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Article

Deep brain stimulation for movement disorders: Patient selection and technical options

Hubert H. Fernandez, MD, Nestor Galvez-Jimenez, MD, Andre G. Machado, MD, PhD, Milind Deogaonkar, MD and Scott Cooper, MD, PhD
Cleveland Clinic Journal of Medicine July 2012, 79 (7 suppl 2) S19-S24; DOI: https://doi.org/10.3949/ccjm.79.s2a.04
Hubert H. Fernandez
Cleveland Clinic
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Nestor Galvez-Jimenez
Cleveland Clinic Florida
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Andre G. Machado
Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH
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  • For correspondence: machada@ccf.org
Milind Deogaonkar
Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH
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Scott Cooper
Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH
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ABSTRACT

Deep brain stimulation (DBS) is used as a treatment for movement disorders. Unlike ablative procedures, DBS is reversible and adjustable. It is approved in the United States for treatment of Parkinson disease (PD), dystonia, and tremor. This surgical procedure is considered safe and effective for the management of the motor symptoms of these disorders, although it does not cure the underlying conditions. Potential complications of DBS surgery include intracranial hemorrhage, infections, and complications related to the hardware. There may also be complications related to stimulation or programming, although these are usually associated with dosages of dopaminergic medications and are reversible. DBS is usually performed under conscious sedation with awake evaluation during intraoperative physiologic testing. Typically, the procedure is performed with stereotactic image guidance, using computed tomography or magnetic resonance imaging (MRI) for targeting. Surgery can be accomplished with stereotactic frames or frameless systems. Recently, intraoperative MRI guidance has become available and is an alternative to the traditional surgical procedure, allowing for implantation of the DBS device under general anesthesia.

  • Copyright © 2012 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 79 (7 suppl 2)
Cleveland Clinic Journal of Medicine
Vol. 79, Issue 7 suppl 2
1 Jul 2012
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Deep brain stimulation for movement disorders: Patient selection and technical options
Hubert H. Fernandez, Nestor Galvez-Jimenez, Andre G. Machado, Milind Deogaonkar, Scott Cooper
Cleveland Clinic Journal of Medicine Jul 2012, 79 (7 suppl 2) S19-S24; DOI: 10.3949/ccjm.79.s2a.04

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Deep brain stimulation for movement disorders: Patient selection and technical options
Hubert H. Fernandez, Nestor Galvez-Jimenez, Andre G. Machado, Milind Deogaonkar, Scott Cooper
Cleveland Clinic Journal of Medicine Jul 2012, 79 (7 suppl 2) S19-S24; DOI: 10.3949/ccjm.79.s2a.04
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