Tuesday, October 16, 2012 - Surgical Option for Parkinson’s Disease Now Offered at Winchester Medical Center

Key participants in neurosurgical first at Winchester Medical Center
Lee Selznick, MD: Neurosurgeon - Virginia Brain and Spine Center
Mariecken Fowler, MD: Neurologist - Winchester Neurological Consultants

Dale Sines: First Winchester Medical Center patient to undergo Deep Brain Stimulation (DBS) Surgery to treat Parkinson’s disease.

Dale Sines, 70, from Keyser, WV, was diagnosed with Parkinson’s disease in 2005, and underwent the two-part DBS surgical process beginning on September 18, 2012, when Dr. Lee Selznick placed electrodes in the area of the brain known as the globus pallidus. The second phase of the process took place October 5 when the Deep Brain Stimulator was implanted in his chest and connected to the electrodes.

Working with Dr. Selznick was neurologist Dr. Mariecken Fowler who coordinated the micro-electrode recording and programming of the deep brain stimulator.

The first surgical phase involves the insertion of two electrodes into a region of the brain that affects movement. Wires connected to the electrodes are brought through the skull and placed beneath the scalp. The second part of the surgery involves implanting a Deep Brain Stimulator in the upper chest and connecting it to the wires beneath the scalp.

On Monday, October 8, Dr. Fowler activated the DBS device. Mr. Sines gained immediate relief from a number of the symptoms associated with his disease: his hand tremors stopped, his range of motion increased and he walks more comfortably and confidently. He reports his ability to sleep has made a remarkable improvement.

Parkinson’s disease
Parkinson's disease is a slowly progressing, degenerative disease that is usually associated with the following symptoms, all of which result from the loss of dopamine-producing brain cells:
• Tremor or trembling of the arms, jaw, legs, and face
• Stiffness or rigidity of the limbs and trunk
• Bradykinesia (slowness of movement)
• Postural instability, or impaired balance and coordination

Dopamine is a substance produced in the body that has many effects, including smooth and coordinated muscle movement.

About 60,000 Americans are newly diagnosed with Parkinson's disease each year, and more than 1 million Americans affected at any one time. In addition, more people suffer from Parkinson's disease than multiple sclerosis, muscular dystrophy, and amyotrophic lateral sclerosis combined.

With DBS surgery a small electrode is placed in the critical parts of the brain that help to control movement.

“There are three potential targets for DBS treatment: the thalamus, subthalamic nucleus, or globus pallidus,” noted Dr. Selznick. “The target is chosen based on the patient’s specific symptom profile.”

The electrode is attached to a small battery in the chest wall and is connected by wires that are placed under the skin. The stimulator is then turned on and interrupts the normal flow of information in the brain and can help to decrease symptoms of Parkinson's disease.

The treatment is aimed at helping the tremor or rigidity that comes with the disease. In most patients, surgery decreases the amount of medication that is needed to control the symptoms of Parkinson's disease.

“DBS can decrease the amount of medication required by a patient by approximately 50% and these medications often have significant side effects," said Dr. Fowler. “Medication treatment can result in significant fluctuations of symptoms throughout the day and night. DBS helps to keep a much more even level of functioning through the day, therefore helping quality of life significantly.”

“Dr. Selznick and Dr. Fowler have a passion for helping patients with Parkinson’s disease. We are excited that they are making this treatment option available,” says Tonya Smith, Winchester Medical Center Vice President of Operations. “This is an innovative service and one that we expect to grow in the coming year. Parkinson’s is a common affliction, and while this does not cure the underlying problem it can provide patients with tremendous symptom relief.”