibiotics after surgery and daily wound care
- Wounds closed by Prof. YILMAZ himself
- In our own case series the infection rate is 1.6%.
Devices we use
We implant systems from all three leading manufacturers, Medtronic, Abbott and Boston Scientific, including sensing (adaptive) DBS systems such as Medtronic Percept™ and remote-programmable systems such as Abbott Liberta™ with NeuroSphere™ Virtual Clinic. Rechargeable stimulators are often preferred in dystonia because stimulation needs more energy.
Frequently asked questions
How long does DBS surgery for dystonia take?
The operation usually takes several hours, including imaging, planning and implantation of the stimulator, all under general anesthesia.
Is DBS surgery painful?
You are asleep during surgery. Afterwards, wound pain is usually mild and controlled with ordinary pain relief.
Can I fly home after DBS?
Yes. Patients fly home at the end of the program. You receive a device card for airport security.
Can I have an MRI after DBS?
Modern DBS systems are MRI-conditional: MRI is possible under specific conditions. We give you the details for your device.
Sources
- Volkmann J, Wolters A, Kupsch A, et al. Pallidal deep brain stimulation in patients with primary generalised or segmental dystonia: 5-year follow-up of a randomised trial. Lancet Neurol. 2012;11(12):1029–1038. Source