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How Deep Brain Stimulation Can Restore Your Steady Hands

Cleveland-Clinic-Logo-e14051002911852The content and information below is republished with permission from the Cleveland Clinic.
Lana Laurendeau can’t remember a time when her hands didn’t shake. For years, the shaking made it hard for her to eat without making a mess, drink from a glass without using both hands and put on jewelry.  The shaking also made it increasingly hard for her to do her job as a professional hairdresser.
“I was always afraid I would cut my clients instead of just cutting their hair,” Ms. Laurendeau says. “People thought I was nervous all the time.”

Photo courtesy of Cleveland Clinic
Photo courtesy of Cleveland Clinic

As the condition her became progressively worse, she went to see neurologist Michal Gostkowski, DO, at Cleveland Clinc’s Center for Neurological Restoration at the Richard E. Jacobs Health Center in Avon, OH. He diagnosed her with essential tremor, which is similar to Parkinson’s disease.
“Essential tremor causes more disability than Parkinson’s, particularly in the hands,” Dr. Goskowski says. “And it is a condition that is not always recognized by physicians, so patients may go undiagnosed.”
Misfiring brain
Dr. Gostkowski recommended that Ms. Laurendeau undergo a procedure called deep brain stimulation. In deep brain stimulation, surgeons create a small hole in the skull. A neurosurgeon uses computerized mapping and recording to implant an electrode in the precise part of the brain that is misfiring and causing the tremor.
Wires connect the electrodes to a type of pacemaker device that surgeons implant under the skin, such as  in the chest below the collarbone. The pacemaker can be easily programmed with a computer via radio signals. Patients use special magnets to turn the device on or off.
Deep brain stimulation also treats Parkinson’s disease, muscle contractions called dystonia and tremors that can come with multiple sclerosis.
Patients are awake for part of the procedure so that neurosurgeons and intraoperative neurologists can get feedback directly from the patients.
“The surgeon needs to make certain that he or she is optimally targeting the correct part of that patient’s brain,” Dr. Gostkowski says.
Dr. Gostkowski says patients are generally hospitalized for around five days after the surgery and that deep brain stimulation is highly successful for many of his patients.
Regaining control
While the idea of deep brain stimulation scared her, Ms. Laurendeau was determined to regain control of her life. She went through with the procedure in October 2012.
She elected to have the part of her brain that controls her dominant left hand treated first, since just one side of the brain can be operated on at a time.  Dr. Gostkowski was in the operating room to help surgeons navigate placement of the electrodes.
Today, the mother of three teenage boys is thrilled that her left hand is tremor-free when she turns on the stimulator. She turns the device off at night via a remote control to preserve the electrode’s battery, which surgeons implanted in her abdomen.
Ms. Laurendeau says she may eventually have her right hand corrected, but for now, she is enjoying resuming many of the normal activities of life.
“I can apply eyeliner and paint my fingernails,” she says. “The difference is amazing.”
– Brain and Spine Team, health.clevelandclinic.org

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