What is deep brain stimulation?
Deep brain stimulation, or DBS, is a neurosurgical procedure that involves the placement of electrodes into the brain. The electrodes are connected to an implanted medical device, sometimes referred to as a brain pacemaker that delivers continuous low-voltage electrical impulses to the targeted area of the brain. These pulses block the abnormal firing of neurons in the targeted area providing therapeutic relief for patients whose symptoms are not adequately controlled by medication.
DBS is used to restore normal function in patients with physiological and movement disorders such as essential tremor and dystonia. Its goals are to reduce muscle tone, improve function, and prevent the progression of movement disorders to other areas of the body.
A history of firsts
When it comes to DBS surgery, Cook Children's continues to lead the way for kids. Today, thanks to our introduction of iMRI guided asleep DBS surgery, we're setting a new milestone. The iMRI and real time intraoperative image guidance technology helps with procedure visualization so patients now can remain asleep during surgery.
This new technology makes the benefits of deep brain stimulation available to certain kids who couldn't undergo awake surgery.
Why choose deep brain stimulation surgery?
Imagine putting your arms out and your leg pops up, even though you didn't intend it to. Or trying to make your left leg stay still, but it won't, no matter how much you will it to. Children with dystonia experience all kinds of involuntary movement, and it is often combined with extremely painful muscle contortions, all of which can interfere with even the simple tasks most of us take for granted such as talking, walking, dressing ... even eating. Dystonia and similar movement disorders such as essential tremor can be very, very frustrating for adult patients, and even more so for a child.
DBS surgery can reduce and, in many cases, restore movement, making significant improvements to a patient's quality of life. And with the introduction of real-time neurosurgical image guidance and procedure visualization, which makes asleep DBS possible for children, Cook Children's offers one of the most recognized and advanced pediatric DBS programs available.
How is deep brain stimulation surgery performed?
Deep brain stimulation surgery involves two parts: implanting electrodes into the brain and a pacemaker under the skin of the chest. The two devices are connected by the surgeons and electrical impulses are sent from the pacemaker to the brain to correct the abnormal impulses of the movement disorder. At many other hospitals the devices are implanted in two different surgeries and then connected. At Cook Children's the devices are placed at the same time so the child only has to undergo one surgery. Since the first implant in 2007, Cook Children's established itself as one of the elite DBS programs in the nation, with 13 surgical cases over a 10-month period.
The neurosurgical intervention procedure
Cook Children's is the first pediatric medical
center to perform deep brain stimulation (DBS)
on sleeping patients with dystonia. The iMRI
and real time intraoperative image guidance
technology helps with procedure visualization
so patients now can remain asleep during surgery.
The integrated system of software, disposable
components and reusable hardware is used
for planning and targeting. It is the only
technology that enables minimally invasive
neurosurgery under continuous MRI guidance
with superior visualization of the brain's tissue.
Benefits of real-time neurosurgical visualization at Cook Children's:
- Allows DBS on sleeping patients.
- Increases patient comfort, and decreases anxiety during surgery.
- Facilitates treatment for patients who would otherwise not make good neurosurgery candidates.
After either type of DBS surgery, your child will return home. Within a few weeks, he or she will need to come back to our neurosciences center where the doctor will adjust their pacemaker. You will also be given instruction in exercises to helps your child gain as much mobility as possible. As your child progresses and as grows, additional visits will be required to adjust the pacemaker.
Whether your child undergoes awake DBS or asleep DBS, there's one thing you can trust: from diagnosis through rehab in our Movement Disorder Center, Cook Children's neurosciences team works closely with your child, your family, and your child's pediatrician to ensure the very best outcome possible.
Our program offers a dedicated team in a unique collaborative setting including:
- Neurologists with movement disorder experience
- Neurosurgeons with experience in stereotactic localization (operating on a small target)
- Physical therapists
- Occupational therapists
- Operating room support
- Skilled nurses
- Child Life specialists
- MRI technicians