Deep Brain Stimulation for peace of mind
Deep Brain Stimulation (DBS) controls tremors and eases muscle stiffness in patients with Parkinson’s disease, essential tremor and dystonia.
It began with a slight tremor between the thumb and forefinger of Linda Greulich’s left hand. “I thought it was silly at first,” says Linda. “I’m right handed, so it didn’t really bother me. Then my toes began to curl, and I quickly realized that something else was going on. ”That 'something else' was a frightening diagnosis for the mother of two.
”I was only 42 years old at the time. It was early-onset Parkinson’s disease,” says Linda. “Once I saw the neurologist, I learned there were more symptoms that I was not aware of.”
For more than 20 years after her diagnosis, Linda’s symptoms were controlled by medication, but by Spring 2014, she found herself needing to take more frequent doses – every 30 minutes to an hour – with very little relief. She had tremors in both hands, slowness and stiffness in all of her extremities, and she was barely able to function.
That’s when she was referred to Devin Binder, M.D., Ph.D., neurosurgeon at Orange Coast Medical Center.
After Medication Fails
Linda met with Dr. Binder in June 2014, intending to simply learn and gather information about DBS from one of the leading experts in the region. She had already researched the procedure and, despite the high success rate for Parkinson’s patients, she remained hesitant.
“I was nervous about the surgery,” says Linda. “But discussing the procedure with Dr. Binder gave me confidence. During that very first visit, I decided DBS was the best way for me to regain my independence.”
In two separate surgeries, just a week apart, Dr. Binder implanted thin electrodes in precise locations in the left and right sides of Linda’s brain. Two hair-thin wires exited her skull and were threaded under her skin to points just beneath her collarbone. Linda was hospitalized for just 24 hours after each surgery.
“With DBS, accuracy and precision in electrode placement determine success. If you’re off by more than a millimeter, it’s like being off by a mile,” explains Dr. Binder.
Two weeks after her second implant, Linda had two small battery packs – like those of a cardiac pacemaker – implanted on either side of her chest. The battery packs supply continual electrical impulses to the brain.
“They’re tiny; you can’t feel them, but they block brain signals that cause the tremors and other symptoms,” says Dr. Binder. “The target region of the brain is inactivated, not destroyed, so this procedure is actually reversible.”
Just The Right Amount
Accuracy is equally critical when it comes to programming the DBS system. Using a remote control-like unit, the system is set and adjusted externally by a highly skilled neurologist.
“The neurologist’s job is to find that sweet spot – that perfect combination of electrical impulse and medication.” says Mindy Bixby, D.O., a neurologist at Orange Coast Medical Center who is fellowship-trained in both neurorehabilitation and movement disorders. “There are actually four contacts on the electrode and these can be turned on and off individually, as needed, or you can modify the intensity and frequency of the electrical impulse for each. It may take several visits to get it just right. And the results are remarkable.”
For Linda, the multiple visits and the hour-long commute from her home in the Inland Empire to Orange Coast Medical Center were well worth the effort.
“I’m a different human being. Before the procedure, I was like a four-year-old who couldn’t sit still. Now, all of a sudden, I have my life back. I can walk, sit still and eat on my own – simple things that other people just take for granted.”