DBS gives you greater motion control and can reduce the number of medications you need, along with associated side effects. It's important for our team to know that the electrodes are working before a patient leaves the operating room. Therefore, patients are kept sedated, but awake and able to respond to doctors during the procedure. This approach has other benefits, too.
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General anesthesia can have unwanted neurological effects, important to avoid during brain surgery. Plus, avoiding general anesthesia shortens your hospital stay. In fact, most DBS patients go home the next day. Our DBS physicians welcome your doctor's input at every stage of your care.
Through teleconferencing, your doctor can consult with our team before or even during surgery. Our neurologist will also provide your doctor with instructions for follow-up care, so you can receive post-surgical treatment close to home.
After DBS surgery, our neurologist and nurse practitioner work together to program the generator for optimal movement control. You will continue to visit the doctor for adjustments, as needed. We may also recommend that you work with a physical or occupational therapist as you move off of your medications and into a post-surgical recovery. Our goal is to eliminate the need for most medications.
This can help to shorten the waiting lists. Janssens receives his PhD on 25 June. In DBS, the surgeon places electrodes deep into the brain, through small openings at the top of the skull.
The electrodes are connected to a pacemaker that delivers pulses, which virtually suppresses the uncontrolled movement and vibration of the limbs. The treatment makes a normal life possible for patients again. Unfortunately, as the largest Dutch newspaper De Telegraaf reported in February , waiting times are long, which led to parliamentary questions.see
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In the Netherlands, the waiting period can be as long as two years, and in other countries, too, this is a similar problem. Unchanged since The DBS electrodes in Parkinson's disease patients usually have to end up in the nucleus subthalamicus, a crucial part of the brain that measures only 8 by 4 millimeters. The greater part of it is focused on movements, but the edges control emotions and learning processes, among other things. Highly precise positioning is therefore essential. The bottleneck here is the current technique is to place the DBS, a technique that has not essentially changed since the invention of DBS in the s.
Error range Surgeons now still place DBS electrodes by clamping to the patient's head a construction that is actually too weak for that precise task. However, the greatest inaccuracy is caused by the fact that there is no fixed reference point for the placement of the electrodes.
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The doctors first localize the target in the brain with an MRI scan, and with a CT scan they then record the position of the skull in relation to the construction on the head, the stereotactic frame. These two images are placed over each other to see where the target is relative to the frame. This results in a margin of error that can be as high as a few millimeters, which is considerable in view of the small size of the target, the nucleus subthalamicus.
Fixed reference point Marc Janssens developed an entirely new technique that is much more precise. The key role in this is played by the adaptor disc he developed, which gives the intervention a fixed reference point. This disc is placed on the back of the head using three surgical screws.
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This is much less unpleasant and less painful than the stereotactic frame, which is clamped to the head with four pins through the skin. The disc contains a reference triangle that is clearly visible on the MRI scan. Extremely compact and stiff After the MRI scan, the patient goes to the new instrument that Janssens designed and built for the placement of the electrodes. The adapter disc, which is still attached to the head, is clicked onto it, so that the patient takes the fixed reference point with him.