Effect on dyskinesia is variable (may be pro-dyskinetic in some and anti-dyskinetic in other patients)Significant reduction in contralateral tremor measurable for up to three months in some patients; occasional patients…
Figure 6.1 Deep brain stimulation (DBS) system, including a neurostimulator, extension, and DBS lead. Figure courtesy of Medtronic, Inc.; used with permission. Figure 6.2 Patient and clinician programmers. Figure courtesy…
Figure 11.1 Lesion and deep brain stimulator placement for OCD, adapted from Greenberg et al., 2010.6 (Right) Targets in axial view: 1a, anterior thermocapsulotomy; 1b, posterior target used for gamma…
Figure 10.1 Skull x-ray showing DBS leads in an epilepsy patient treated with deep brain stimulation of the anterior nucleus of the thalamus. Figure 10.2 Sagittal MRI image of the…
(1 patient at 60)2 or 3 (6 or 7)Ostrem et al. (2014)2371.5–4.560–9060–140Central or dorsal (unipolar or bipolar) Electrode configuration With very few exceptions,37 most clinicians have used unipolar (monopolar) electrode…
Figure 5.1 Schematic representation of the lines of electrical force that radiate from the negative electrode (cathode) for various configurations. In the case of unipolar configuration (a), where there is…
Figure 7.1 Programming algorithm for ventral intermediate deep brain stimulation (Vim DBS) in essential tremor (ET) patients. The usual parameters for Vim stimulation are amplitude of 1–4 V, pulse width…
Figure 1.1 Implanted components of the deep brain stimulation (DBS) system include the DBS leads, extensions, and neurostimulator. Figure courtesy of Medtronic; used with permission. The DBS lead, containing an…
PrimidoneGabapentinTopiramateAtenololSotalolAlprazolamClonazepamNadololNimodipinePregabalinZonisamideClozapine Target selection The ventral intermediate nucleus (Vim) of the thalamus is the most well-studied and only FDA-approved DBS surgical target for ET. Stimulation is highly effective at abolishing contralateral…
Figure 12.1 Algorithm for assessment and troubleshooting post-DBS. On the second day, the patient will have been “off” medication overnight (if the patient has PD) and stimulation will be “on.”…
