"We're gonna place this electrode down to the target spot that we chose." This woman has essential tremor, a condition ten-times more common than Parkinson's. The mind functions fine but the hands, head and neck shake uncontrollably. "Try to put your index finger right near my index finger."
While she's awake, doctors drill a hole in her skull. During the surgery -- called deep brain stimulation -- they place tiny wire electrodes in her brain and attach them to a battery-powered device in her chest. When turned on, it emits an electrical pulse. When it's in the perfect spot, the shaking stops. "Now I'm gonna turn it on. Try to touch my hand." "Upwards of 95 percent of patients who have this will be able to return to being able to do what they wanted to do."
Mike Bate's hands once shook so much he didn't want to get out of bed. "I couldn't feed myself. I couldn't button buttons."
He tried two different medications. He stopped shaking, but he also slept all day. "They knocked me out." He opted for surgery. A year later he still has a slight tremble, but watch the difference -- here the device is on … here, it's off. "I can't even pick up that can."
"I don't know why anybody would want to go through life like that." This handyman now puts his hands to work. "It's like day and night. It's like being reborn." Making even the slower moments of retirement much more enjoyable. "Enjoying the good life."
The deep brain stimulation surgery can cause tingling in the face and limbs, and in Mike's case, it slowed his speech. Medication is an alternative, and doctors say it's effective in 60-percent of cases. The drugs used to treat essential tremor carry side effects of drowsiness and depression.
BACKGROUND: Essential tremor is a progressive neurological disorder where the arms, hands head and neck shake during voluntary movements such as eating and writing. Some patients may have unsteadiness and problems with gait and balance that are above and beyond the signs of normal aging. Other diseases or conditions don't cause essential tremor, although it's sometimes confused with Parkinson's disease. It can happen at any age, but it's most common in older adults. According to the National Institutes of Health, essential tremor may affect as many as 14 percent of people over the age of 65. Essential tremor is ten to twenty times more prevalent than Parkinson's disease and is the most common of the movement disorders, affecting more than 10 million Americans.
ESSENTIAL TREMOR VS. PARKINSON'S DISEASE: Many people associate tremors with Parkinson's disease, but the two conditions are very different.
• Essential tremor typically occurs when hands are in use. Tremors from Parkinson's are most prominent when a person's hands are at their side or resting in their lap.
• Essential tremor doesn't cause other health problems. Parkinson's is associated with a stooped posture, slow movement and shuffling gait.
• Essential tremor can involve your hands, head and voice. Tremors from Parkinson's typically affect your hands, but not the head and voice.
DEEP BRAIN STIMULATION: For almost 50 percent of people with essential tremor, medication doesn't work or it carries debilitating side effects. That's when many consider surgery. During deep brain stimulation surgery, the patient is awake. A neurosurgeon implants an electrode into the thalamus portion of the brain. That electrode is connected to an implanted neurostimulator placed near the collarbone. During the surgery, patients are asked to perform tasks that have been difficult or impossible prior to surgery, like holding a mug and touching the point of their finger to something. As surgeons adjust the setting, they often see immediate improvement and the shaking stops. The signal emitted from the stimulator interrupts the signal in the brain that tells the body to move uncontrollably. Patients routinely go back to the doctor to have their stimulators fine-tuned. Patients also take home a remote control that can switch the device on or off. When it's in the off mode, tremors come back immediately.
FOR MORE INFORMATION, PLEASE CONTACT:
Cindy Nelson, Public Affairs
The Mayo Clinic
Jacksonville, FL
Nelson.cynthia1@mayo.edu
(904) 953-0464
