Deep Brain Stimulation Surgery
A team of experts, including a movement disorder specialist and a brain surgeon, conducts an extensive assessment when considering DBS for someone. They review your medications and symptoms, examine you when you’re on and off Parkinson’s medication, and take brain imaging scans. They also may do detailed memory/thinking testing to detect any problems that could worsen with DBS. If your doctors do recommend you for DBS and you are considering the surgery, discuss with your care team the potential benefits as each person’s experience is unique. It’s also critical to discuss the potential surgical risks, including bleeding, stroke and infection.
In DBS surgery, the surgeon places thin wires called electrodes into one or both sides of the brain, in specific areas that control movement. Usually you remain awake during surgery so you can answer questions and perform certain tasks to make sure the electrodes are positioned correctly. Some medical centers now use brain imaging to guide the electrodes to the right spot while a person is asleep. Each method has its pros and cons and may not be suitable for everyone or available everywhere.
Once the electrodes are in place, the surgeon connects them to a battery-operated device , which usually is placed under the skin below the collarbone. This device, called a neurostimulator, delivers continuous electrical pulses through the electrodes.
What Causes The Disease
The precise cause of PD is unknown, although some cases of PD are hereditary and can be traced to specific genetic mutations. Most cases are sporadicthat is, the disease does not typically run in families. It is thought that PD likely results from a combination of genetics and exposure to one or more unknown environmental factors that trigger the disease.
The protein alpha-synuclein. The affected brain cells of people with PD contain Lewy bodiesdeposits of the protein alpha-synuclein. Researchers do not yet know why Lewy bodies form or what role they play in the disease. Some research suggests that the cells protein disposal system may fail in people with PD, causing proteins to build up to harmful levels and trigger cell death. Additional studies have found evidence that clumps of protein that develop inside brain cells of people with PD may contribute to the death of neurons.
Genetics. Several genetic mutations are associated with PD, including the alpha-synuclein gene, and many more genes have been tentatively linked to the disorder. The same genes and proteins that are altered in inherited cases may also be altered in sporadic cases by environmental toxins or other factors.
Environment. Exposure to certain toxins has caused parkinsonian symptoms in rare circumstances . Other still-unidentified environmental factors may also cause PD in genetically susceptible individuals.
Naturalremedy For Parkinsons #10 Foods You Must Avoid
There are certain foods that are known to worsen thesymptoms of Parkinsons and certain foods that are known to help. Healthadvocate, Dr Joseph Mercola, says that Parkinsons disease is primarily relatedto poor lifestyle choices, particularly poor dietary habits. Increasing yourbodys natural dopamine levels is also extremely important in your fight againstPD.
The foods and liquids you should be eating and drinkingmore of to help you along include:
· Clean Filtered Water Clean filtered water helpsto flush toxins from the body and hydrate the cells .Try and aim to drink at least two liters of water every day, and under nocircumstances drink tap water! Tap water is laced with toxic fluoride and otherchemicals and heavy metals so NEVER drink it. Buy yourself a good quality waterfilter. Its worth the investment.
· Whole Foods and Raw Foods Eat plenty oforganic mixed berries, green leafy vegetables, liver , fish,eggs, nuts and seeds such as chia and flaxseeds, along with plenty of herbs andspices. When it comes to buying any of these remember fresh is alwaysbest.
· Consume Lots of Probiotics Good gutbacteria are needed for strong immunity and healthy digestive function, whichin turn produces healthy brain and nerve function. You can learn how to makeyour own probiotic rich foods such as kefir, sauerkraut, kombucha and yogurt hereCultures for Health.
The foods you should be avoiding or not eating at allinclude:
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Will I Have To Limit My Activity Following Deep Brain Stimulation Surgery
- You should not engage in light activities for 2 weeks after surgery. This includes housework and sexual activity.
- You should not engage in heavy activities for 4 to 6 weeks after surgery. This includes jogging, swimming, or any physical education classes. Anything strenuous should be avoided to allow your surgical wound to heal properly. If you have any questions about activities, call your doctor before performing them.
- You should not lift more than 5 lbs. for at least 2 weeks.
- You should not raise your arms above your shoulders or over bend or stretch your neck.
- Depending on the type of work you do, you may return to work within 4 to 6 weeks.
Benefits And Side Effects
FUS is a less invasive approach than others doctors do not need to make incisions or holes in the skull, meaning there is a lower risk of infections and bleeds. The procedure is also incredibly precise, limiting damage to surrounding parts of the brain.
Currently, a doctor may only use FUS for the treatment of tremors due to Parkinsons. Clinical trials are investigating the potential benefits of FUS in targeting other areas of the brain to help treat symptoms such as dyskinesias.
A person can usually return home the same day as the procedure, but they may experience some side effects such as numbness in the face or arms, poor balance, and speech and swallowing problems. However, these side effects tend to be temporary.
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How Does The Neurosurgeon Know Where To Place The Electrodes In My Brain
Positioning the electrodes in the brain is the most critical step. The electrodes have to be placed in an exact location in the brain to improve symptoms. Computed tomography or magnetic resonance imaging scans are taken before and/or during the procedure to pinpoint the exact areas to target and guide the lead and electrode placement. Many times an electrode may be used to record brain cell activity at the target site to improve lead placement.
How Should I Care For The Surgical Area Once I Am Home
- Your stitches or staples will be removed 10 to 14 days after surgery.
- Each of the four pin sites should be kept covered with band aids until they are dry. You will be able to wash your head with a damp cloth, avoiding the surgical area.
- You may only shampoo your hair the day after your stitches or staples are removed, but only very gently.
- You should not scratch or irritate the wound areas.
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Disadvantages Of Regional Anesthesia Over General Anesthesia
Regional anesthesia will not eliminate Parkinson’s symptoms, such as tremor or rigidity, except in the areas directly affected by the anesthetic.
Tremor can interfere with some monitoring device and makes it more difficult to interpret.
If the surgery is delicate, the surgeon may want the patient to be absolutely still.
The surgical procedure may not be possible under regional anesthesia.
Complementary And Supportive Therapies
A wide variety of complementary and supportive therapies may be used for PD, including:
A healthy diet. At this time there are no specific vitamins, minerals, or other nutrients that have any proven therapeutic value in PD. The National Institute of Neurological Disorders and Stroke and other components of the National Institutes of Health are funding research to determine if caffeine, antioxidants, and other dietary factors may be beneficial for preventing or treating PD. A normal, healthy diet can promote overall well-being for people with PD just as it would for anyone else. Eating a fiber-rich diet and drinking plenty of fluids also can help alleviate constipation. A high protein diet, however, may limit levodopas absorption.
Exercise. Exercise can help people with PD improve their mobility, flexibility, and body strength. It also can improve well-being, balance, minimize gait problems, and strengthen certain muscles so that people can speak and swallow better. General physical activity, such as walking, gardening, swimming, calisthenics, and using exercise machines, can have other benefit. People with PD should always check with their doctors before beginning a new exercise program.
Alternative approaches that are used by some individuals with PD include:
Natural Treatment For Parkinsons #1 Cannabis/medicalmarijuana:
Cannabis, aka medical marijuana, is an incredibletreatment for Parkinsons disease. You can have a Parkinsons patient shakingviolently and uncontrollably, and yet within 30-40 minutes of self-administering with some cannabis, their symptoms will almost completely disappear. Watch this short 2minute video from Parkinsons sufferer, Ian Frizell, who shows you what he waslike before self-medicating with cannabis and then again after. The change is truly astonishing!
Taylor French is another Parkinsons patient thatundergoes a remarkable transformation once he ingests what he calls nutritional vegetable extract . This guy has an advanced form ofParkinsons and is normally confined to a wheelchair with limited use of hisbody due to stiff and rigid muscles . But after ingestingsome cannabis hes able to walk, and incredibly, in his video he even getsinto his car and drives off down the road!
You can view it here
Elyse Del Francia also tells the story of her Parkinsonssuffering husband, and the time she decided to smother his morning pancakes withsome canabutter. She said
Within45 minutes of eating a pancake with marijuana on it, he stopped shaking. Thatwas my lightbulb moment. Thats when I knew that I was onto something thatwould relieve his pain and suffering, because its horrible, horrible, to haveParkinsons Disease and not have any relief. I feel that this is something thathelps so many people in so many ways with pain and suffering. 5
Do Symptoms Get Worse
PD does not affect everyone the same way. The rate of progression and the particular symptoms differ among individuals.
PD symptoms typically begin on one side of the body. However, the disease eventually affects both sides, although symptoms are often less severe on one side than on the other.
Early symptoms of PD may be subtle and occur gradually. Affected people may feel mild tremors or have difficulty getting out of a chair. Activities may take longer to complete than in the past. Muscles stiffen and movement may be slower. The persons face may lack expression and animation . People may notice that they speak too softly or with hesitation, or that their handwriting is slow and looks cramped or small. This very early period may last a long time before the more classical and obvious motor symptoms appear.
As the disease progresses, symptoms may begin to interfere with daily activities. Affected individuals may not be able to hold utensils steady or they may find that the shaking makes reading a newspaper difficult.
People with PD often develop a so-called parkinsonian gait that includes a tendency to lean forward, taking small quick steps as if hurrying , and reduced swinging in one or both arms. They may have trouble initiating movement , and they may stop suddenly as they walk .
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Purpose Of Brain Surgery For Parkinsons Disease
Parkinsons disease surgery is used to treat motor effects of Parkinsons disease, such as tremor, but it does not help non-motor effects, such as reduced facial expression and dry skin.
Parkinsons disease can range from mild to severe, and it can be very disabling when the disease is severe. When high doses of medication are needed to control the symptoms, the medication can cause side effects such as dyskinesia , hallucinations, or both.
You might benefit from surgery if your symptoms do not improve adequately with medication or if you experience severe medication side effects.
Unilateral Versus Bilateral Surgery
Determination about unilateral or bilateral lead placement is done during preoperative evaluations. Most centers perform bilateral lead placement as a majority of patients have axial and bilateral symptoms. Lead implantation can be performed simultaneously during a single session or in a staged approach with placement of a lead for the most affected side first followed by the contralateral side after several weeks or months. The literature on staged compared to simultaneous approach for lead placement is limited. A staged procedure may potentially reduce the risk of DBS-associated complications and recovery time . However, a retrospective analysis comparing staged and simultaneous approach found no significant difference between 90-day postoperative complications and annualized cost . For older patients or those with predominant one-sided symptoms, unilateral DBS may be considered . Unilateral DBS in either STN or GPi has been shown to improve motor symptoms and quality of life , with a greater benefit with GPi-DBS on quality of life .
Would I Be Suitable For Surgery
Your consultant or neurologist will be the best person to advise you. It is important that you discuss any questions and concerns you may have with a neurosurgeon if you are considering this option. You may also want to discuss the statistics of how many operations the surgeon has performed and the results that have been achieved.
A neurologist will consider many factors before determining if a patient is a good candidate, including their symptom control, their responsiveness to levodopa and their age.
The right time for DBS therapy is when your body no longer responds as well to medication as it used to, but before medication stops working completely. It is important to remember that if you wait too long, DBS will not be an option. DBS is not a last resort.
See also Surgical therapies.
Naturalremedy For Parkinsons #7 Omega
Animal based omega-3 fatty acids are a powerful weapon inthe fight against Parkinsons disease. One of the main fatty acids, DHA, is oneof the essential building blocks for the human brain. Half of your brain andeyes are made up of fat and a large proportion of this is DHA fat.
Omega-3 fatty acids have the unique ability to cross theblood-brain barrier, something most conventional drugs cannot do. They helpincrease dopamine levels and reduce neuroinflammation in the brain, while atthe same time, stimulating neuron growth. So basically, EPA and DHA help preventbrain cell damage and keep the nervous system in tip top working order! 4
Best sources of animal based omega-3s are either fishoil, cod liver oil or krill oil. High strength krill oil is the preferred option as thiscontains a substance called Astaxanthin. Astaxanthin is a potent brain food nutrientthat has been shown to prevent neurodegeneration and inflammation of the brain.For dosages, take AT LEAST the highest recommended amount listed on the bottle the same goes with fish oil or cod liver oil. You cant overdose on thesesupplements so theres nothing to be concerned about. In fact, the more omega-3syou can get into you the better the results!
In addition to this, try and eat some cold water fattyfish such as salmon, tuna, mackerel, sardines or herring 3-4 times a week foran extra supply of DHA and EPA.
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Would Surgery Be State Funded If Not How Much Does It Cost
The availability of surgical procedures on national health services varies from country to country, and even from region to region, so you will need to check locally. Make sure you also check on the provision of any follow-up care or further surgery that may be needed.
Costs vary from country to country so, again, you should check locally. Depending on the country you live in, some costs may or may not be paid by the state.
Will I Be Asleep During The Entire Procedure
You will be sedated or receive local anesthesia for part of the procedure, may or may not be awake for lead and electrode placement, and will be asleep when the impulse generator is implanted. To provide more details:
- A local anesthetic is applied to areas of the head where pins or screws are used to secure the head frame and sedation is given.
- You will be sedated during the beginning of the procedure, while the surgical team is opening the skin and drilling the opening in the skull for placement of the lead.
- Most patients will be awake for lead and electrode placement. This part of the procedure is not painful, as the brain does not feel pain. Being awake allows the surgical team to interact with you when testing the effects of the stimulation. However, some patients who cannot tolerate the procedure while awake can have the electrode and lead placed under general anesthesia. The lead placement is guided in real time by magnetic resonance imaging. The procedure is performed in a special MR-equipped operation room.
- Implantation of the pulse generator in the chest and connection of the leads from the device to the lead in the brain is usually done under general anesthesia.
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Medication For Parkinsons Disease
Once the doctor diagnoses Parkinsons disease, the next decision is whether a patient should receive medication, which depends on the following:
The degree of functional impairment
The degree of cognitive impairment
Ability to tolerate antiparkinsonian medication
The advice of the attending doctor
No two patients react the same way to a given drug, therefore, it takes time and patience to find an appropriate medication and dosage to alleviate symptoms.
What Diseases And Conditions Resemble Parkinsons Disease
PD is the most common form of parkinsonism, in which disorders of other causes produce features and symptoms that closely resemble Parkinsons disease. Many disorders can cause symptoms similar to those of PD, including:
Several diseases, including MSA, CBD, and PSP, are sometimes referred to as Parkinsons-plus diseases because they have the symptoms of PD plus additional features.
In very rare cases, parkinsonian symptoms may appear in people before the age of 20. This condition is called juvenile parkinsonism. It often begins with dystonia and bradykinesia, and the symptoms often improve with levodopa medication.
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