What is neurostimulator?
DBS is a surgical treatment method which can be applied to mainly Parkinson’s Disease and can also be applied to other diseases like Dystonia (disease group that causes involuntary movement disorders in the body), Tremor, Epilepsy, Huntington’s disease (a genetic illness that causes progressive impairment of movement coordination) with a high success rate. DBS is especially widespread in the treatment of Parkinson’s disease. Symptoms such as tremor, gait disturbance, speech impairment of the Parkinsonian patients who underwent DBS surgery can be substantially recovered in a short period of time after the procedure. When the patients are examined in detail by brain surgeon for DBS surgery, various diagnostic tests should evaluate the patient’s suitability for the operation. DBS surgery can be applied to a patient thought to benefit from the treatment by the brain surgeon.
DBS Surgery
Electrodes are placed through thin wires from a small hole in the brain region of about 2-3 millimeters in diameter that is responsible for the disease during DBS surgery. A neurostimulator placed in the abdomen or chest area, electrically stimulates the problematic brain area continuously. DBS surgery takes about 4-5 hours. The patients are awake during the operation and do not feel any serious pain. Approximately 2-3 weeks after the operation of the DBS are needed to adjust the neurostimulator. The average life span of the neurostimulator is 5-6 years. When the neurostimulator starts to run out, it can be replaced by an operation which takes about 15-30 minutes. The most important advantage of DBS treatment is that it can be controlled and adjusted according to the patient. Especially in patients with Parkinson’s disease, complaints can be eliminated in a significant manner after DBS surgery. The operation is a treatment method with high patient satisfaction because of a painless surgical procedure, rapid elimination in complaints and minimization of drug side effects.
What is Parkinson’s disease?
Parkinson’s disease is a disease of the movement system that occurs due to a defect in the brain of a substance called dopamine allowing us to perform our movements smoothly, regularly, and fluently. The disease is often seen in older ages and more frequently in men. Although the cause is not fully known, it has been reported that exposure to some toxic substances in genetically predisposed individuals triggers Parkinson’s disease. Parkinson’s disease is characterized by slowing down movements, walking forward with small steps, dullness, a dull expression of face which is called mask face, and trembling on one side of the body. Parkinson’s disease is seen in one patient out of every 300 people over 65 years of age.
The main treatment for Parkinson’s disease is replacing the substance we call dopamine, which is lacking in the brain, with medicines. Drug treatments are adequate in a large proportion of early stage Parkinson’s patients. DBS operations may be on the agenda in Parkinson’s patients where medication is not sufficient.
DBS Surgery for Parkinson’s disease
About 10-15% of Parkinson’s patients are undergoing DBS surgery. Parkinson’s patients who are unable to use their medication due to the side effects or when medication treatment are no longer sufficient are advised to do DBS surgery. DBS operations are preferred more frequently in Parkinson’s disease patients, especially those with severe tremor. In Parkinson’s patients who cannot perform daily activities such as forking, knotting, tying shoes, writing, etc., there is a rapid recovery after DBS surgery and patients can gain independence again in their daily lives. The success rate of DBS surgery in Parkinson’s patients is approximately 85-90%. The use of medication in patients after the operation is seriously decreasing and the efficacy of the medications used is also increasing. Patients with Parkinson’s disease over the age of 75, uncontrolled diabetes, high blood pressure, pain heart disease, and severe memory problems are not eligible for DBS surgery.
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