siliconindia | | October 20209Until now this surgery has been proven clinically to have the best results in treating Dystonia and Parkinson's disease. But in India, DBS is very rarely used to treat patients suffering from epileptic seizures. The procedure involved implanting electrodes in the specific parts of the brain that directly connects to a pacemaker. This pacemaker maintains and controls the minimum current of the brain that helps the central part of the brain to prevent seizures. This pacemaker is almost similar to what is used for heart. After the successful implantation, the patient was observed for 2 days and had shown complete results. No adverse events like bleeding in the brain, infection, depression or memory problems were seen. The patient had never ever had any attacks thereafter and is back to his normal life.What is Deep Brain Stimulation (DBS)?In deep brain stimulation (DBS), surgeons implant electrodes into a specific part of your brain. The electrodes are connected to a generator implanted in your chest near your collarbone that sends electrical pulses to your brain and completely remove the seizure.Deep brain stimulation is most often offered to people when the effect of medications has completely stopped working for them and the number of seizures is more than 15 per day.Understanding the DBS FunctioningThe DBS system consists of 3 parts ­ Lead, Extension and a Neurostimulator.1. Lead ­ a thin insulated wire which is implanted in a small opening in skull. This wire reaches to the specific part of the brain where the epileptic activity happens. Our brain is active all the time and seizure attacks occur when there is a sudden burst of intense electrical activity.2. Extension ­ An insulated wire that is connected to the neurostimulator and is passed under the skin of the head, neck and shoulder.3. Neurostimulator ­ A device known as a pacemaker is placed inside the skin of chest, preferably under the collarbone. This device is used to control and sent the minimum signal required for the normal functioning of the brain. It is a small, battery-powered device that sends electrical impulses to the brain. These impulses travel through leads to electrodes which are placed in the anterior nucleus of the thalamus. Thalamus is the part of brain which is responsible for the spread of seizures.To diagnose the exact location of the brain that generates the epileptic attacks, MRI, PET and CT scan of the patient is performed. Then the surgery is performed in two phases. In the first phase, two electrodes are implanted in the affected part of the brain through small incisions made in the skull. The placement of the leads is monitored on image guidance system for accuracy and precision. In the second phase, the neurostimulator is placed under the skin of the collarbone and the extension connects it to the leads. DBS Works Where Medicines Doesn'tDBS is preferred only when the effects of medication tend to stop functioning. Over a period of time the effect of the medicines on the body tends to stop and hence the frequency of medicine intake increases. If a patient is prescribed to take the medicine thrice a day, then due to the loss of effect, they might need it more than 8 times a day. This affects their quality of life as they tend to get on and off that many times. This is where DBS surgery is beneficial as it stimulates that part of the brain which generates the seizure attack. What DBS does is that it provides a constant effect on the patient for 24 hours thereby stabilizing the quality of life. To diagnose the exact location of the brain that generates the epileptic attacks, MRI, PET and CT scan of the patient is performedSumit Singh
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