It is important that your medical provider be aware that you have DBS since there are some procedures that can not be performed if you have DBS. Examples of procedures that are not safe to be performed with DBS are body MRI, certain types of cautery and diathermy (a form of ultrasound used in specific situations to speed tissue healing.) It is recommended that your doctor call Medtronic Inc. (current DBS manufacturer) clinician support services (800) 707-0933 before any procedure to review if there are any concerns or interactions with your device.
One way to alert clinicians that you have DBS in an emergency situation is to wear a medic alert bracelet. This bracelet can be inscribed with important information such as allergies and a statement that you have DBS. You can include the emergency clinician support phone number and warnings such as “MRI and diathermy contraindicated.”
Mammograms are often a concern because they are done close to the battery site. Mammograms can be performed as long as the technician avoids compression of the battery which is usually located just below the clavicle in the chest. It is important not to compress the battery or extension wires. Breast MRI can not be performed. Diagnostic ultrasound of suspicious breast lesions can usually be performed if needed; but once again the ultrasound probe should not be used over or directly adjacent to the battery. Your technician should call the Medtronic customer support number listed above for more specific guidance.
DBS treats movement symptoms of Parkinson’s specifically tremor, dystonia motor offs and dyskinesia. DBS does not typically improve speech and in some cases can be associated with worsening speech. The following information may help you understand the complex association between speech changes with Parkinson’s and DBS:
- DBS typically helps motor symptoms that also respond to medicine. Although difficult to predict, DBS may improve speech if levodopa also significantly improves speech. However, in most cases, speech is not helped by medicines suggesting DBS will also not help.
- If speech is still responsive to levodopa, under-medication can also worsen speech. Medicines are often reduced after surgery.
- Subthalamic (STN) DBS surgery can affect ‘verbal fluency’. This can be noticed as a difficulty ‘finding or getting the right word out’.
- DBS programming can worsen speech as a noted side effect to over-stimulation. This is probably the most common cause of significant speech change after surgery.
- Speech can worsen as Parkinson’s progresses over time even with DBS. This is usually a gradual decline.
- Immediate change in speech after surgery can occur as a result of brain bleeding or other problem during surgery. This can improve over time.
- A speech therapist can help you understand the potential impact of DBS on speech and help improve communication at any stage of your disease.
This information serves as a guide only. Only your healthcare provider can answer the questions about how DBS will impact speech for you.