What is a brain pacemaker?
The brain pacemaker is a technical device used to treat various neurological diseases. A surgeon inserts the brain pacemaker – similar to a cardiac pacemaker – into the brain, where it delivers high-frequency electrical impulses to specific areas of the brain. This is known as deep brain stimulation. Although the exact mechanism of action of the procedure has not yet been clarified, it is assumed that the electrical impulses inhibit certain brain areas and thus alleviate the symptoms of neurological diseases.
When is brain pacemaker therapy performed?
Possible areas of application are various neurological diseases. A brain pacemaker is most frequently used for Parkinson’s disease: Here, “deep brain stimulation” improves the typical tremor (tremor) and over-mobility (dyskinesia) of those affected. Other diseases in which patients can benefit from a brain pacemaker are:
- essential tremor (movement disorder, usually of the hands)
- generalized or segmental dystonia (involuntary contraction of skeletal muscles)
- Huntington’s chorea
- focal epilepsy
- psychiatric obsessive-compulsive disorder
What do you do during therapy with a brain pacemaker?
Before a doctor inserts a brain pacemaker, he examines the patient. He carefully documents the patient’s characteristic signs of illness and determines how they develop throughout the day. An examination of the brain using magnetic resonance imaging (MRI) and a memory test follow.
On the basis of these preliminary examinations, the physician can weigh the individual risk of possible side effects against the resulting benefits of the brain pacemaker.
Brain pacemaker: implantation
First, the neurosurgeon fixes the patient’s head in a so-called stereotactic ring. This is attached to the skull bone under local anesthesia and prevents movement of the head. A repeat MRI image of the head provides the necessary information on the brain area being searched for and enables precise planning of the access route.
Through a small incision in the skin, the neurosurgeon obtains an unobstructed view of the bony skullcap. He now drills a tiny hole in the bone through which he inserts several microelectrodes into the brain. The insertion of the electrodes is painless because the brain itself has no pain sensors.
The rest of the operation is performed under general anesthesia. The surgeon now inserts the pulse generator of the brain pacemaker below the collarbone or in the chest area under the patient’s skin and connects it to the electrodes in the brain via a cable that also runs under the skin. The entire procedure takes about five to six hours.
What are the risks of brain pacemaker therapy?
There are some risks associated with deep brain stimulation, about which the doctor informs the patient in detail in advance. A distinction is made between the complications that can arise from the surgical intervention and the side effects caused by the electronic stimulation of the selected brain region.
Risks due to the surgery
As with all surgeries, the procedure can result in injury to blood vessels and corresponding bleeding. If the bleeding presses on brain tissue, neurological symptoms may occur in rare cases, for example paralysis or speech disorders. However, these usually regress. Other possible complications are:
- Incorrect placement or slippage of the electrodes (a new procedure may then be necessary).
- Infections with brain or meningitis (encephalitis, meningitis)
- @ technical malfunctions of the brain pacemaker
Risks due to the electrical stimulation
What do I have to consider after the insertion of the brain pacemaker?
The pulse generator of the brain pacemaker can be programmed through the skin and is only switched on a few days after the operation. First, you should recover from the procedure. Please keep in mind that it can take several weeks until the pulses are individually set. So be patient if you do not feel the desired treatment success right at the beginning.
Also keep in mind that the brain pacemaker does not treat the cause of the condition, but only relieves its symptoms. This means that your symptoms will return if the brain pacemaker is turned off or removed.
The batteries in a brain pacemaker run down after about two to seven years and need to be replaced. However, this follow-up procedure does not require a general anesthetic; a local anesthetic is sufficient.
