With the push of a button, Dr. Mark Burnett switches off the deep brain stimulation system in his patient Jairo Molina. The tremors from Parkinson’s disease quickly return. They go up from Molina’s fingers until, within seconds, his whole body is moving. Then Burnett turns the system back on and Molina’s tremors start to ease until they are almost gone.
Burnett, a neurosurgeon at NeuroTexas, placed the system into Molina last month at Baylor Scott & White Medical Center Lakeway and started seeing results 48 hours later. He placed two leads into the Parkinson’s-affected place deep in Molina’s brain. The leads are at the tip of wires that travel underneath the skin down behind the ear, down the side of his neck to a computer mouse-size stimulator under the skin in his chest. The stimulator sends electronic pulses through those wires to the leads in the brain to control the tremors.
While similar systems have been around since the early 2000s, Burnett says, the difference with what Molina has and what other patients have received is the way the systems get there. Molina was the first patient in Texas to have the stimulator inserted in one surgery while asleep. A second patient has since had the surgery, with a third in the works, Burnett says.
Before, patients had to have two different surgeries — one to place the leads and the second to put in the stimulator. The patients also had to be awake for hours and strapped into a device while the sensors were being placed and tested to make sure doctors were in the right place. Previously, doctors knew where to place the leads based on listening to the structures of the brain to find out where the tremor was coming from. Patients also would have to go off their medication for the surgery, and the whole process would take six to eight weeks from first surgery to turning the stimulator on.
Now doctors know exactly where to place the leads by taking finely sliced MRI scans of the brain a few weeks before the surgery. The scans are then fed into a computer to create a 3D scan of the brain. This process allows doctors to see the Parkinson’s-affected area that is about the size of a Rice Krispie, Burnett explains. On the day of the surgery, doctors use a robot about the size of a soda can and a CAT scan to place the leads exactly where they need to go. During that same surgery, doctors also are able to place the stimulator in the chest and connect the lead wires to the stimulator.
All of this is done while the patient is asleep, and the patient doesn’t have to stop taking his medication in preparation for the surgery. Patients usually spend a night in the hospital and go home. About 48 hours later, the stimulator is turned on and the tremors go away.
https://www.mystatesman.com/lifestyles/parenting/brain-surgery-ends-tremors-for-veteran-with-parkinson/4zkWbCNn5Zoy9wL0fEC0XN/
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