Brain Neurostimulator Nixes Tremor Shakes

Advanced treatment helps patients with essential tremor or Parkinson’s regain control.

For 30 years, Bob struggled to control his hands. During a three-hour procedure, DBS restored that control.

Most of what Bob Carlton saw of Vietnam during his two wartime tours of duty was seen from the cockpit of an A-1 Skyraider, which means he played a significant role in saving the lives of hundreds, if not thousands, of soldiers and civilians.

“I was the bombardier navigator on a special plane that was outfitted to run electronic countermeasures,” Bob explains. “I ran missions where our job was to jam the radar that controlled enemy guns and surface-to-air missiles.”

Bob ran 162 such missions across the five years he served as a naval aviator. He also ran a couple of missions that didn’t go quite as planned. Both resulted in crashes that Bob says he’s fortunate to have lived through.

“The first occurred when the catapult on the aircraft carrier we were flying off of failed,” Bob remembers. “That plane went straight into the water. Never even got airborne. The second was the result of an engine fire, so I’m actually quite lucky to be here.”

Lucky indeed, but a couple of years ago, Bob began to feel like his luck was running out. A battle with essential tremor, a nervous system disorder that mostly causes involuntary twitching in the hands, was the reason.

“For me, the problem started about 30 years ago,” says Bob, now 70. “It started with occasional little shakes in my left hand. Over time, it got worse. A lot worse. It moved into both hands and got so bad it was hard to do almost anything.

“Just about anything you do with your hands, I couldn’t do. I couldn’t hold a fork or spoon or control a toothbrush, so eating and brushing my teeth were very difficult. The problem also made it hard for me to do one of my favorite hobbies, woodworking.

“I love to make little toys for kids – planes, trains and cars. I’ve done it for years, and it takes a lot of dexterity. But this tremor thing made it really difficult. Not impossible. Just difficult. A lot of people wonder how I still did it. I told them, You learn to adapt.

About a year ago, Bob grew tired of adapting. The shaking in his hands became so bad that after years of trying to control the problem through medication, he finally accepted his neurologist’s advice to try an advanced treatment option for the disorder.

Regaining Control

That treatment is called deep brain stimulation, or DBS. It is an FDA-approved procedure in which the patient is implanted with a small pacemaker-sized device that delivers electrical impulses to specified areas of the brain.

Known as a neurostimulator, the device is placed beneath the skin in the chest, and impulses are delivered through electrodes implanted in the brain and connected to the device by wires beneath the skin.

The neurostimulator Bob received was made by Boston Scientific, which is lauded by neurologists and neurosurgeons for its advanced development of neuromodulation devices for patients with Parkinson’s disease and essential tremor.

“They’re a great group to work with on every level, a very strong company,” raves Kai McGreevy, MD, DABPN, RPVI, RPNI, RMSK, a board-certified neurologist and founder of McGreevy NeuroHealth, which has offices in St. Augustine and Palm Coast.

“Since my fellowship training, I’ve had nothing but great experiences with Boston Scientific and have largely stuck with them because I’ve had very good success with the neuromodulation techniques they offer for both the brain and the spine.”

Studies show that within a year of being implanted with a Boston Scientific DBS device, Parkinson’s disease and essential tremor patients experience a 90 percent improvement in motor function and a 30 percent decrease in required medications for their conditions.

As it was with Bob, candidacy for DBS is typically determined by a neurologist, who performs a series of tests to evaluate the patient’s likely response to the therapy.

It doesn’t just work, it changes your life. It truly is a life-changing surgery. – Bob

Once a patient is deemed a candidate for DBS therapy, an MRI and CT scan of the brain is performed to determine where to place the leads, which are coated wires with electrodes at the tip.

Placement of the leads is performed during a procedure that begins with the patient being sedated. The patient’s head is then placed in a frame that ensures the head remains steady throughout the procedure. Next, a small haircut is made over the incision site.

After a CT scan is performed to determine the exact point at which the brain will be accessed, the surgeon makes a small incision in the scalp and uses a surgical drill to create the opening in the skull through which the leads will be placed.

Movement disorder patients such as Bob are often awakened during the procedure and asked to perform small movements once the leads are situated to confirm effective placement.

“When I was woken up, I could see and hear everything, but I didn’t feel any pain because the brain doesn’t feel pain,” Bob says. “And when they placed the leads, it was like a switch that stops the tremor was being turned on and off. It was amazing.”

The number of leads depends on the disorder. Some patients require only one whereas others need one on each side of the head. In either case, the procedure is typically followed by an overnight hospital stay for observation.

The neurostimulator is placed at a later date in a small pouch created under the skin below the collarbone. Then, an insulated extension wire is run from the electrodes in the scalp, behind the ear and down the neck to the chest, where it is connected beneath the skin to the neurostimulator.

After it’s programmed by the neurologist, a handheld controller is used by the patient to turn the DBS system on and off. As needed, stimulation settings can be changed to adjust to changes in the patient’s condition.

 

 

Seminar

Tuesday, January 17 • 6 p.m.
Aloft Jacksonville Tapestry Park Hotel
Register online: learndbs.com/1493
Speaker: Dr. D. Tavanaiepour, UF Health Neurosurgery

 

 

 

 

 

Seminar

Wednesday, February 8 • 11 a.m.
Palm Coast Community Center
Register online: learndbs.com/1496
Speaker: Dr. A. Keebaugh, Boston Scientific

 

 

 

 

 

 

Seminar

Tuesday, February 14 • 11 a.m.
Ponte Vedra Beach Public Library
Register online: learndbs.com/1497
Speaker: Dr. P. Tipton, Mayo Clinic Neurology

 

 

Life-Changing Procedure

Bob underwent the approximately three-hour DBS procedure in September 2021. When he was released the next day, he felt “like a new man.”

“To me, this is the greatest surgery there is,” Bob raves. “It’s unbelievable. In three hours, a problem I had for 30 years was fixed. There was no waiting around for anything to take effect or for the condition to improve. It was immediate.

“This surgery met my needs in every way I hoped. My hands are as steady as a rock now. I can do anything I want with them. I’m not restrained in any way. There’s just no comparison between how I was before and how I am now.”

The impact DBS has made on Bob’s life is so great that he gladly shares his story during DBS seminars sponsored by Boston Scientific.

“People want to know, What’s the surgery like and does it really work?” Bob relates. “Well, I’ve been through it, so I’m there to tell them what it’s like and that it doesn’t just work, it changes your life. It truly is a life-changing surgery.

“And as far as Boston Scientific goes, the people are the best in the world, in my opinion. I can’t say enough great things about them. The work they’ve done in this field is remarkable. As I said, it’s life-changing.”

To learn more about the procedure, attend one of the seminars listed above and/or visit online at https://www.dbsandme.com.

© FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb
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