Parkinson’s Disease – Surgical Treatment

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Types of Surgery - Continued

Therapy Controllers

A patient places the compact, handheld therapy controller over the neurostimulator and presses buttons to turn one or both of the neurostimulators ON and OFF, to view the system's ON/OFF status, and to check the system's battery status.

Patients with a Kinetra® neurostimulator may use the Access® Therapy Controller, which allows them limited control over stimulation parameters within a physician’s prescribed limits.

Graphic Model-Stereotactic Brain Surgery

During needle-guided (stereotactic) brain surgery, the patient remains awake. This is for two reasons.

The first is that the brain itself has no pain sensors, and once the initial incision is made (using a local anesthetic like Novocain), there is no pain.
The second is that patient must be able to respond to the surgical team's questions about what he is experiencing during the surgical procedure. The pathway to the target lies close to several other important structures in the brain that may be inadvertently stimulated during the procedure. This may cause unusual sensations such as flashing lights, tingling, or experience of emotions. The patient then reports these sensations to the surgeon during the procedure. Avoiding these areas is crucial for a successful surgery.

As surgery requires very precise placement of surgical instruments, a three-dimensional frame is attached to the patient's head to guide the surgeon. The frame may be uncomfortable and local anesthetics maybe used to ease the discomfort. Before surgery, patients will also undergo several imaging procedures, in order to identify the target and other landmarks within the brain. Depending on the center, the procedures may include Magnetic Resonance Imaging (MRI) scans, Computerized Tomography (CT), or ventriculography.

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