ACTIVA:
Some patients with parkinsons disease
or essential tremor who are not helped by drugs or who have dose-limiting
side effects elect to undergo surgery for treatment of severe
disabling tremor.
Tremor control therapy is an adaptable therapy that uses mild
electric pulses to stimulate the brain and block the signals that
cause tremor. The therapy includes the implantation of an insulated
wire lead into the thalamus area of the brain. The lead is connected
to a pulse generator (like a cardiac pacemaker) implanted beneath
the skin in the chest area. The stimulation is turned on by the
patient with a hand-held magnet. All parts of the system are implanted
under the skin.
Using pacemaker technology refined for neurological application, thalamic stimulation works by blocking the thalamocortical pathway common to the mechanism of both Parkinsonian and essential tremor. Unlike previous surgical approaches, however, it is reversible (the stimulator can be turned off if side effects occur), and it can be adjusted (current can be applied proportional to need).
Based on the scientific literature, a large majority of patients can expect excellent tremor control opposite to the side of surgery. The risk of a significant, lasting side-effect is less than 2%. Surgery is well tolerated by patients, performed almost entirely under local anesthesia, and involves an overnight stay in the hospital. Although patients return to their regular physician for customary care, our neurological team assumes full responsibility for stimulator management. Both the procedure and the device are covered by Medicare, as well as other third-party payers.
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