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Deep Brain Stimulation for Stubborn Hypertension

Case Study Suggests Stimulating Brain With Electrical Impulses May Treat High Blood Pressure
By
WebMD Health News
Reviewed by Laura J. Martin, MD

side view of brain illustration

Jan. 24, 2011 -- Using electrical pulses to stimulate nerve centers deep within the brain may reduce high blood pressure that can’t be controlled with medication, a case report shows.

Doctors in the U.K. made the discovery after implanting a device that works as an electric stimulator of a region of the brain in a 55-year-old man who had developed chronic pain on the left side of his body following a stroke.

Though his pain eventually returned after four months, his doctors report that their patient’s previously uncontrolled blood pressure has remained normal for nearly three years.

That was a surprise because experts had long thought that pain had to be reduced to see a reduction in blood pressure.

“Pain creates stress and that can have an effect on one’s blood pressure,” says Nikunj J. Patel, MD, a neurosurgeon at Frenchay Hospital in Bristol, U.K., and an author of the case study.

Patel says that makes the impact of the case study “startling and exciting” because if  studies bear the findings out, deep brain stimulation may one day help people with hypertension whose blood pressure remains uncontrolled on multiple medications.

The case study is published in the Jan. 25 issue of Neurology.

While the case study is only an example of the phenomenon occurring in a single person, previous reports have observed the same kinds of reductions in blood pressure in people getting deep brain stimulation for pain, though researchers had believed that the blood pressure benefit was directly tied to the degree of pain relief the person experienced.

“What their case report shows is that blood pressure can be reduced in a sustained fashion in a patient with unsuccessful deep brain stimulation for pain,” says Erlick Pereira, MD, a neurosurgeon at the University of Oxford. Pereira wrote about blood pressure reductions in a patient getting deep brain stimulation in the January 2010 issue of the Journal of Clinical Neuroscience.

“I think that’s important because it paves the way for potentially studying patients without chronic pain and offering the treatment sometime in the future to reduce blood pressure,” he says.

Blood Pressure Control

The doctors report that their patient, immediately following his stroke, had spiking blood pressure that ranged from 153/89 to 265/96. Normal blood pressure is 120/80 or lower.

Even after taking a combination of four different hypertension medications, the man was unable to get his blood pressure down, and eventually, though he regained movement after being partially paralyzed by his stroke, he developed a chronic pain.

Doctors tried for three years to control their patient’s pain, without success. So they agreed that he might be a candidate for deep brain stimulation, which can sometimes be helpful for people who can’t find relief any other way.

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