Deep Brain Stimulation at Banner Boswell offers relief for Parkinson’s tremors
SUN CITY, Ariz. (Feb. 26, 2009) – Banner Boswell Medical Center in Sun City is just one of four centers in Arizona offering deep brain stimulation, a surgical therapy approved by the Food and Drug Administration to treat the motor symptoms associated with Parkinson’s disease or essential tremor.
Neurosurgeon David Pootrakul, MD, and Banner Boswell’s neurosurgical team has been performing deep brain stimulation since 2004. In the largest study of its kind published in the Jan. 7 issue of the Journal of the American Medical Association, researchers concluded that deep brain stimulation improves both physical function and quality of life after six months in patients with Parkinson’s disease.
“In the appropriate patients, DBS can take Parkinson’s back about five years earlier to the ‘honeymoon’ phase of the disease where it was manageable with medication,” according to Holly Shill, MD, neurologist and movement disorders specialist on the medical staff at Banner Boswell.
Before undergoing deep brain stimulation surgery in December 2008, David Hall, 61, described the worst of his Parkinson’s disease symptoms and medication side effects as “death and dying spells.” Diagnosed with Parkinson’s in 2002, Hall continued his work as a neonatologist in Phoenix until the symptoms of the disease forced him to retire in 2005. The disease caused stiffness and pain in Hall’s left leg, and had significantly limited his coordination and mobility. The medication took its toll too, taking away his appetite, interfering with his sleep and robbing him of his ability to function normally.
Now, just two months after Hall’s deep brain stimulationsurgery, he reports markedly reduced pain, has been sleeping better and has been able to reduce his daily medication intake by a third.
He and his wife of 31 years, Lynda, a retired nurse practitioner, thoroughly researched his options before deciding to try deep brain stimulation.
“My goals for the surgery were to have more comfort, better mobility, and at least a 50 percent reduction in medications,” Hall said. “It’s important to be realistic about your goals and outcomes. Parkinson’s is a progressive, treatable – but not curable – illness. You reassess your life, goals and expectations. This is not like having your teeth cleaned. It’s major surgery and I was well prepared.”
Hall’s story isn’t unique. Sun City resident John DePesa, 75, underwent deep brain stimulation in 2005 to lessen the uncontrollable shaking he experienced in his arms due to essential tremor, a neurological condition that is estimated to affect 10 million Americans.
“Until you’ve gone through it, you can’t begin to grasp how frustrating the shaking is,” DePesa said.\
Diagnosed in his twenties, the tremors became so severe in his early sixties that DePesa’s ability to live a normal life vanished. It was nearly impossible to do everyday tasks like cutting his food, testing his blood sugar, or even signing his name.
DePesa says the surgery changed his life. “I feel fantastic. Completely different. I don’t even take medication anymore for the tremors.”
Deep brain stimulation therapy works much like a cardiac pacemaker. A pulse generator is implanted beneath the skin in the chest and sends electrical signals through a wire in the neck and up to the region of the brain that controls movement. Leads – thin, insulated wires – typically are placed on both sides of the brain to lessen tremors, stiffness and slowness.
The surgical procedure is divided into two phases. During the first surgery, the neurosurgeon inserts the leads through a small opening in the skull and implants them in the target sites within the brain. The patient is awake during this procedure to ensure correct placement of the leads. The patient typically stays in the Intensive Care Unit overnight and returns home the following day. The second phase of deep brain stimulation surgery occurs about a week later as an outpatient procedure lasting 45 to 90 minutes. The neurosurgeon implants the pulse generator and wire extension underneath the collar bone in the chest. Patients typically follow up in their neurologist’s office about a week later to begin programming the device settings.
As with any surgical procedure, there are risks associated with deep brain stimulation. Patients interested in the procedure are encouraged to speak with their neurologist to determine if they are a candidate for deep brain stimulation. Dr. Shill points out that while deep brain stimulation patients “on average, experience significant and sustained improvements," some experience neuropsychiatric side effects such as hypomania (a euphoric, untouchable feeling) which can lead to more impulsive decision-making.
Parkinson’s disease is a progressive neurological disease which manifests in patients through a variety of motor and non-motor symptoms. There is currently no cure for the more than 1.5 million Americans who suffer from the disease.
For more information about Deep Brain Stimulation at Banner Boswell, visit www.bannerhealth.com, keyword: Boswell DBS.
About Banner Boswell Medical Center
Banner Boswell Medical Center is a 501-bed, acute-care hospital located in Sun City, Ariz. Founded in 1970, Banner Boswell offers comprehensive neurological services and care, in addition to heart services, cancer care, orthopedics, women’s diagnostics, emergency care, and medical and surgical services. Banner Boswell is part of nonprofit Banner Health, the leading provider of health services in the Valley with 22 hospitals throughout the West. For more information about Banner Boswell, visit www.bannerhealth.com, keyword: Boswell.
