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Brain & Nervous System Health Center

Pacemaker for the Brain Effectively Stops Tremors

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In this study, the researchers followed 49 patients who underwent surgery to have the deep brain stimulation "pacemaker" inserted and found that 16% had the stimulators removed due to loss of effectiveness during a 40-month follow-up period. In addition, there were several instances of device-related complications requiring a second brain surgery.

Neurologist James Tetrud, MD, of California's Parkinson's Institute, says many of his older patients who are candidates for the surgical implant choose not to have it because they fear the surgery more than the tremors.

"Essential tremor is not life-threatening, and this is a potentially dangerous procedure, especially in older patients," Tetrud says. "In general, the older patients I have seen are quite appropriately reluctant to undergo brain surgery. They choose to live with what appear to be very disabling tremors rather than undergo surgery."

Tetrud says many patients also do not want to put up with the "hardware" that comes with the stimulator. The electrode implanted into the thalamus is connected by lead wire under the skin to a pulse generator, which is placed under the skin near the collarbone. When activated, the device sends a constant stream of electrical pulses to the brain, blocking tremors. To turn the stimulator on and off, the patient touches a hand-held magnet over the generator.

Ryan's doctors had to replace and reroute a broken lead wire several months after his initial surgery, and he had a second stimulator implanted two years ago. But Ryan says he would do it all again in a second.

"Before the implant, the smallest things -- like drinking from a glass -- were incredibly hard," he says. "I would usually carry a straw with me or would pick restaurants where I knew they brought you drinks with a straw. I don't think I had ever had a cup of coffee until two or three years ago. Now I sometimes turn the stimulator off just to remind myself of what I couldn't do before and how easy life has become."

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