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Cutting Edge Technology Blocking Electrical Signals That Cause Neurological Impairment

What is Deep Brain Stimulation?

Deep Brain Stimulation or DBS as it is commonly known is a medical procedure to treat neurological symptoms that are disabling for the human body. Using electrical impulses to stimulate target areas in the brain, DBS is a surgical procedure that is most commonly used to treat symptoms of Parkinsons Disease like tremor, stiffness, slow movement, inability to walk, rigidity etc. It is also used to treat essential tremor, a common nerve disorder in people.

How do you know if you need DBS?

DBS is only used for patients on whom medication does not work effectively to control neurological disorders, through a procedure that blocks electrical signals from targeted areas in the brain without destroying any healthy brain tissue. DBS is not known to cure Parkinsons Disease or any severe neurological condition but decreases the use of medication and improves the quality of life of patients. DBS could also be used to treat the following conditions:

Essential tremor: A condition in which there is a constant rhythmic trembling of the head, voice, limbs.

Multiple Sclerosis: A disease that affects the central nervous system of people.

Intractible Pain: A pain that cannot be controlled by medical or surgical procedures.

Psychiatric Conditions: Includes conditions such as depression, obsessive compulsive disorder, anxiety etc. and do not respond to any kind of medication or treatment Alzheimer’s Disease.

How is DBS done?

DBS uses parts of the brain that are located in the front, in the cerebrum. It is a procedure through which a lead or an electrode is planted in the brain and a neurostimulator, a small battery operated medical device is implantedin the upper chest, under the skin. This is connected to the electrode in the brain through a wire. This device transmits electrical stimulation to parts of the brain that control our movement, thereby blocking abnormal nerve signals that cause tremors or other neurological disorders. Some surgeons also use a process known as micro-electrode recording to monitor the nerve cells and identify the exact area of the brain that needs to be targeted through DBS. In some cases the electrode and the neurostimulator is implanted at the same time while at times it is done through separate procedures. After the neurostimulator is places, it is programmed to deliver the electrical signal a few weeks after it is implanted. Neurosurgeons also use MRI or a CT scan to identify and locate the exact spot in the brain before the procedure is undertaken.

What happens after the procedure?

Patients are advised antibiotics after a DBS procedure to avoid any kind of infection. Patients also need to visit the doctor a few times to adjust the stimulation. Basic care like keeping the incisions clean and dry and avoiding heavy physical activity should be done to ensure a faster recovery.

What are the risks?

DBS is a brain surgery and therefore like any other surgery has associated risks. Some of these include seizures, disability, swelling of the brain and infection, strokes, seizures etc. Patients must speak to their doctor in detail and understand all associated risks before going through the process.

What are the other tests that need to be done for DBS?

When a patient is put through DBS, they need to go through some other tests to make sure that they are fit for the procedure and also diagnose the line of treatment needed. The following are the tests and other medical processes patients need to undergo:

Radiology: MRI scan with contrast of the brain, CT scan of the brain with the stereotactic frame.

Laboratory Tests: These include CBC, Renal profile (basic), Blood grouping, HIV/HbsAg/HCV screening, Chest x-ray, ECG.

Medication: IV Antibiotics perioperative, Syndopa plus (3 -4 tabs/day), CR (1 – 2tabs/day).

Anaesthetic Procedure: A standard DBS procedure is done keeping the patient awake for most part of it. The stereotactic head frame and burr hole is put under local anaesthesia and brain mapping is done to check for the optimal location of the electrode and its efficacy and possible side effects. The skin where the incision is made is also anaesthetised and patients are given mild medication to help anxiety. It is only when the neurostimulator is placed that the patient is put under general anaesthesia.

What is the cost for DBS?

The evaluation process to determine whether a patient requires DBS or not costs USD 1500 approximately. The surgery could cost anywhere between USD 22000 for surgery with a non-programmable devise to USD 26500 for one with a programmable devise. Doctors Beyond Borders works with doctors and hospitals across the country to offer best packages available for patients requiring DBS. The extensive network of Doctors Beyond Borders ensures that patients can look at various packages and procedures involved and make the best choice that fits their budget and requirements.

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