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2 results

  • Chapter 6 - Managing essential tremor patients treated with deep brain stimulation

  • Edited by William J. Marks, Jr, University of California, San Francisco
  • Book:
    Deep Brain Stimulation Management
    Published online:
    10 November 2010
    Print publication:
    28 October 2010, pp 56-61

  • Summary

    This introductory chapter gives a brief overview of the book Deep Brain Stimulation Management, touching on the key topics pertaining to use of deep brain stimulation (DBS) for clinicians. DBS has evolved as an important and established treatment for movement disorders, and new indications for DBS in the treatment of neurological and psychiatric disorders are emerging. It uses a device with three implantable components: quadripolar brain lead(s), neurostimulator(s), and extension wire(s). There are three major movement disorders for which DBS is indicated: essential tremor, Parkinson's disease, and dystonia. DBS is a chronic neuromodulation therapy and not a surgical treatment. The chapter also gives an overview of how other chapters in this book are organized. This book serves as a practical reference, a "go to" guide to be kept in the clinic and consulted in the course of managing patients being considered for or treated with DBS.

  • Appendix A: - Motor diary

  • Edited by William J. Marks, Jr, University of California, San Francisco
  • Book:
    Deep Brain Stimulation Management
    Published online:
    10 November 2010
    Print publication:
    28 October 2010, pp 141-141

  • Summary

    This chapter discusses the evaluation for and management of Vim deep brain stimulation (DBS) in the essential tremor (ET) patient. It is important to document the tasks that are of particular importance to the patient, such as writing, and putting on make-up. The majority of DBS clinicians initiate programming two to four weeks after Vim DBS lead implantation. Prior to initiating DBS programming, electrode impedance measurements should be performed to confirm integrity of the DBS system and its connections, and also to document a baseline measurement for future reference during troubleshooting. Stimulation-related adverse effects for DBS in the region of the Vim include paresthesia, dysarthria, incoordination, pain, asthenia, abnormal thinking, and headache. Often, stimulation parameters remain remarkably stable over time and provide excellent tremor suppression for many years. The neurostimulator can be turned off by the patient using the patient programmer.