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Deep Brain Stimulation: Have you ever considered it?


Have you ever considered Deep Brain Stimulation? That question threw me for a loop this past week during my most recent Neurologist appointment.  I have been asked this question by a handful of people but I hadn’t paid much thought to it until this week



Deep brain stimulation. DBS. Brain Surgery. Drilling into my brain.  “A Brain Pacemaker.” Neurostimulator. Neurosurgeon. Electrodes.


Just a very small handful of the thoughts running through my brain over this past week.




The definition of Deep Brain Stimulation is a neurosurgical procedure involving the placement of a medical device called a neurostimulator (often referred to as a brain pacemaker) which sends electrical impulses, through implanted electrodes, to a specific targets in the brain for the treatment of various movement disorders. 



Heavy stuff, right? Average female in their mid/late twenties isn’t weighing the Pros and Cons of brain surgery.  But hey, I am definitely not someone to be considered average.



FDA approved since 1997, the surgery is now approved for various diseases and conditions, such as  Parkinson’s, Essential Tremors, OCD, epilepsy, dystonia, chronic pain, and depression to name a few. What I personally find puzzling, is that exact action of the DBS is not known. However, various hypothesis have been put together to explain the why and how DBS has been proven to have had such positive results.  



The direct actions of the neurostimulator on the brain cells is debated but by sending high-frequency impulses to the certain parts of brain, the stimulator can regulate symptoms and directly reduce side effects induced by various medications or making a medication regimen more tolerable. 



As with any surgery, there are risks. At the end of the day this is still Deep Brain surgery.  The major complications include hemorrhage in 1-2% of patients and infection in 3-5%.  The side effects after DBS can include apathy, hallucinations, cognitive dysfunction, depression, and euphoria.  These may be temporary and related to correct placement of electrodes thereby making the side effects reversible. 



The DBS device is made up of 3 parts, the implanted pulse generator (IPG), the leads, and an extension. All three parts are surgically placed inside the body, the leads get implanted under local or general anesthesia.  Drilling a 14mm hole in diameter in the skull, a probe is inserted using either a frame based or frameless ‘stereotaxis.’ During the awake procedure, the neurosurgeon has the patient perform actions to determine the ideal placement of electrodes.  During the fully asleep procedure a guided MRI is used to identify the placement of electrodes. 



After surgery, swelling of the brain tissue, mild disorientation and sleepiness are normal.  After 2-4 weeks, the patient will have a follow up visit to have their sutures removed. Their stimulator will then be turned on and programmed.  Whew, did you get all that? Just a small summary, but definitely a significant amount of information.  






Dr. Abigail Rao, a neurosurgeon at Norton Brownsboro Hospital has brought new techniques to Louisville, Kentucky (my hometown).  She, along with her medical team, are performing deep brain stimulation awake and fully anesthetized. Please see the attached article. 



A 2014 study found about 100,000 individuals worldwide have been implanted with DBS systems, most of whom have Parkinson’s disease or essential tremor.  I personally always knew DBS would be in my life plan at some point, I never thought I would be considering it in my twenties! 



DBS: Abigail Rao, New technique  


#deepbrainstimulation #Essentialtremors #DBS #Nuerology #deepbrainsurgery #honestyisstrength #shareyourstory #Shareyourknowledge #movementconditions #brainpacemaker 

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