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The ETMC Neurological Institute now provides deep brain stimulation treatment at our Movement Disorder Center with Dr. George M. Plotking.
This treatment for Parkinson's Disease and Essential Tremor patients uses Activa Therapy. This has proven widely effective for both Parkinson's and Essential Tremor control. Many patients feel they have been given their lives back with deep brain stimulation.
With deep brain stimulation, signals are delivered to precisely targeted areas within each side of the brain. Continuous stimulation of these areas blocks the signals that cause Parkinson's disabling motor symptoms. Many patients achieve greater control over their body movements.
A pacemaker for the brain
Utilizing the Medtronic brain pacemaker, doctors are now able to reduce the tremors seen in patients with advanced Parkinson's Disease whose symptoms are not relieved by medications.
The deep brain stimulation system involves three implants:
Lead -- a thin insulated coiled wire with four electrodes at the tip that is implanted in the brain.
Extension -- The lead is connected to an extension, a thin, insulated coiled wire that is threaded under the skin from the head, down the neck and into the upper chest.
Neurostimulator -- These medical devices similar to cardiac pacemakers are implanted in the chest near the patient's collar bone. These deliver the electrical stimulation to the brain's targeted areas via the extension and lead.
The pulses delivered to the brain can be non-invasively adjusted and transmitted via radio telemetry to the neurostimulator.
The electrical pulses block the brain signals that cause Parkinson's symptoms.
What's involved in the procedure?
Activa Therapy is provided by a multidisciplinary team at the ETMC Neurological Institute.
First a neurologist selects appropriate patients and provides care after a neurosurgeon precisely implants the system that delivers the therapeutic stimulation.
Implanting one system (consisting of the neurostimulator, extension and lead} usually takes about four hours. Two systems are used for Activa Parkinson's Control Therapy-
After recovery from the surgery, the patient returns to the neurologist for stimulation transmitter reprogramming. This helps optimize symptom control and minimizes any side effects. Routine follow-up appointments are then scheduled.
Once the device is implanted, adjustments may be made using a portable programmer that controls and monitors the neurostimulator functions. This is done noninvasively in an outpatient setting.
At typical settings, the system's battery lasts an average of three to five years, but it could be less than three years depending on individual patient requirements.
A simple surgical procedure is used to replace the neurostimulator; the extension and lead are typically not replaced.
Patients describe the benefits of this therapy as amazing. From simple pleasures such as going to dinner with friends without the fear of twitching to the performance of more complex tasks, patients find they are no longer prisoners in their own bodies.
Evaluation and Referral
Not all Parkinson's or Essential Tremor patients are candidates for deep brain stimulation. At the ETMC Neurological Institute patients are evaluated by Dr. George M. Plotkin, Movement Disorder Center medical director. He specializes in movement disorders including Parkinsonism and essential tremor. Patients who are suitable candidates for this treatment are referred to Drs. Mark Be Renfro, Paul Detwiler andThomas Grahm, neurosurgeons, for evaluation for the surgery.
Cost and Coverage
Deep brain treatment costs vary by benefit plan. Currently, Medicare and some health care plans allow for coverage of Activa Parkinson' s Control Therapy in many states. Most patients will be responsible for a deductible and/or co-payment/co-insurance.
Some Parkinson's patients may find that their out-of-pocket costs decrease after receiving Activa Therapy as a result of requiring fewer health care services.
