Functional and Stereotactic Neurosurgery provides comprehensive evaluation and the care for patients with movement disorders, epilepsy, obsessive-compulsive disorder, and certain chronic pain syndromes.
Patients who are diagnosed with Parkinson’s disease, have a medically intractable tremor or intolerance to medication side effects and do not have any significant cognitive or psychiatric problems are eligible for Deep Brain Stimulation (DBS). The team of physicians at BNA performs a thorough examination before the procedure to determine if symptoms will respond to DBS. Up to 85% of patients usually achieve a reduction in symptoms with about 50% reduction in medications.
Each neurological disorder has specific target neurons and for Parkinson’s disease, these neurons are in the subthalamic nucleus and globus pallidus. The localization of these specific target areas and precise placement of electrodes is achieved using stereotactic 3-dimensional image guidance and electrophysiological exploration techniques. The stereotactic frameless technology used in our clinic does not require patient immobilization during the procedure and therefore is more comfortable for patients.
Dystonia is characterized by uncontrolled movements of a limb and/or the entire body. DBS is performed as an aid in the management of chronic and drug-refractory primary dystonia, including generalized and segmental dystonia, hemidystonia, and cervical dystonia (torticollis). It is more effective in the patients with the absence of structural brain abnormalities with an expected 30 to 50% improvement in symptoms after DBS for primary generalized dystonia.
DBS can be effective in the management of all types of tremor including essential, as well as tremor and involuntary movements associated with Parkinson’s disease and multiple sclerosis. The patients that have symptoms not adequately controlled by medications and leading to significant functional disability can be helped by DBS. About 70% of patients with essential tremor report improved activities of daily living and up to 90% reduction of contralateral limb tremor.
Epilepsy is the second most common brain disorder followed by a stroke. Epileptic seizures are recurrent seizures without a reversible metabolic source that are caused by abnormal electrical activity in the brain. Seizures clinically can present as convulsive (unusual body movements) or nonconvulsive seizures. Both types usually involve a change in the level or loss of consciousness. Causes of this hyperexcitability could be genetic, congenital, tumor, traumatic or ischemic injury. Therefore, it is important to correctly diagnose and treat the underlying cause.