Deep Brain Stimulation
Deep Brain Stimulation, Parkinson Surgery, Tremor, Dystonia, OCD Treatment at World's Best Hospital in India
Indian doctors with training in brain conditions (neurologists), brain surgeons (neurosurgeons), doctors with training in mental conditions (psychiatrists), pain specialists, specialized programming nurses and other specialists use an integrated team approach to treating people who have deep brain stimulation. Indian specialists have successfully used deep brain stimulation to treat hundreds of people who have essential tremor, Parkinson's disease and dystonia. Recently, doctors have used DBS to treat people who have cluster headaches, Tourette syndrome, epilepsy and chronic pain that hasn't responded to other treatment.
Neuro specialists in India use computer-assisted brain surgery, intraoperative MRI and awake brain surgery during deep brain stimulation.
Indian Neurologists are ranked among the Best surgeons for neurology and neurosurgery worldwide. Because the brain can shift slightly during surgery, there is the possibility that the electrodes can become displaced or dislodged. This may cause more profound complications such as personality changes, but electrode misplacement is relatively easy to identify using CT.
After 2–4 weeks, there is a follow-up to remove sutures, turn on the neurostimulator and program it.
What is Deep Brain Stimulation ?
Deep brain stimulation surgery technique involves implanting electrodes inside the deep nuclei of brain called as subthalamus under local anesthesia. These electrodes are then connected to IPG (Pacemaker) implanted underneath the skin below the clavicle through the connecting leads under general anesthesia. To perform any kind of activity, the patient has to switch on the device with the help of a patient programmer. This stimulates the deep brain nuclei, which results in improvement of all the symptoms of Parkinson disease.
With the progress of disease the parameters of stimulation are changed over a period of time so that patients can remain symptom free for long period. The patient himself can change the stimulation parameters with the help of patient programmer. Normally the life of the pacemaker is five years and after that a new pacemaker replaces it. The electrodes remain in position for life long.Rechargeble Pace makers are now available that can be recharged at home.The life of these pace makers are 15-20 years.The stimulation of subthalamic nucleus through this device leads to improvement in all the symptoms of advanced Parkinson disease.
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.
DBS System consists of three implanted components :
- 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.
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.