- So the first thing I want you to do is to bring out your hands like this.
Okay, good. With this finger, reach out to my finger.
Try to hold it there. Okay, then touch your nose.
- So I met Jim about three months ago now,
and he was quite debilitated from his tremor of both upper extremities.
- I basically can't write. Eating is a challenge.
They've tried physical therapy, medications, and on and on.
So this procedure was introduced.
I met with Dr. Cajigas.
He talked to me about the whole procedure, spent a lot of time.
He said, “Yeah, we can get this done.”
- Deep brain stimulation is a
therapy that uses electrical stimulation directly to
deep structures within the brain to treat conditions with involuntary movements,
like essential tremor, Parkinson's disease, and dystonia.
- It's similar to placing a pacemaker in the heart.
In fact, I often tell patients that have tremor
that they have a condition much like atrial fibrillation,
which a lot of people know about.
Deep brain stimulation is very much a similar type of device,
except instead of the wires going into the heart,
they're placed very carefully, with precise instruments, into the brain.
- We place a special frame on the head.
The patient is under light sedation.
We get to the point where we make a small incision in the scalp,
and make a dime-size opening in the skull.
- So we’ve marked the entry point on the skull, now we're going to do some drilling.
This is a device that we use to drive the electrode down to our target in the brain.
- Once we're happy with where we're located, we test the limits.
So the amplitude is slowly increased, and we're looking for both
the benefit of the stimulation as well as the side effects.
- Let's go ahead and start.
Can you pretend you're drinking from that?
Try to bring that up to your face.
What do you think?
- They're happy tears, right? Yeah.
- When we activate the deep brain stimulation device
patients can feel immediately improved.
A light switch just turns on.
Try to trace that spiral and write your name, okay?
I think it's a little bit better, no?
Now you get to take a break, relax, take a nap.
The plan is to try to get you home tomorrow.
- Great.
- The programing involves testing
a few different locations on each lead
to see which one is providing the best benefit and the least side effects,
and sort of trying to steer the current field in the right direction from the lead.
- Once we actually have optimized the device,
patients are expected to really have long, durable,
extremely transformative effects to their quality of life.
We are being pioneers in delivering this therapy to new indications,
but we are also pioneers in trying to improve this technology,
such that it can be more personalized here at Penn.
- I think that neurologists should be aware that there are more options
now than there were five years ago for their patients with essential tremor
and Parkinson's disease, both surgically and medically.
We can actually now program people while they're in their house.
- While this therapy is performed at Pennsylvania Hospital,
it is available to patients throughout the Penn Medicine system.
- They can see our experts at Lancaster General Hospital, Princeton Hospital.
We have experts here across every discipline of the clinical neurosciences,
not limited to neurosurgery and neurology, but also psychiatry, neuropsychology,
social work, nursing, physical therapy, speech therapy.
And we know that that type of expertise leads to better outcomes for our patients.
- Because nobody's the same. Every patient is unique, their problem is unique,
and you can't just have the same solution for everyone.
And that's the type of care you can expect at Penn Medicine.
- Between the two of them,
I am the most blessed that I've ever been.
Thank you all, have a good time, let's get on with it.
[applause]