October 11, 2017

A Pacemaker for the Brain? This Surgery Is Changing Lives for Patients with Parkinson’s, Essential Tremor

By Richard Lytle Jr., MD

A surgical procedure known as deep brain stimulation (DBS) is used to treat neurological symptoms associated with Parkinson’s disease, essential tremor and dystonia. This procedure is recommend for patients whose symptoms cannot be adequately controlled with medication. A surgically implanted, battery-operated device – similar to a pacemaker – delivers electrical pulses to targeted structures in the brain. These electrical pulses work to suppress symptoms associated with Parkinson’s disease and essential tremor.

Benefits of DBS will help to improve the motor symptoms of Parkinson’s disease including:

  • Rigidity – Stiffness or inflexibility of the limbs
  • Bradykinesia/Akinesia – Slowness or absence of movement (also known as freezing)
  • Tremor – Involuntary, regular shaking of the limb
  • Dyskinesia – Involuntary wiggly/jerking movements

Most Parkinson’s patients will experience a reduction in medication after surgery. Most tremor patients will see abolishment or significant reduction in their tremor. Some patients will require less help from family and caregivers, thus regaining some of their independence.

DBS is a two-step surgery procedure, scheduled a few weeks apart. During the first surgery an electrode is placed in the brain. The second stage is connecting the extension to the electrode and the generator. During the first phase, the patient will be awake. During the second phase, the patient will be under general anesthesia.

After surgery, the patient will have multiple follow-up visits with the team. The patient will have a couple of appointments with the Neurosurgery team. We will optimize the settings over a period of time during several visits with the programing neurologist.

DBS surgery is covered by Medicare, Medicaid and most commercial insurances.

The Food and Drug Administration has approved the placement of DBS electrodes for the patients diagnosed with essential tremor, Parkinson’s disease, dystonia and obsessive compulsive disorder.

At Mission Health, we only implant for essential tremor and Parkinson’s. Dystonia and obsessive compulsive disorder patients are better served at an academic medical center.

Richard A Lytle Jr., MD, is a neurosurgeon performing DBS procedures at Mission Hospital.