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Neuroscience Center

Deep Brain Stimulation

Parkinson disease and other movement disorders are debilitating conditions. Patients with Parkinson’s suffer from loss of muscle control, including tremors when the body is at rest, slowness of movement, stiffness and difficulty walking.

Essential tremor--another nervous system disorder--tends to be more disabling than Parkinson's. It can affect almost any part of the body, but the trembling occurs most often in the hands as a person attempts a voluntary movement such as raising a spoon to the mouth. 

Dystonia is a neurologic disorder in which muscles contract involuntarily, resulting in repetitive twisting movements and awkward postures.

A procedure performed at Barnes-Jewish & Washington University Neuroscience Center offers hope for alleviating the worst symptoms of these disorders.

Understanding Deep Brain Stimulation

Deep brain stimulation involves an implantable device that delivers continuous, mild electrical impulses to the brain. The stimulation in Parkinson's patients targets the subthalamic nucleus, one of the regions of the brain that controls movement and that is overly active in persons with the disease. The procedure has proven successful in relieving not only tremor, but other symptoms of the disorder as well.

Deep brain stimulation in essential tremor patients targets the ventralis intermedius (VIM) nucleus of the thalamus region of the brain and reduces tremor. In primary dystonia patients, the stimulation targets the globus pallidus externus and has proven effective in relieving symptoms.

The device can be turned on and off or removed if necessary, and stimulation levels are adjusted according to individual needs.

Proving to Be One of the Most Beneficial Treatments Available

Based on our previous overall experience, this may be one of the best treatment options for selected patients with advanced Parkinson's disease. Many have returned to a relatively normal, active life, usually with a significant reduction in their medication. Not all patients are good candidates for the surgery, however. Our team of neurologists and neurosurgeons can evaluate each candidate to determine the risks and benefits of deep brain stimulation.

Patients who do undergo deep brain stimulation often have less need for Parkinson’s disease medications. These medications can effectively “unfreeze” the muscular system, but sometimes come with their own side effects.

Our neurosurgeons have implanted the device in hundreds of patients with Parkinson's and other forms of tremor. Deep brain stimulation is approved by the U.S. Food and Drug Administration (FDA) for all three types of tremors. (Because of the low number of dystonia patients treated, the FDA has approved the treatment through a humanitarian device exemption.) 

For a referral to a Washington University neurologist or neurosurgeon at Barnes-Jewish Hospital, call .

Ralph Dacey, MD

Neurosurgeon, Barnes-Jewish & Washington University Neuroscience Center

 

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