Battery therapy for movement disorders and pain

What is a movement disorder?

Situations such as slowness, irregularity in movements or tremors during the initiation and maintenance of movements without loss of strength or sensation are defined as movement disorders.

For what reasons do movement disorders occur?

Most movement disorders are caused by the decrease or irregularity of the chemicals that enable communication between cells in the brain. The genetic basis of the problem also exists, but it has not been fully resolved yet. Genetic studies are being carried out in this direction in Parkinson’s disease. It is known that essential tremor, which is especially common, is genetically transmitted in families.

In which diseases are movement disorders more common?

The most well-known movement disorder diseases are Parkinson’s and essential tremor, which are seen in middle and older age groups. Essential tremor is a more common disease but requires less treatment. Parkinson’s is a problem on which more scientific studies are being conducted and more effective treatments are being investigated.

What are the symptoms of Parkinson’s?

• Frequent slowing down of movements
• A general state of stiffness in the body
• balance disorder
• Tremor at rest

What is the procedure for diagnosis and treatment of Parkinson’s?

In its early days, Parkinson’s can be confused with other movement disorder diseases. After diagnosis, drug treatment is first administered. Sometimes, while there are periods when it progresses rapidly, there may also be periods where it does not progress at all for years. However, as the disease progresses, albeit slowly, surgical treatment may be on the agenda. Especially in cases where there is no response to drug treatment (such as insufficient drugs or side effects), the surgical treatment option is considered.

Is there a recommended appropriate time for a more effective surgical treatment?

There is a period when surgery is most beneficial, especially in Parkinson’s disease, which coincides with the middle stage of the disease. In the very early stages, patients do not need surgery because they benefit sufficiently from drug treatment. In very advanced stages, there is a situation where surgery will no longer benefit. Therefore, it is important to consider and evaluate surgery at an early stage.

When is brain stimulation treatment used?

A brain pacemaker is a small device placed in the chest, similar to a pacemaker. It precisely transmits electricity to a center in the brain through two electrodes. These centers are the centers that cause problems in movement disorders. In this way, movement disorders are reduced or eliminated.

How is brain stimulation surgery performed?

For brain stimulation surgery, first a map of the brain is created using imaging methods. At Anadolu Health Center, the preliminary preparation part of the surgery is performed outside the operating room as much as possible. At this stage, after determining the target via computer, it is planned how to reach it in the healthiest way. Afterwards, the patient is taken into surgery under general anesthesia. Electrodes are placed in the determined places and checked again with imaging methods to see if they are in the right places. After the electrodes are connected to the battery under the skin on the chest via extension cables, the patient is woken up.

What are the benefits of performing brain stimulation surgery under general anesthesia for the patient?

Brain stimulation surgeries have been performed since 1979. According to figures, it is a treatment that has been successfully applied to more than 300 thousand Parkinson’s patients to date. In the early days, when technology was not as developed as it is today, the patient was left awake and some tests were performed, especially since it was not sure where the electrodes were placed during surgery. However, today, with the introduction of advanced imaging techniques and innovative applications such as hybrid operating rooms, this is no longer necessary. Surgeries can be performed under general anesthesia. This provides comfort to the patient and significantly shortens the surgery time. With the techniques applied at Anadolu Health Center, the surgery is completed in 4-4.5 hours.

What is the recovery period after surgery?

Patients stay in the hospital for 1-2 days. The patient is kept in intensive care for closer monitoring on the first night, but most patients are able to go home on the first day after surgery.

What is the success rate of brain stimulation surgery in solving Parkinson’s, epilepsy and tremor problems?

First of all, brain stimulation is a treatment that aims to reduce the patient’s complaints, not to treat the disease itself. This is important because when the patient’s complaints are reduced, the quality of life increases significantly. If the goals set when planning the surgery are achieved, the patient’s complaints decrease by 80-85% or even higher. Problems such as not being able to hold a glass or a pen or walking are largely eliminated. Brain pacemaker provides 85% success in reducing tremor complaints. There is a 60-65% improvement in complaints of slowness of movement and stiffness in the body. Balance problems decrease by 50-60%. Of course, what is important here is that the electrode is exactly targeted and at the right point. As a result, considering that it is a closed surgery and the targeted area is a very small area of ​​3-4 mm, positioning the electrodes in the right place is an important factor that increases the success of the result.

Can battery therapy be applied to everyone?

There is no age limit. Although most movement disorders in children are of genetic origin, brain stimulation treatment is also successfully applied to them. The important thing in brain stimulation treatment is; The patient does not have conditions that would prevent surgery, such as heart, blood pressure or lung diseases. Patients for whom medications are insufficient or the desired doses cannot be given due to side effects also benefit from battery therapy.

What is the lifespan of the batteries used? Is it changed at regular intervals?

There are two types of batteries; rechargeable and non-rechargeable batteries. Non-rechargeable batteries are used for 5-6 years. Rechargeable batteries have a lifespan of 10-12 years. When the battery expires, it can be replaced in 10-15 minutes. Moreover, the patient does not need to receive general anesthesia.

Where exactly is the brain battery placed?

The battery part of the battery is usually placed under the skin, under the collarbone in the chest.

Should we consult a doctor at the slightest tremor problem?

It is important for patients to consult a doctor in any distressing situation. Consulting a doctor early, especially in case of movement disorders, prevents the patient from missing the most suitable time for surgery.

Are batteries used for chronic pain?

There are batteries placed on the spinal cord for this type of pain. It is not used for movement disorders, but for chronic pain. For example, it is used for pain that continues or becomes chronic after spine surgery (pain due to diabetes, pain caused by nerve damage, after herniated disc surgery).