Deep Brain Stimulation for Advanced Parkinson's Disease - Health Education - DesiMD Healthcare - India

Deep Brain Stimulation for Advanced Parkinson's Disease

Dr.Venkataramana N K profile Authored by Dr.Venkataramana N K on 5 Jan 2015 - 13:09.

Parkinson's disease is a progressive, degenerative movement disorder affecting an average of one in every 10,000 people. Commonly known as shaking palsy, it manifests itself as a disorder of movement, which includes tremor (shaking of hands and legs), rigidity (stiffness) bradykinesia (slowness of all movements), loss of facial expressions and disturbances of posture, balance and walking.

Though it usually affects people over the age of 50, younger individuals also get affected. Despite the large number of medications available for the treatment of early and moderately advanced disease, their efficacy in the advanced disease is limited, providing only symptomatic relief and no improvement in the quality of life. Moreover with prolonged usage, benefits wear off requiring increasing dosages and adverse side effects.

Deep Brain Stimulation:

Deep Brain Stimulation is a novel technique of providing high frequency stimulation to selected target nuclei in the brain. It has emerged as an effective alternative to Thalamotomy and Pallidotomy. Recent knowledge and understanding of physiology of Basal Ganglia and Thalamus advancements in electrophysiology, neuro imaging, stereotactic neurosurgery, interactive computer guidance devices and neuro stimulation equipment have made this successful.

Micro Electrode Recording:

It is an electrophysiological device to confirm the correct location of the electrode in the brain. This is a sophisticated technique of recording the electrical activity of the brain cells. It can make the surgery more accurate, safe and absolutely scientific.

Benefits of DBS :

DBS is the only surgery that improves all the symptoms like tremor, rigidity, akinesia, postural instability and gait virtually in all with a rewarding functional ability.Advanced Parkinson’s disease with inadequate benefit from medical therapy, with fluctuations and dyskinesia are ideal candidates for DBS.

Age is not a contra-indication – although one has to be medically fit with no signs of depression or dementia (intellectual deterioration). DBS makes no lesion in the brain. It is reversible, adjustable and programmable to individual requirements. 

Long term follow up:

DBS requires programming and setting the parameter of stimulation to achieve best functional outcome, suitable to the individual.  Supportive physiotherapy, speech therapy and general supportive measures will further improve their quality.  Though DBS relieves majority of the symptoms, small doses of medications need to be continued.

Restoring Hope:

A 61 year-old, Bhagwan with Parkinson’s disease approached us for help with symptoms ranging from progressively reducing mobility to difficulty in walking (bradykinesia), and tremors that chiefly affected his hands. He had been suffering from these degenerative symptoms for 15 years.

Over the last four years, he had nearly lost his ability to write as well. Since being diagnosed with Parkinson’s he had been put on increasingly higher doses of medicines just to keep his basic mobility going. Now his dosages had reached a point when he could no longer bear the side-effects including dyskinesia. The patient was up against the wall, caught in a classically tragic Parkinson’s predicament where he had to make a choice between two options: limited but painful mobility with the medicines or near-complete immobility without them.

We at BGS-GIN offered him a third option: DBS or Deep Brain Stimulation, surgery. The patient agreed and went through this completely safe procedure that involved placing electrodes on either side of the Sub Thalamic Nucleus, a small lens-shaped nucleus in the basal ganglia system of the brain, through burr-holes and connecting them to a battery on the chest wall with subcutaneous cables.

Post-surgery, based on evaluation, the voltage and frequency of the stimulation were adjusted. Following the procedure, this 61-year-old chronic patient of Parkinson’s regained his regular movements and was able to not merely walk but also attend to his business on his own. He is on regular follow up and the medicines are being tapered off.

 

 

 

*Disclaimer
*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.