DEEP BRAIN STIMULATION
In this article you can find the answers for What is the Deep Brain Stimulation surgery? How is deep brain stimulation surgery performs? Which patients are candidate for Deep Brain Stimulation surgery? Which important factors are important to decide to surgery?
Deep brain stimulation (DBS) surgery (brain pacemaker surgery) is a technological surgical procedure involving the placement of two electrodes inside the brain and connect them to a battery (implantable pulse generator). This implantable pulse generator (medical battery) sends electrical impulses, through implanted electrodes, to specific targets in the brain (brain nuclei) for the treatment of some disorders including Parkinson's disease, essential tremor, dystonia, Obsessive–Compulsive Disorder (OCD), and Epilepsy.
Deep brain stimulation (DBS) surgery is performed in two parts.
In first part we need to implant the two bilateral electrodes inside to the some brain nuclei (which targeted area by MRI images before) via two small holes under local or general anesthesia. In this part of the surgery the patient doesn’t feel any pain because of the local anesthesia. When we are implanting the electrodes, we do a micro electrode recording (listening the sound of the brain) to evaluate the areas of the brain and to be sure to implant the electrodes in correct position. After the implantation we send a test signals to evaluate the effect of the electrodes and we evaluate the patient's symptoms (is the tremor stopped? or is the rigidity resolved?) We can change the position of the electrodes by this evaluation if it’s necessary. When the surgical team satisfied about the Micro electrode recording and Macrostimulation results we can forward to the second stage.
In second stage we need to implant the Implantable Pulse Generator (IPG) (battery) under the skin on sub clavicle area and we need to connect it to electrodes by extension wires from under the skin. In this stage we need to take the patient under general anesthesia.
Deep Brain Stimulation surgery / DBS (brain pacemaker surgery) can use for the following disorders:
· Parkinson's disease:
· Essential tremor:
· Dystonia:
· Epilepsy
· Obsessive Compulsive Disorder (OCD)
The patient candidate for DBS are;
If the medications are inadequate to suppress the symptoms or began to cause side effects.
if the patient has a movement disorder with worsening symptoms (tremor, stiffness) and the medications have begun to lose effectiveness.
If the patient has troubling "off" periods when the medication wears off before the next dose can be taken. If the patients troubling "on" periods when develop medication-induced dyskinesias (excessive wiggling of the torso, head, and/or limbs).
Especially in Parkinson’s disease, the levodopa response is so important. If the patient's response to levodopa treatment is positive, it means that the patient will benefit from Deep Brain Stimulation surgery. If the medications are inadequate to suppress the symptoms or began to cause side effects, the patient must be have Deep Brain Stimulation surgery.
You need to remember there isn’t any surgery without risk.
General complications of any surgeries are infection, bleeding, blood clots, and reactions to anesthesia. Since the Deep Brain Stimulation surgery does only from two bur hole Complications of the Deep Brain Stimulation surgery is low when it's compared by the other cranial surgeries. But the experience of the whole surgery team is so important like all surgeries.
DBS may also cause worsening of some symptoms in some patients such as speech and balance impairments. In that point the evaluation of the patient before the surgery by an experienced team is so crucial.
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