Helping to Restore the Quality of Life in Patients

~ By Jessica Edgar, Prime Time For Seniors ~

DBS Therapy manages some of the most disabling motor symptoms of the three most common movement disor­ders: Essential Tremor, Parkinson’s disease, and Dystonia. It is an adjust­able and reversible treatment for motor symptoms of these disorders that offer patients a better quality of life. It can offer patients with essential tremor or Parkinson’s disease an improvement of their motor control, mobility, and functional ability.

I recently had the pleasure of meeting with Dr. Adam Hebb, the Medical Director of Function­al Neurosurgery for the Colo­rado Brain & Spine Institute, and he explained the basics of the procedure and the three necessi­ties for potential candidates.

The surgery usually takes on average two to three hours and involves two different parts. The patient is also awake during surgery, this enables the physi­cian to ask questions and test cognitive functions. The first part is to implant leads in the part of your brain called the thalamus for essential tremor patients and the subthalamic nucleus for Parkinson’s patients. This is where the surgeon will test stimulation to ensure proper lead positioning. Surgeons custom­ize the lead placement according to the specific patient with only 2-3 millimeters of space to place the lead. This is the most deli­cate and important part of the surgery. Although improperly placed leads can be fixed with additional surgery, the side ef­fects could be worsening trem­ors. The second part is to implant the neurostimulator. This is simi­lar to a pacemaker. The patient is sedated for this part and the neurostimulator is placed in the chest below the collarbone under the skin. The leads will also be connected with extensions that are placed under the skin to the stimulator from the chest to your neck and head.

After healing from the proce­dure, the doctor will turn on the device and adjust the program to best control your individual symptoms. Essential tremor patients do see some immediate relief, while Parkinson’s patients need some fine tuning which can take a few months. Again, this varies according to patient.

Along with the surgery, a mul­tidisciplinary team of clinicians are involved in the process. This includes one or two neurologists, a neurosurgeon, and neurophysi­ologist that help decide if you are a candidate for DBS therapy. As mentioned before, there are three necessities or steps that are covered before surgery. The first step is to be properly diagnosed. It is suggested to see a neurolo­gist for a proper diagnosis. Most Parkinson’s patients will be eligible later in their progres­sion or once the medication starts becoming less effective or causing intolerable side effects. Essential Tremor is often diag­nosed through discussion of symptoms and examination of your reflexes, strength, walk, and coordination. The second step is the expectations of the patient. This will obviously vary accord­ing to patient. The third step is the accurate lead placement that is customized for each patient. As stated, it is critical to the mil­limeter.

The effects of DBS last for years and restore not only quality of life, but regaining confidence and freedoms that have been lost. But each patient’s story is different.

In the April edition, we will go more in-depth on the surgery and how it helps Parkinson’s disease and Essential Tremor. We will also have patient stories relating to the surgery and post life surgery. It is also worth mentioning that since the surgery has been FDA approved, it is covered by insurance including Medicare and Medicaid. In the meantime, here are a few links to check out more about DBS and success Videos:

• http://stimlab.org/?page_id=75
  This site is a more in depth look at the surgery and what the surgeon is looking for. This is a presenta­tion put together by Dr. Adam Hebb.
• http://swedishhospital.com/dbs
  This site is from the hospital that Dr. Hebb currently works from and performs DBS surgeries.
• http://www.medtronicdbs.com/
  The company, Medtronic’s, web­site with information pertaining to DBS

Part 2 of this series may be read here.