 |
 |
Hello everyone, With the recent posting about DBS I thought I would scan an article on the procedure that appeared in our Halifax Daily News last March 29th. The Queen Elizabeth II Health Sciences Centre, under the direction of Dr. Ivar Mendez, is the only centre in Canada with a neural transplantation program. Recently Dr. Mendez began to perform DBS surgery. For more information, check the Dalhousie University Medical School, Division of Neurosurgery (http://www.mcms.dal.ca/dnts/mainpage.html) for more information. BTW, the Halifax Daily News was a pioneer on the Internet. TTFN Peter ========================================================== Halifax Daily News, March 29, 1998 Electrode controls Parkinson's disease By SHAUNE MacKINLAY The Daily News John Phinney used to shake so badly with Parkinson's disease he couldn't even feed himself. Sometimes the tremors were so severe he would shake right out of bed. Last month everything changed for the 56-year-old New Brunswick man thanks to a new treatment at Halifax's QEII Health Sciences Centre. Phinney is the first Atlantic Canadian to undergo a procedure called deep brain stimulation. Now, just over six weeks since his surgery, he's regained some of the control that was robbed from him since Parkinson's hit almost 13 years ago. "I feel a lot different about life now," Phinney said in an interview from his Campobello Island home. During the procedure, which only gained American and Canadian approval in the past year, a tiny electrode is guided into the middle of the brain to the thalamus, where sensory nerves originate. It's a very precise target, about two millimetres wide and four millimetres long, explained neurosurgeon Dr. Ivar Mendez. "It's a little electrode that goes into the brain and it's connected by a cable to a small computer implanted beneath the skin in the chest," he said. The small device in the chest, called a pulse generator, can be programmed through the skin by an external computer to provide varying degrees of electrical stimulation to the brain. For Phinney, that stimulation has meant an end to the tremors on one side of his body. "It's just like magic. Can you imagine, after 12 years for the first time he's able to use his right side," Mendez said. A second surgery in six months' time for the other side of his brain should make him appear relatively normal, Mendez said. Parkinson's kills off brain cells that produce dopamine, a chemical neurotransmitter which sends messages between nerve cells in the brain. The result is tremors, slow movement and muscle stiffness. Deep brain stimulation does not affect dopamine levels, so it is considered a treatment, not a cure. "The only thing that it does is interrupts a pattern, that is their pattern that produces tremor. It's like a jamming device that jams the signals," Mendez says. Phinney's wife, Sandra, calls it nothing short of a miracle." As her husband's illness progressed, she became his caregiver. She fed him, dressed him, and shaved him. A year ago, his condition deteriorated to the point that he was unable to walk- Now he's looking after himself again and he can walk up to a quarter-mile. "He walked my granddaughter to the end of the driveway to the bus this morning," Sandra Phinney said. For a man who always looked after his family, life had become almost unbearable. "I didn't care if I lived or died," he said. He was frightened by the prospect of brain surgery, but felt he had nowhere else to turn. His wife said she knew her husband had a skilled doctor, but she put her faith in another set of hands. "I prayed and my prayers were answered and I knew it was going to be all right," she said. Phinney now appears on a video used by Mendez to explain the surgery In the first scene, he's sifting on a hospital bed, his arms, legs and mouth moving constantly. When tries to trace a spiral on a piece of paper or draw a straight line, he can only scribble. Before the surgery, an MRI scan of Phinney's brain was transmitted to a computer where it was used to develop a model, a kind of virtual reality plan for tie surgery Coordinates determined by the model were then set on a metal head harness attached to Phinney's skull with four pins. The coordinates on the harness determine precisely where the electrode will go. "You make a small hole in the skull then you put this probe all the way up to the middle of the brain," Mendez said. The patient is awake the entire time. In Phinney's next video appearance, after the surgery, he continues to shake until Mendez turns his pulse generator on with a magnetic switch. One side is quickly still. When asked again to trace the spiral and draw a straight line, Phinney does it with relative ease. Mendez said the computer can stay in Phinney's chest forever, but he must get the battery changed every five years. There are now 14 people on the waiting list for the procedure at the QEH. George Turnbull, president of the Parkinson's Foundation of Canada, Nova Scotia division, said the surgery holds great promise for patients whose condition has deteriorated to the point where it can no longer be managed with drugs. Despite its successful outcomes, he cautions the procedure is not an answer for Parkinson's. "It alleviates the symptoms, but it doesn't cure the condition," he said. ************************************************************************** Peter Kidd Learning Materials Consulting Services 62 Coronation Avenue, Halifax, Nova Scotia B3N 2M6 Canada Tel/FAX: (902) 443-4262 Email: [log in to unmask] URL: http://www.chebucto.ns.ca/~aa163/peterkidd.html