DBS Therapy for Parkinson's control helps reduce some of the
symptoms of Parkinson's disease and is used in conjunction with
medication. Electrical stimulation is delivered to targeted areas on both
sides of the brain to help relieve symptoms on both sides of the body. You may
be a candidate for this therapy if your symptoms respond to levodopa, but
levodopa andor other medications have become less effective or ineffective.
The benefit of deep brain stimulation
in controlling tremors and improving motor function for those with Parkinson's
disease appears to last at least 10 years, according to a small new study.
Parkinson’s disease is one of several conditions called motor system disorders,
which are caused by the loss of dopamine-producing brain cells. The main
symptoms of Parkinson's disease are tremors or trembling in hands, arms, legs,
jaw and face; rigidity or stiffness of the limbs and trunk; slowed movement;
and impaired balance and coordination.
As the disease progresses, patients
can have difficulty walking, talking or doing other simple tasks, In deep brain
stimulation, a surgeon implants a small device called a neurostimulator under
the skin near the collar bone. The doctor then positions wires from the device
with electrodes on their ends in areas of the brain that control motor function.
The device works by electrically stimulating these areas, blocking abnormal
nerve signals that cause the tremor in Parkinson's disease patients.
"Deep brain stimulation is still
effective in improving motor signs in advanced Parkinson's disease patients 10
years after the surgery". However, this surgery does not stop the slow
progression of the disease over time, as documented by the progressive loss of
benefit that both deep brain stimulation and the drug levodopa show in
improving walking, balance and speech over the years, Parkinson's disease
patients who are considering deep brain stimulation surgery should always ask
their doctor how long the benefit lasts after surgery
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DBS uses a surgically implanted medical device, similar to a cardiac pacemaker, to deliver electrical stimulation to precisely targeted areas within the brain. Stimulation of these areas blocks the signals that cause the disabling motor symptoms of Parkinson's disease. The electrical stimulation can be noninvasively adjusted to maximize treatment benefits. As a result, many individuals may achieve greater control over their body movements.
- Lead – A lead consists of four thin coiled insulated wires with four electrodes at the lead tip. The lead is implanted in the brain.
- Extension – An extension connects to the lead and is threaded under the skin from the head, down the neck and into the upper chest.
- Neurostimulator – The neurostimulator connects to the extension. This small, sealed device, similar to a cardiac pacemaker, contains a battery and electronics. The neurostimulator is usually implanted beneath the skin in the chest below the collarbone (depending on the patient, a surgeon may implant the neurostimulator in the abdomen). Sometimes called a "brain pacemaker," it produces the electrical pulses needed for stimulation. These electrical pulses are delivered through the extension and lead to the targeted areas in the brain. The pulses can be adjusted wirelessly to check or change the neurostimulator settings.
After the Deep Brain Stimulation procedure
The doctor may advise few antibiotics to prevent infection. The patient may need to visit the doctor several times after the surgery to adjust the stimulation with the help of programming. The doctor may prescribe a detailed medication plan to the patient. The patient should take some precautions after the surgery and follow the instructions given by the doctors. He/she should take care of the incisions and the surgical region on the head, by keeping it dry and covered. Heavy physical activities and lifting heavy weights should be avoided for few weeks after the surgery. Regular follow-up with the treating doctor should be done.
Deep Brain Stimulation Surgery Advantage:
- In this surgery we do not injure the brain so it is relatively risk free.
- Completely reversible and programmable
- Parkinson medications are reduced which results in improvement of drug related side effects.
- There is improvement of quality of life in both off and on stage of the disease.
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