Deep Brain Stimulation in Malaysia

The deep brain stimulation system comprises the following:

• An electrode, which is a long, thin insulated wire placed in the brain
• A neurostimulator, which is commonly implanted near the collarbone
• An insulated wire that connects the electrode to the neurostimulator

A rigid frame is used to ensure that the electrode is correctly placed in the specific area of the brain. The patient may need to remain awake in the initial stage of the surgery to report any sensorial changes.

After it is connected, the neurostimulator sends electrical impulses through the extension wires to the electrode and into the brain. This helps in reducing certain symptoms of movement disorder and tremors.

What diseases are treated with DBS?
Deep brain stimulation is used to treat Parkinson’s disease, Tremor and Dystonia.

It may not fully cure Parkinson’s disease, but it decreases the severity of the symptoms.

How is a DBS Surgery Performed?
Deep brain stimulation surgery is usually done in two stages. In the first stage, the patient is usually awake under local anesthesia. The patient’s head is placed in a rigid frame. Screws are used to fix the head to the frame. A small hole is drilled in the skull and the electrode is placed in the particular part of the brain. If the surgery needs to be performed on both parts of the brain, two holes are made on both sides of the skull and two electrodes are inserted. Small amounts of electrical impulses are sent over the electrode to ensure that it is properly connected to the specific area of the brain that is causing the patient’s symptoms. Various neurological tests may be performed.

In the second stage of the surgery, general anesthesia is administered on the patient and the patient remains unconscious throughout the surgery. A small incision is made below the collarbone. The neurostimulator is implanted under the skin. In some cases the neurostimulator is placed in the lower chest area. Another incision is made behind the patient’s ear. An extension wire is passed under the skin from the head, neck and shoulder. This extension wire connects the electrode to the neurostimulator. The incision is closed and the wires and the device are concealed inside the body.

What are the Pre-surgical Preparations for Deep Brain Stimulation?

• The patient will have a physical examination.
• The patient needs to do a CT scan and MRI scan to locate the specific region of the brain that causes tremors and symptoms of movement disorder.
• The patient should inform the doctor about:
  • The patient’s health conditions, such as pregnancy
  • Any medication that the patient is taking
  • Alcohol that the patient may be consuming
• Some medications that the patient is taking may be stopped a number of days before the surgery.
• The patient should avoid smoking.
• The doctor may ask the patient’s hair to be washed with a special shampoo on the night before the surgery.