Deep brain stimulator





Deep brain stimulation (DBS) is a surgery to implant a device that sends electrical signals to brain areas responsible for body movement. Electrodes are placed deep in the brain and are connected to a stimulator device. Similar to a heart pacemaker, a neuro-stimulator uses electric pulses to regulate brain activity. The electrodes are placed on both the left and right sides of the brain through small holes made at the top of the skull. The electrodes are connected by long wires that travel under the skin and down the neck to a battery-powered stimulator under the skin of the chest. When turned on, the stimulator sends electrical pulses to block the faulty nerve signals causing tremors, rigidity, and other symptoms.

Deep brain stimulation (DBS) is a surgery

Deep brain stimulation (DBS) is a surgery to implant a device that sends electrical signals to brain areas responsible for body movement. Electrodes are placed deep in the brain and are connected to a stimulator device. Similar to a heart pacemaker, a neurostimulator uses electric pulses to regulate brain activity. DBS can help reduce the symptoms of tremor, slowness, stiffness, and walking problems caused by Parkinson’s disease, dystonia, or essential tremor. Successful DBS allows people to potentially reduce their medications and improve their quality of life.



Who is a candidate?


Brain pacemaker implant is useful for the patients to have a movement disorder with worsening symptoms such as tremor and stiffness due to Neurological diseases, so, a DBS can help treat many of these symptoms:
1. Parkinson’s disease: tremor, rigidity, and slowness of movement caused by the death of dopamine-producing nerve cells responsible for relaying messages that control body movement.
2. Dystonia: involuntary movements and prolonged muscle contraction, resulting in twisting or writhing body motions, tremor, and abnormal posture.
3. Spasms can often be suppressed by “sensory tricks,” such as touching the face, eyebrows, or hands.


Before surgery


A team of specialists including a neurologist, neuropsychologist, and neurosurgeon will evaluate your condition to determine if surgery is the right option.
• The evaluation includes thinking and memory, current medications, and general health
• The video of Body movements such as walking, finger tap, and rising from a chair before and after the medication is recorded and the symptoms and abilities are measured using the Unified Parkinson Disease Rating Scale (UPDRS).
• Typically some tests such as blood tests, electrocardiograms, chest X-ray and MRI scans of the brain will be performed several days before surgery.
• Patients are recommended to stop taking all non-steroidal anti-inflammatory medicines like Naprosyn, Advil, Motrin, Nuprin, Aleve, and etc. 1 week before surgery.
• Smoking, chewing tobacco, and drinking alcohol are forbidden 2 weeks before surgery.
• Taking Parkinson’s medication is not permitted the night before surgery.


What happens after surgery?


Successful DBS is related to:
1) Appropriate patient selection,
2) Appropriate selection of the brain area for stimulation,
3) Precise positioning of the electrode during surgery,
4) Medication management
After surgery, you may take your regular dose of Parkinson’s medication immediately. You are kept overnight for monitoring and observation. Most patients are discharged home the next day. During the recovery time after implanting the electrodes, you may feel better than normal.



Why Iran?


Deep Brain Stimulation surgery is one of the most successful surgeries in Iran. The main center to perform DBS in Iran is SHIRAZ hospital. All neurological surgeries in Iran are performed in the most developed hospitals with expert specialists. They use the best treatment for neurological diseases and the most affordable cost compared to other countries even Asians.
After your evaluation and videotaping are completed, Specialists and surgeons in Iran will discuss the case at a conference with multiple physicians, nurses, and surgeons. The team determines the best treatment plan for each patient. If the team agrees that you are a good candidate for DBS, you will be contacted to schedule an appointment with a neurosurgeon.
DBS surgery is performed by a neurosurgeon with specialized training in functional neurosurgery from the best universities all around the world. The surgical team also includes the most expert neurologists, nurses and anesthesia technicians.
Brain swelling around the electrode tip causes a lesion effect that lasts a couple of days to weeks.



Cost


The cost for brain pacemaker devices and surgery is about $100,000 but private insurance can be decreased to 35000$. In Canada, the surgery costs about $90,000 but is usually covered by insurance and decreases to 30000$. The cost of DBS in India starts from 20000 $ while it can be performed in Iran by less than 15000$.


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