Deep Brain Stimulation: A New Life for People with Parkinson's, Dystonia, and Essential Tremor

Deep Brain Stimulation: A New Life for People with Parkinson's, Dystonia, and Essential Tremor
By Kelvin L. Chou MD, Susan Grube RN MSN, Parag Patil MD PhD

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Product Description

In the United States, an estimated 42 million people suffer from some form of movement disorder. Common movement disorders include Parkinson's disease (PD), essential tremor (ET), and dystonia. Although medications may be helpful for these conditions, in many patients, symptoms cannot be controlled with medications alone. In such situations, their physicians may recommend a surgical procedure known as Deep Brain Stimulation (DBS). DBS is a revolutionary technology using an implanted device to deliver electrical stimulation to the brain to help symptoms, alleviate suffering, and improve quality of life. The Food and Drug Administration (FDA) approved DBS as a treatment for essential tremor in 1997, for Parkinson's disease in 2002, and dystonia in 2003.

Deep brain stimulation has dramatically changed the lives of many patients with uncontrollable tremors. Patients often can resume normal activities, such as feeding and dressing themselves, and can have active and fulfilling lives. The need for anti-tremor medications is often reduced or eliminated.

Though it's no longer considered experimental, DBS is, for now, still used as a second- or third-line treatment, reserved for patients with more advanced cases of the disease and those for whom medication alone is inadequate or can't be adjusted precisely enough to keep their tremors and writhing under control.

However the idea of this surgery being a "last resort" is an evolving concept. Ten years ago doctors were operating on only the most severe, disabled, wheelchair-dependent patients, now they are operating on patients with moderate-to-severe cases of PD, ET and Dystonia. The thought is that this trend will continue. Instead of saying "wait another five to ten years until you become more disabled" doctors are realizing that the earlier they use DBS, the more they can improve the quality of life of their patients.


Product Details

  • Amazon Sales Rank: #1132519 in Books
  • Brand: Unknown
  • Published on: 2011-12-21
  • Original language: English
  • Number of items: 1
  • Dimensions: 9.02" h x .36" w x 5.98" l, .50 pounds
  • Binding: Paperback
  • 166 pages

Editorial Reviews

Review
"Everything you need to know about deep brain stimulation. From the first consideration to long-term care, this is an invaluable resource that patients, their families, and their physicians will want at their fingertips." -Matthew B. Stern, MD, Parker Family Professor of Neurology, Director, Parkinson's Disease and Movement Disorders Center, University of Pennsylvania

"Finally! A comprehensive, no-nonsense, authoritatively written book on deep brain stimulation, specifically for the patient and caregiver. It masterfully navigates the full journey of anyone considering DBS from start to finish, painting a clear, step-by-step, realistic picture of this life-changing breakthrough therapy." -Hubert H. Fernandez, MD, Online Medical Editor, Movement Disorders Society and Head of Movement Disorders, Center for Neurological Restoration, Cleveland Clinic

"A must-read for patients considering DBS surgery." -Rajesh Pahwa, MD, Laverne and Joyce Rider Professor of Neurology, Director, Parkinson Disease and Movement Disorder Center, University of Kansas Medical Center (20111117) --Matthew B. Stern, MD, Parker Family Professor of Neurology, Director, Parkinson's Disease and Movement Disorders Center, University

About the Author
Kelvin L. Chou is a board-certified, fellowship-trained neurologist with expertise in Parkinson's disease and other movement disorders. He has been at University of Michigan since 2007, where he is an Associate Professor of Neurology and Neurosurgery and Co-Director of the STIM (Surgical Therapies Improving Movement) program. He has also been named to the "Best Doctors in America" list.

Susan Grube is an advanced practice registered nurse who has been with the University of Michigan Department of Neurosurgery for 19 years. She has undergone specialized training in the care of patients with deep brain stimulation (DBS), and is the coordinator of the STIM (Surgical Therapies Improving Movement) program. She is a resource to those interested in learning about DBS, and to those who have been implanted with a DBS system.

Parag G. Patil is a neurosurgeon specializing in deep brain stimulation for Parkinson's disease, movement disorders and other conditions. He is an Assistant Professor of Neurosurgery and Co-Director of the STIM (Surgical Therapies Improving Movement) Program at UM. His research has been featured in Time magazine and on the cover of Neurosurgery.


Customer Reviews

Most helpful customer reviews

1 of 1 people found the following review helpful.
5Required reading for anybody involved with Parkinson's either as a patient or as a carer
By R. G. Michel
This is a well-written book that explains the issues in an understandable fashion. I consider this book required reading for anybody involved with Parkinson's either as a patient or a carer, especially if the Parkinson's is at an advanced stage closer to the time when DBS might be required. For a neophyte Parkinson's patient it is less necessary, as the knowledge and technology of DBS is changing so fast that in less than five years the book will likely be out of date. The only issue that to me is not quite clear in the book is with respect to some of the cognitive requirements for the implementation of DBS. As the medications normally used in Parkinson's can induce hallucinations and paranoid delusions when the dosage is too high, the decision about DBS could be confused. This is not really addressed in the book.

1 of 1 people found the following review helpful.
5Is Deep Brain Stimulation as Good as Science Fiction?
By Amazon Customer
Number of stars: 5

The book, Deep Brain Stimulation, by Kelvin L. Chou, Susan Grube, and Parag Patil, is for patients considering deep brain stimulation therapy for a variety of neurological disorders. Kelvin L. Chou is a neurologist, who graduated from the University of Michigan medical school and is a professor of neurology at the University of Michigan with expertise in movement disorders. He is also a co-director of the Surgical Therapies Improving Movement (STIM) program. He has been named to the “Best Doctors in America” list. He reviews several journals and has first authored several research publications. Dr. Chou has also authored several other books on movement disorders and Parkinson’s disease. Susan Grube is a registered nurse involved with the University of Michigan Department of Neurosurgery for 19 years. Parag Patil is a neurosurgeon and associate professor and co-director of STIM at the University of Michigan as well. He is a well-respected researcher with work being featured in Time and on the cover of Neurosurgery. Together, the three authors provide excellent and credible insight into deep brain stimulation from both, a doctor’s perspective, and patient’s perspective. Deep brain stimulation (DBS) is a surgical intervention that can be used to treat movement disorders for those who have symptoms severely lowering quality of life. It works by implanting a generator around the collarbone area and then placing electrodes into regions of the brain that are decided on a patient to patient basis. Some movement disorders treated by this treatment are Parkinson’s disease, dystonia, and essential tremor. There are risks involved with the surgery and reading this book will shed light on a scarcely known, but potentially life-restoring procedure. I believe this book is a must read for anyone who has or knows someone with a movement disorder that is seriously comprising quality of life.
The main point of this book is to provide information to prospective patients and families on the process of deep brain stimulation from how patients are selected to how patients react to the therapy. Anyone who reads this book will learn more than just what deep brain stimulation is and how it works. The book delves into the history of movement disorders and how treatments progressed to where they are today. Readers will also learn about how patients qualify for surgery, what the pros and cons of the surgery are, the timetable of care, how to assemble a good heath care team, the role of friends and family, and what happens the day of surgery. For example, the authors warn the reader that the surgery is risky and that not all physicians will know if someone is a good candidate or not. That is why they write a chapter on how important it is to have a good team, because they are also the ones that will tell someone if the surgery is worth the risks. They go on to give conditions for which someone should consider surgery, such as “having motor fluctuations that interfere with activities and cannot be resolved with medication changes” (Chou, 23). The authors discuss what happens after the surgery, how to maintain the system, what to do if it is not controlling symptoms, maintenance, and the possible risks and long term effects. The book also has an FAQ, as well as glossary for terms, support organizations, and a list of commonly prescribed medications.
The authors’ writing style makes the book easy to read as they do a good job explaining every concept and step of the process. The authors accomplish this by going into detail every step of the way making sure the reader has the proper background knowledge to understand all the topics being discussed and they also provide illustrations and diagrams. An example of this is that the authors go over the involved anatomy of the brain and what happens to cause each movement disorder, such as describing how dopamine works and how the basal ganglia and primary motor cortex play a role in movement disorders. They also go into detail about the parts of the DBS system and how they are regulated and then how they are placed in the body and how they work. The simplicity of the book can be seen when the authors use an I Love Lucy scene to illustrate what happens during Parkinson’s disease by saying: “Think of the candy factory as the brain and Lucy and Ethel as the basal ganglia. Lucy and Ethel cannot keep up with the signals (candy) coming from the brain, and as a result, the signals get messed up (gets eaten or stuffed in hats). In a normal brain (or candy shop), two workers should be able to keep up with the flow of signals (chocolate) coming from the brain (conveyor belt)…” (Chou, 13). The book does a great job of describing the process from consultation to rehab and life with the system and explains what the pros and cons are. The authors do a great job of staying objective throughout the book, which I feel is a great way to establish credibility. They do not try to persuade or dissuade a patient from the surgery, but instead, present the facts in a way that the patient or family can confidently make a decision.
Overall, I recommend this book to anyone who has or knows someone with a movement disorder or if they want to learn about the treatment and disorders like I did. The book does an excellent job of going into a great amount of detail every step of the way from how patients are selected to what questions to ask, what happens during surgery, how the patient is taken care of and the prognosis. It simplifies everything in a way that anyone can understand it, even without any prior background knowledge.

1 of 1 people found the following review helpful.
4Deep Brain Stimulation: A New Life for People
By D. C. Small
This book gives a balanced approach to the Deep Brain Stimulation surgery. It gives the pros and cons. It also tells the patient about the knowledge and experience gained in the past 20 years.
DBS surgery is better than the new form of an old method, ultrasound destroys the few neurons that cause the tremors. DBS does not purposely destroy any neurons. As both my neurologist and my neurosurgeon have said, it is reversible. The ultrasound method is not.

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