What is a Brain Pacemaker?
Öz are devices that allow us to deliver electric current to the hücries in the brain that we target, especially in movement disorders. Many diseases can be successfully treated with this procedure called "nöromodülation".
In which diseases is it used?
Parkinson's disease, movement disorders such as tremor and dystonia, epilepsy, Tourette's syndrome, obsessive-compulsive disorders, Hutchington's disease, major depression, Alzheimer's disease, obesity, pain syndromes, restless leg syndrome.
What does a brain pacemaker provide in the treatment of the patient?
It is most commonly used to treat movement disorders in our day and age. The pathophysiology of these diseases is complex. Brain pacemakers do not cure the disease. It improves patients' symptoms. Patients have a disrupted daily life. The doses of the drugs they use are reduced. The side effects of the drug are eliminated.
How is the treatment process in Parkinson's patients?
Complaints related to dopamine deficiency occur in these patients. In these patients, we often see tremor (tremor), rigidity-freezing (rigidity), slowing of movements (bradykinesia) and imbalance (postural instability). These patients are initially given medical treatment. Dopamine treatment becomes inadequate over time and side effects of the drug such as dyskinesia and on-off states may occur. Patients with progression of the disease despite medication, patients who do not respond to dopamine treatment, and patients whose daily life is negatively affected due to side effects are suitable candidates for brain pacing. These patients are evaluated and prepared for surgery by neurology, psychiatry and neurosurgery. Surgical success is high in the early period and tolerance may develop over time.
How to insert a brain pacemaker
Batteries are installed in 3 stages.
In the first stage; the doses of the patient's medications are reduced by the nöroloji. The patient does not take his/her medication on the morning of surgery. We put Frame (erçerçeve cap) on the patient under local anesthesia. MRI or brain tomography is being performed. We calculate the coordinates of the previously determined nucleus from these images in a special computer program.
In the second stage, we take the patient to the operating room. We perform awake surgery. In the appropriate position, we drill 2 holes in the patient's skull, right and left. We insert 2 mm electrodes and look at the electrical activity of the target brain cells. With this method called micro-recording, we map these hücries. By giving electrical impulses to the patient (Macrostimulation), the patient is examined by our Nöroloji doctor. If the patient states that he/she has benefited and that there are no side effects, we place permanent electrodes (such as wires).
Üçünthü (final) stage; general anesthesia (we do it by putting the patient to sleep. It takes about 1 hour) we place the brain pacemaker under the skin with an incision made in the skin under the cöprücübone in the patient's göğüs region.
Is it necessary to change the battery?
Patients' battery settings may continue for 2-3 weeks after surgery. In general, the battery adjustment and new dose settings of the drugs are completed in the 1st month.
The battery's life span varies between 5-8 years depending on how it is used. When the battery runs out, the entire system can be replaced in a 15-20 minute procedure (under anesthesia) without the need to remove it. Rechargeable batteries are used. They should be charged once a week or every other day.
What are the complications of surgery?
The most common bleeding and infection can occur in 1% of cases.
Other possible complications can be güçsüweakness in the arm and leg, vision problems.
