Functional Neurosurgery

Our functional neurosurgeons use a variety of techniques to treat movement disorders, epilepsy, and pain. Please see more information about each of these areas below.

Movement Disorders

Our multidisciplinary team treats movement disorders including Parkinson’s disease, essential tremor, and dystonia with techniques such as deep brain stimulation and stereotactic radiosurgery.

Deep Brain Stimulation

What is deep brain stimulation?

Deep brain stimulation (DBS) is a type of brain surgery. During this surgery, thin wires (electrodes) are implanted permanently into specific areas of the brain. These electrodes are connected by wires under the skin to a small electrical unit called a generator. The generator is similar to a heart pacemaker and is placed under the skin of the chest. It allows for constant electrical stimulation of specific brain areas involved in movement disorders.

What is the advantage of DBS compared to other interventional procedures?

Other interventional procedures to treat movement disorders involve destruction of brain tissue and are therefore irreversible. In contrast, DBS allows us to control the abnormal activity of brain cells near the stimulating electrode without destroying brain tissue. The generator can be adjusted or turned off, allowing for greater flexibility in the treatment of neurological conditions.

How does DBS help movement problems? Is it a cure?

The goal of DBS is to improve the control of movement and related quality of life. Depending on the type of movement disorders this may result in a reduction in tremor, rigidity, dyskinesia, or dystonia. Your neurologist and neurosurgeon will discuss specifically which of your symptoms they anticipate to improve with DBS surgery. DBS is not a cure for any disease. It helps control the symptoms of your condition and may provide you with a better quality of life.

Epilepsy

For patients with medication resistant epilepsy, surgical treatment may provide the best chance for seizure control and improved quality of life. Surgery for epilepsy includes surgery to diagnose and/or to treat seizures.

Surgeries that might be recommended by your neurologist/neurosurgeon to better locate where your seizure are coming from to allow future surgical treatment of your epilepsy include the following:

  • Stereo EEG (SEEG): multiple thin electrodes are temporarily placed into various regions of the brain to detect the region that seizures are coming from
  • Subdural grid/strip electrodes: strips of electrodes are temporarily implanted inside the skull on the surface of the brain to detect the region that seizures are coming from

Surgical treatment options for epilepsy include:

  • Surgical resection: when safe to do so, the brain region that seizures are originating from can be surgically removed, providing the chance for the patient to be seizure free
  • MRI guided laser ablation: a laser probe is inserted into the brain region that seizures are originating from and heated up under MRI guidance to damage the diseased brain tissue.
  • Responsive neurostimulation (RNS): electrodes are inserted into the brain region that seizures are thought to originate from and connected to a generator. The generator records EEG from the brain and delivers stimulation to abort the seizure when concerning activity is detected.
  • Deep brain stimulation (DBS): electrodes are inserted into a deep brain region and deliver constant stimulation to disrupt abnormal brain activity related to seizures
  • Vagus nerve stimulation (VNS): an electrode is connected to the vagus nerve in the neck and delivers electrical stimulation to decrease seizures.

Pain

Pain related conditions we treat include the following:

  • Trigeminal neuralgia
  • Glossopharyngeal neuralgia
  • Post laminectomy syndrome
  • Cancer pain
  • Spasticity
  • Hemifacial spasm

Surgical treatment options for pain/spasticity include:

  • Microvascular decompression
  • Radiofrequency or balloon compression rhizotomy
  • Spinal cord stimulation
  • Deep brain stimulation (DBS)
  • Cingulotomy
  • Intrathecal baclofen pump