DBS can greatly improve quality of life for people with essential tremor. DBS is not a cure, but it can regulate signals in the brain that cause tremors. It can greatly reduce tremor symptoms, especially in your hands and legs.

• Up to 90% of patients with essential tremor have at least moderate symptom relief after DBS.
• DBS involves two surgeries up to a week apart.
• DBS works by regulating abnormal signals in the brain that cause tremors.

Jump to:

• Am I a candidate for DBS?
• How DBS can help essential tremor
• Preparing for DBS
• Surgery and beyond

Am I a candidate for DBS?

If your medication does not control your essential tremor, or it causes severe side effects, DBS might be an option for you. Our quiz can help you learn whether you are a good candidate.

Disclaimer: This quiz is not professional medical advice, diagnosis or treatment. Always talk to your doctor or other health care provider about a medical condition.

Have the medications stopped working to control your tremor?

Or do you have severe side effects from your tremor medications, like drowsiness, low blood pressure or dizziness?

Next steps

If you answered yes to all of the questions above, you might be a good candidate for DBS.

Print this form and share it with your doctor. You will need a referral if you want to be evaluated for DBS at OHSU.

When we receive your referral, we will contact you to schedule an evaluation. Our neurology team will examine you and learn about your history to determine if you are a good candidate for DBS. If it is not right for you, your team will talk with you about other options, including changing your medication.

How DBS can help essential tremor

During DBS surgery, a surgeon places tiny electrodes in certain areas of your brain. The electrodes help correct faulty brain signals that cause tremors, especially in your hands and legs. Learn more about the benefits of DBS for patients with movement disorders.

DBS does not help all essential tremor symptoms. It is not helpful for voice or head tremors.

Focused ultrasound is another treatment option for essential tremor. We will work with you to help you choose the right treatment for your tremor. Your preferences, the severity and type of symptoms you have, and your lifestyle goals are all important factors to consider.

Preparing for DBS

Having a complete evaluation by movement disorder specialists is an important part of DBS for essential tremor. At OHSU, we bring a team of experts together to make sure you are a good candidate for DBS. Our team reviews your symptoms and medications. The team also talks with you about potential benefits and risks specific to your condition.

DBS appointments

Evaluation

You will meet with:

• A neurologist who specializes in movement disorders
• A neurosurgeon
• A physical therapist who will evaluate your gait and balance
• A speech therapist who will check how you speak and swallow
• A neuropsychologist who will evaluate your memory and thinking
• A social worker who talks about caregiving or other help you might need

After these appointments, we will review your results and determine whether you are a good candidate for DBS.

Pre-surgery appointments

If you are a good candidate for DBS, you will have pre-surgery appointments with our team:

Internal medicine appointment: A provider in our Preoperative Medicine Clinic will make sure you are healthy enough for surgery and anesthesia.

MRI appointment: We will take a precise scan of your brain with a special MRI (magnetic resonance imaging) unit. The images will help your neurosurgeon plan where to place the electrodes during surgery.

If you live in the Portland area, your MRI appointment will be about two weeks before surgery. If you travel to OHSU from out of state, it will be a few days before surgery.

Neurosurgery appointment: Your neurosurgeon will discuss the details of your surgery with you and answer your questions. We will also give you instructions for the day of surgery and care after surgery.

Surgery and beyond

DBS includes two surgeries and follow-up appointments. Learn more about DBS surgery and follow-up care.

First surgery: We place the DBS electrodes in your brain.

Second surgery: Up to a week after the first surgery, we place an implanted pulse generator (IPG) under your skin, just below your collarbone. We connect thin wires from the electrodes in your brain to the IPG.

After surgery: A month after the second surgery, we will adjust the DBS settings with a small device called a programmer. This can be done in our clinic or, in some cases, in your local neurologist's office. You will have monthly programming appointments for several months. After that, you will see your neurologist every six months for routine care and any needed adjustments.

Surgery and beyond

DBS includes two surgeries and follow-up appointments.

First surgery: We place the DBS electrodes in your brain.

Second surgery: Up to a week after the first surgery, we place an implanted pulse generator (IPG) under your skin, just below your collarbone. We connect thin wires from the electrodes in your brain to the IPG.

After surgery: A month after the second surgery, we will adjust the DBS settings with a small device called a programmer. This can be done in our clinic or, in some cases, in your local neurologist's office. You will have monthly programming appointments for several months. After that, you will see your neurologist every six months for routine care and any needed adjustments. Learn more about what to expect after DBS surgery.

DBS appointments for out-of-town patients
If you live outside the Portland area, we do everything we can to limit travel. We try to schedule appointments on the same day. In some cases, we offer appointments over a secure video connection from your local neurologist’s office. Your local neurologist can also help with some early and final appointments.

DBS appointments for out-of-town patients

If you live outside the Portland area, we do everything we can to limit travel. We try to schedule appointments on the same day. In some cases, we offer appointments over a secure video connection from your local neurologist’s office. Your local neurologist can also help with some early and final appointments.