                
|
 All patients considering DBS for the treatment of movement disorders must first be assessed by a neurologist with specialized training in movement disorders. Stephen Grill, M.D., Ph.D., (on right in photo below) and Suzanne Goldstein, M.D. of the Parkinson's Disease and Movements Dirosders Center of Maryland are the neurologists that perform this assessment for the DBS program at Johns Hopkins. 
Three to four weeks after surgery, the patient is ready to have the stimulator
turned on and programmed. This programming is performed by a team including
Dr. Grill and Dr. Goldstein, as well as the DBS Nurse Coordinator, Becky
Dunlop. Many patients experience some level of benefit from the implant
immediately following surgery. This is thought to be due to swelling around
the tip of the implanted electrode. However, this effect often diminishes
over the following weeks to months. The initial programming session generally
takes several hours. The implanted device is checked in order to determine
that it is functioning correctly, and various parameters of stimulation
(voltage, frequency of stimulator and which electrodes are used) are programmed.
This process requires continuous feedback from the patient to ascertain
that there are benefits and to identify any side effects.Patients typically return several times during the following months until the stimulator is programmed optimally. Because this involves a degree of trial and error, the process can be frustrating. Some patients express that not all of their symptoms have been treated as much as they would have liked. Most patients show very significant benefits, as long as the expectations going into the surgery are understood. Neurologists interested in patient selection and post-operative DBS programming may register to attend a Medtronic training course on Patient Selection and Programming at www.activauniversity.com |
