>
> I would appreciate any information anyone has on "deep brain stimulation" it
> has been suggested by my wife's neurologist . I have not been able to find
> any info as yet. any help would be welcome.
>
> [log in to unmask]
>
I can't remember where I got this article, probably from a PD Newsletter from
the "Movers and Shakers" Parkinson's Association in New South Wales
(Australia), but it seems a good discussion of Deep Brain Stimulation, and I
used it in the newsletter I did for the Victorian PD Association. It was
written by Jo Stratmoen:
Deep brain stimulation has been used successfully to mange the tremor which is
the trademark of Parkinson's disase.
As part of an international study, doctors from Sydney's St Vincent"s Hospital
have used a procedure which involves implanting an electrode into the thalamus.
This electrode is timulated by a pacemaker which is turned on and off by
placing a specially designed handheld magnet over it.
Originally developed by French researchers, the procedure is performed in two
stages.
Initially, a stereotactic frame and computer calculate the exact target site
within the thalamus for placment of the electrode.
Since the tremor associated with Parkinson's disease disappears when the
patient is asleep, the electrode is implanted using local anaesthesia only,
ensuring the patient is alert.
After a small hole is made in the skull, a fine electrode is passed into the
brain to the identified site.
Before being fixed into position the electrode is stimulated to ensure the
tremor is stopped.
In the second stage, a pacemaker is inserted under general anaesthetic.
This is placed in a position similar to that of a heart pacemaker and connected
to the electrode in the brain by an internal cable which passes down the inside
of the neck into the chest.
This pacemaker is then programmed to stimulate the electrode at regular
intervals.
In the late 1950's and early 1960's electrodes were planted in the thalamus and
a lesion created to stop essential tremor and tremor associated with
Parkinson's disease.
Dr. Dudley O'Sullivan, a neurologist involved in the current study, said that
the introduction of levodopa in the early 1970's such surgery was rarely used
and tremor was routinely treated medically.
"Although levodopa remains the gold standard of therapy, there is a significant
proportion of cased which are unresponsive to medical management," they said.
In an effort to provide relief for those patients with refractory tremor, in
1987 Professor Alim Benabid, of Grenobsle, France, refined the procedure used
in previous decades, removing the need to create a permanent lesion in the
thalamus.
Dr. O'Sullivan said there were two reasons for designing the pacemaker which
stimulated the electrode to be turned on and off.
"Firstly, since the tremor disappears when the patient is asleep, turning the
pacemaker off at bedtime helps prevent the development of tolerance," he said.
"Secondly, it preserved the batteries. Tolerance generally only seems to occur
in those patients with essential tremor, and not those with a genuine
Parkinson's related tremor."
Dr. O'Sullivan said the deep brain stimulaation procedure had been successful
in controlling tremor in all four patients treated to date in the Australian
study.
Jo Stratmoen
________
I had to type the above, so please excuse any typing errors.
Celia Jones
