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Deep Brain Stimulation for Parkinson Surgery
Relevant information about Deep Brain Stimulation for Parkinson Surgery.
Deep Brain Stimulation is a surgical procedure performed to treat disabling neurological symptoms that is usually done to treat the debilitating symptoms of Parkinson’s Disease. The procedure is recommended only for patients whose symptoms cannot be totally controlled with medications. Deep Brain Stimulation operates with a surgically implanted battery-operated medical device. This device, known as neurostimulator, delivers electrical impulses to areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and Parkinson symptoms.
The procedure is used to treat Parkinson’s Disease symptoms. Parkinson's Disease is a chronic brain disease characterized by gradually tremor, muscle rigidity and difficulties with starting and stopping motion movements. All these symptoms tend to get worse over time. The cause of this disease is generally unknown, but in a small proportion it is known to be caused by genetic mutations.
The Brain Deep Stimulation device consists of three components. These are the leads, which are also called electrodes, the neurostimulator and the extension, which is a cable that connects the neurostimulator and the leads or electrodes. The device must be put inside of the patient’s body and head. This is usually done in a procedure that is divided in two parts. These two parts are two different surgical procedures. During the first surgery, the electrodes are placed into the brain, but left unconnected. To achieve this, first of all, the brain areas that will be treated have to be located. There are several ways in which this can be done. Some Physicians tend to use only CT or MRI scans. Others will also use an electrode recording technique to map and target the specific areas brain areas that they will need to reach. Once the locations are identified, a small incision is made, and the skin and muscles are removed. When the skull is reached, a small drill is used to make and incision about 14 mm. After this is done, the dura, which is the protective covering of the brain, is cut and the electrodes are implanted within the targeted area in the brain. The loose ends of the electrodes are placed underneath the skin of the head. The skin and muscles are put together and the incision is closed with sutures. Most Parkinson’s Disease patients require this whole procedure to be done on both sides of the brain. The second surgery is usually done one week later. This time the side of the head, neck and upper chest is draped. An incision is made below the collarbone to allow the creation of a small pouch that will hold the neurostimulator. Then, another incision is made behind the ear. Next, the extension is passed from the chest to the head and connected to the electrodes after the loose ends have been removed. All this process is done underneath the skin. To end the surgery, the chest and the ear incisions are closed. There is a final step that consists on turning on and adjusting the neurostimulator. This is usually done after two or four weeks.
Patients should not engage in any kind of activity for 2 weeks after surgery. This includes housework and sexual activity. Heavy activities may be done only after 4 to 6 weeks. This includes any physical education classes. However, to allow the surgical wounds to heal properly, strenuous tasks will be avoided during the post surgical process.
Complications may happen during the brain surgery or after the devices have been put. The most common ones are hardware complications, which happen when the extension breaks or fractures, usually due to erosion through the patient’s skin. Battery failure may be a possible complication but is contemplated. It is assumed that the batteries will last on average from 3 to 5 five years. None of these problems tend to cause serious damage, and are very uncommon.
Deep Brain Stimulation will improve patient’s motion and significantly reduce the Parkinson’s Disease symptoms.
Tremors cannot be eliminated, only reduced. Also, some patients may still need additional medication.
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