Deep Brain Stimulation
Deep Brain Stimulation (DBS) for Severe Facial Pain
What is Deep Brain Stimulation (DBS)?
Deep Brain Stimulation (DBS) is a surgical treatment that delivers small electrical pulses to targeted areas deep within the brain. While DBS is most widely known for treating movement disorders such as Parkinson’s disease, it can also help certain patients with severe, chronic facial pain that has not improved with other treatments.
When is DBS Considered?
DBS is not a first-line treatment for facial pain. For some patients however, the mechanism of facial pain extends beyond the trigeminal nerve itself and originates in the deep structures of the brain. DBS is only considered when medications, nerve procedures, and other surgeries have failed to bring relief. It may be an option for patients with:
- Trigeminal Neuralgia (TN) – especially atypical or secondary forms resistant to other therapies.
- Anesthesia Dolorosa – burning or aching pain that develops after nerve injury or prior surgery for TN.
- Atypical Facial Pain / Persistent Idiopathic Facial Pain (PIFP) – constant or diffuse facial pain without a clear structural cause.
- Postherpetic Neuralgia – lingering nerve pain after shingles involving the trigeminal nerve.
How Does DBS for Severe Facial Pain Work?
The DBS system consists of thin wires (electrodes) implanted into specific brain regions involved in pain perception—often the thalamus, periaqueductal gray (PAG), or anterior cingulate cortex (ACC). These electrodes connect to a small, battery-powered device placed under the skin of the chest. The device sends electrical pulses to interrupt abnormal pain signals.
Potential Benefits
- Reduction in pain intensity.
- Improved ability to function and perform daily activities.
- Less reliance on pain medications.
Risks and Limitations
- Like all brain surgeries, DBS carries risks such as infection, bleeding, or device-related complications.
- Pain relief is not guaranteed—results vary from person to person.
- Requires ongoing follow-up to adjust stimulation settings.
Given the extreme conditions at which this procedure is considered, results are quite limited. At Pacific Neuroscience Institute, our neurosurgical team carefully evaluates each patient to determine whether DBS is appropriate, working closely with pain specialists and neurologists to ensure a comprehensive approach.
