In the United States, an estimated 42 million people suffer from some form of movement disorder. Common movement disorders include Parkinson's disease (PD), essential tremor (ET), and dystonia. Although medications may be helpful for these conditions, in many patients, symptoms cannot be controlled with medications alone. In such situations, their physicians may recommend a surgical procedure known as Deep Brain Stimulation (DBS). DBS is a revolutionary technology using an implanted device to deliver electrical stimulation to the brain to help symptoms, alleviate suffering, and improve quality of life. The Food and Drug Administration (FDA) approved DBS as a treatment for essential tremor in 1997, for Parkinson's disease in 2002, and dystonia in 2003.
Deep brain stimulation has dramatically changed the lives of many patients with uncontrollable tremors. Patients often can resume normal activities, such as feeding and dressing themselves, and can have active and fulfilling lives. The need for anti-tremor medications is often reduced or eliminated.
Though it's no longer considered experimental, DBS is, for now, still used as a second- or third-line treatment, reserved for patients with more advanced cases of the disease and those for whom medication alone is inadequate or can't be adjusted precisely enough to keep their tremors and writhing under control.
However the idea of this surgery being a "last resort" is an evolving concept. Ten years ago doctors were operating on only the most severe, disabled, wheelchair-dependent patients, now they are operating on patients with moderate-to-severe cases of PD, ET and Dystonia. The thought is that this trend will continue. Instead of saying "wait another five to ten years until you become more disabled" doctors are realizing that the earlier they use DBS, the more they can improve the quality of life of their patients.
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"Everything you need to know about deep brain stimulation. From the first consideration to long-term care, this is an invaluable resource that patients, their families, and their physicians will want at their fingertips." -Matthew B. Stern, MD, Parker Family Professor of Neurology, Director, Parkinson's Disease and Movement Disorders Center, University of Pennsylvania
"Finally! A comprehensive, no-nonsense, authoritatively written book on deep brain stimulation, specifically for the patient and caregiver. It masterfully navigates the full journey of anyone considering DBS from start to finish, painting a clear, step-by-step, realistic picture of this life-changing breakthrough therapy." -Hubert H. Fernandez, MD, Online Medical Editor, Movement Disorders Society and Head of Movement Disorders, Center for Neurological Restoration, Cleveland Clinic
"A must-read for patients considering DBS surgery." -Rajesh Pahwa, MD, Laverne and Joyce Rider Professor of Neurology, Director, Parkinson Disease and Movement Disorder Center, University of Kansas Medical Center
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Foreword, Joseph H. Friedman, MD, 1. A Little History on Deep Brain Stimulation 2. How Does DBS Work and What Can It Do for Me? 3. Do I Qualify for Surgery? 4. Choosing the Health Care Team that Is Right for You 5. Your Social Support Network-Family and Friends 6. How to Prepare for the Big Day 7. What Should I Expect during the Surgery? 8. I Had the Surgery. Now What? 9. Taking Care of Your DBS System and Other Precautions 10. Stimulator Battery Maintenance and Checkups 11. My Symptoms Are Not Under Control-Troubleshooting Your System 12. Health Risks and Possible Complications in Surgery 13. Long-Term Clinical and Side Effects 14. Frequently Asked Questions, Appendices, A. Glossary of Terms, B. Support Organizations, C. List of Commonly Prescribed Medications, Index
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About the Authors
Kelvin Chou, MD
is a board-certified, fellowship-trained neurologist with expertise in Parkinson's disease and other movement disorders. He has been at University of Michigan since 2007, where he is an Associate Professor of Neurology and Neurosurgery and Co-Director of the STIM (Surgical Therapies Improving Movement) program. He has also been named to the "Best Doctors in America" list.
Susan Grube, RN, MSN
is an advanced practice registered nurse who has been with the University of Michigan Department of Neurosurgery for 19 years. She has undergone specialized training in the care of patients with deep brain stimulation (DBS), and is the coordinator of the STIM (Surgical Therapies Improving Movement) program. She is a resource to those interested in learning about DBS, and to those who have been implanted with a DBS system.
Parag Patil, MD, PhD
is a neurosurgeon specializing in deep brain stimulation for Parkinson's disease, movement disorders and other conditions. He is an Assistant Professor of Neurosurgery and Co-Director of the STIM (Surgical Therapies Improving Movement) Program at UM. His research has been featured in Time magazine and on the cover of Neurosurgery.