Medical articles on Prevention, Diagnosis and Treatment

Deep Brain Stimulation – Surgery, Cost & Side effects for Parkinson’s

If you have ever watched any recent blockbuster “period” film, then you would have a first hand idea of just how dangerous psychosurgery was when it had first been implemented during the immediate post-war period; as evidence by films like Shutter Island and Sucker Punch, the notorious practice of “lobotomy” is tantamount to having your soul sucked right out of you. Just imagine a pointed object being embedded right in the middle of your forehead. And that was even considered standard practice during the 1950s, ironically, in the supposed “Era of Innocence”. Want an idea of just how infamous it is? Try listening to The Ramones’ Lobotomy; sure, they’re not exactly pointing out the details of this grisly procedure, but at least it can give you an idea of how negative the public’s perception was of psychosurgery in general during the late ‘70s.

Thankfully, that period had long passed us by now. Lobotomy is, of course, still performed, but not in the abusive sense that all mental patients had to undergo it just so their orderlies can keep them “calm”, but rather, as an emergency procedure in the removal of, say, a blood clot in the brain. Psychosurgery had also made some significant advances in its field during the past sixty years. If anything, it’s now bravely pointing the way towards the betterment and future of modern medicine. One fairly new procedure which had gained much acclaim within the medical circles is the use of deep brain stimulation (DBS), a revolutionary technique that has gained much use for clients who have been suffering from Parkinson’s disease? But what is it exactly that makes it so effective in the first place? Let us find out.

What is Deep Brain Stimulation?

Deep brain stimulation is a patient-controlled, continuous, high-frequency electrical stimulation of a specific area of the brain by means of an implanted electrode, which is also controlled by a battery implanted just below the clavicle. The electrical signals coming from those implanted electrodes are said to block the signals from the brain which supposedly causes the muscles to tremble. It is also used as a treatment for dystonia or a generalized impairment of the muscle tone. And judging by the collated global statistics that deep brain stimulation has on its effectiveness, the figures are really pretty impressive for a procedure which had been first devised as recent as 1987.

Deep Brain Stimulation surgery Deep Brain Stimulation    Surgery, Cost & Side effects for Parkinsons

Deep Brain Stimulation Procedure

What is Procedure for Deep Brain Stimulation?

Brain implants are prepared first for the procedure. These brain implants look very similar to “pacemakers”, but only that it is supposed to relieve the tremors. The stimulation can be bilateral or unilateral. Bilateral stimulation of the subthalamic nucleus, which serves as a correlation center for the optic and vestibular impulses that are relayed to the globus pallidus, is thought to be of greater benefit to patients than the results that are achieved with other psychosurgical procedures like thalamotomy, pallidotomy, or fetal nigral tansplantation.

In deep brain stimulation, an electrode is placed in the thalamus and connected to a pulse generator that is implanted in a subcutaneous, subclavicular, or abdominal pouch. The battery-powered pulse generator sends high-frequency electrical impulses through a wire placed under the skin to a lead anchored to the skull. The electrode then blocks the nerve pathways in the brain that cause the resulting tremors.

How Complicated can the Surgical process of Deep Brain Stimulation be?

The electrodes used for the surgical procedure of deep brain stimulation usually measures a millimeter in width. However, the actual process of embedding the electrodes inside the brain is an entirely different matter. It is still quite similar to a lobotomy, wherein a “makeshift” hole is still drilled through the skull. Not only is that a very difficult task—even for the most experienced of surgeons—to perform, but it also needs for one to be extremely careful while doing so. Once the hole has been successfully bored, the surgeons then have to navigate a spot where they can safely implant the electrodes. Once these electrodes have been ingrained in that area of the brain, that is still a part and parcel of the total surgical procedure. The wires that are a part of the electrodes then have to be carefully “teased” until the surgeons are able to make a “path” going through the ear and right down to the chest area, where its wires have to be connected to a small and battery-powered. If you think that this seems to possess a remarkable similarity to a “regular” cardiac pacemaker, that’s because it is really patterned after this procedure.

While it is, technically, a patient-controlled device, the settings on the machine still needs to be adjusted to the client’s normal physiological functions. The machine can be programmed to up to 60,000 presets, so it may result to several months of “fine-tuning” before the client can safely adjust to the specifications of the gadget.

Side-Effects or Complications

If there is one thing to remember about the process of a deep brain stimulation, it is, first and foremost, a surgical procedure. As such, the implementation of this device is not entirely without complication. Some can result from the surgical procedure needed for implantation, while others are complications which have been brought about by the device itself—lead poisoning being a very specific example.

Deep brain stimulation is considered to be relatively safe by modern surgical standards; however, the more important thing is the part that is to be affected. Performing a surgery on the brain is a very risky business, indeed. Some of the possible complications of these may include a hemorrhaging in the brain, or even an unwanted change in the sensorium, mood, behavior, or affect of the client. At the worst, it resembles the effects of lobotomy when it has been first performed on some hapless patients during the 1950s.

Also, it is possible for the client to develop side effects and complications that may be related to certain cardiac disorders. Infection can be a very possible complication due to the fact that a foreign object is basically implanted near the pericardium, like pericarditis, for example.

Deep Brain Stimulation Cost

This part of the piece may deal with some potentially dampening news: no matter in which way you may out it, deep brain stimulation is really costly. If you just look blindly at the average cost of deep brain stimulation, it should set you back about $50,000—and that is even putting it mildly. You also have to take into consideration the team of neurosurgeons that will have to be a part of the procedure; since this is a really dangerous operation, one should have to guarantee that the doctors that he or she will have to contract has the necessary experience and pedigree to carry out the procedure.

Not only that, but one also has to take into account the kind of medications that are needed before, prior, and after the treatment. If the procedure proves to be successful enough, then a necessary follow-up that involves an extensive physical therapy is necessary for the client to fully recover from the strain that the operation may have put on him or her.

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March 10, 2012 This post was written by Categories: Surgery No comments yet

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