Treatment of Cervical Dystonia of Deep Brain Stimulation (DBS)
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Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of accurate diagnostics and surgical treatment of diseases of the central and peripheral nervous system. The department's surgeons annually perform over 5,000 surgical interventions, which indicates their high professionalism and tremendous experience. The key attention is paid to the treatment of cerebrovascular diseases, diseases of the spine and spinal cord, brain and skull base tumors, peripheral nerve lesions, cerebrospinal fluid circulation disorders, as well as pain therapy (functional neurosurgery). The treatment of neurosurgical diseases in children and adolescents is carried out by a specially trained team of experts.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery offers the full range of modern surgical procedures for patients with diseases of the brain, spinal cord, spine, and peripheral nervous system. The department has state-of-the-art equipment, including navigation systems, monitoring devices, surgical microscopes, intraoperative X-ray diagnostic systems, angiography systems, and laser equipment. In addition, a system for minimally invasive stereotactic interventions has been installed in the department's operating room. The department's neurosurgeons use the latest microsurgical and endoscopic techniques in their work. The medical facility is one of only three in Europe to successfully use the VISUALASE™ device for MRI-guided laser ablation to treat epilepsy. This minimally invasive procedure is highly effective and represents a real breakthrough in epilepsy surgery. The department's neurosurgeons always strive to provide the patient with optimal medical care. They talk in detail about each stage of treatment and are happy to answer the patient's questions. Neurologists and specialists in the field of neuroradiology are often involved in the therapeutic process, which guarantees a comprehensive approach to treatment.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the brain, spine, spinal cord and nerves in adults and children. The department keeps pace with new trends in medicine, as well as contributes significantly to their development. Therefore, the most modern diagnostic and therapeutic methods are available here. An individual approach to each clinical case is crucial to ensure optimal treatment results with the preservation of all neurological functions.
Department of Adult and Pediatric Neurosurgery
According to the Focus magazine, the Department of Adult and Pediatric Neurosurgery ranks among the top German medical facilities specializing in the surgical treatment of brain tumors! The department offers the full range of diagnostics and surgical treatment of diseases of the central and peripheral nervous system. A specially trained team of pediatric neurosurgeons provides treatment for various neurosurgical pathologies in children. During the treatment, the doctors use state-of-the-art equipment, in particular, imaging-guided neuronavigation, functional imaging (fMRI), intraoperative mapping, intraoperative videoangiography, etc.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the diagnostics and treatment of the entire spectrum of neurosurgical diseases. The department specializes in the treatment of brain tumors, vascular diseases and intracerebral hemorrhages, spinal diseases, deep brain stimulation, etc. Special competence lies in the field of pediatric neurosurgery. The department offers the very latest highly accurate and minimally invasive treatment methods.
Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery offers the full range of diagnostics and surgical treatment of diseases of the brain, spinal cord and peripheral nerves at the highest international level of modern medicine. The department has four high-tech operating rooms, in which more than 2,400 surgical interventions are performed annually. Surgery to treat tumors of the nervous system in childhood and adulthood is of particular interest to the department's specialists. In addition, the department's medical team has unique clinical experience in the surgical treatment of epilepsy, spinal pathologies and deformities, as well as neurovascular pathologies. The department's doctors have a perfect command of advanced surgical techniques, for example, navigational surgery, intraoperative neuromonitoring, hybrid surgical techniques, which are the basis of successful clinical practice. State-of-the-art computer-assisted systems allow neurosurgeons to plan each stage of surgical intervention as accurately as possible, thereby guaranteeing its high efficiency and safety.
Department of Neurosurgery
The Department of Neurosurgery offers the full range of surgical treatment of diseases of the nervous system and belongs to the largest medical facilities of this kind at the national level. The department has 4 state-of-art operating rooms where more than 2,700 interventions are performed annually. It has the progressive surgical equipment, for example, intraoperative monitoring, neuronavigation, tools for performing minimally invasive operations, which provide the most effective and reliable therapy. The department has earned the reputation of the Center of Competence in the field of tumor surgery of the nervous system and spine.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers modern diagnostics and effective treatment of the full range of diseases, injuries, inflammatory processes, tumors and malformations of the brain, spinal cord and their meninges, as well as spinal diseases. Spinal surgery is performed in collaboration with doctors from the Department of Adult and Pediatric Traumatology, Orthopedic Surgery. The department admits adults and children with malformations of the nervous system, brain and spinal cord tumors, drug-resistant epilepsy and other diseases. As one of the largest medical facilities of this kind in Germany, the department's doctors annually perform more than 2,500 surgical interventions on the brain and spinal cord, peripheral nerve endings. The department's specialists also perform over 400 spinal surgical procedures annually. To achieve high success rates of the surgical treatment, doctors use the very latest equipment, including neuronavigation systems. Thanks to this, surgeons not only successfully eliminate the pathology, but also guarantee the patient maximum safety. The department has 78 beds, including 14 beds in the Intensive Care Unit. The priority goal of the department's medical team is to provide high-quality treatment focused on the patient's needs.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the diagnostics and comprehensive treatment of neurosurgical pathologies, including tumors of the central and peripheral nervous system. The department is the leading Center of Neurosurgery in Northern Germany and is responsible for the implementation of new algorithms for the treatment of patients with brain tumors. To this end, there is an active participation in the international researches and the development of new surgical methods, for example, operations in the waking state. Close interdisciplinary cooperation also contributes to the achievement of optimal treatment results.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery provides top-class medical care for patients with diseases of the central and peripheral nervous systems. The medical facility performs surgery of any complexity on the brain, spinal cord, spine, and peripheral nerves. The department is the largest healthcare facility of this kind in Germany and has a team of highly professional neurosurgeons with long clinical experience. The department's specialists focus on patients with brain tumors (gliomas, meningiomas, and brain metastases), neurovascular diseases (aneurysms, arteriovenous malformations, and dural arteriovenous fistulas), and traumatic brain injuries. Spinal surgeons operate on patients with herniated discs, spinal canal stenosis, spondylolisthesis, spondylodiscitis, spinal fractures, and spinal tumors. The department extensively uses minimally invasive surgical techniques that allow for good therapeutic results with high safety in surgical manipulations. The medical facility has two hybrid operating rooms with state-of-the-art equipment, including the Zeego® intraoperative robotic angiography system and the intraoperative Brainsuite® MRI.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of diagnostics and treatment of diseases of the central and peripheral nervous system. The medical institution occupies a leading position in this sector in Europe. The neurosurgeons of the department have at their disposal four high-tech operating rooms, in which more than 3,500 interventions are performed annually. Active clinical and experimental research activities, as well as close cooperation with national and international reputable research centers, promote the introduction of innovative treatment techniques that are available only in a few clinics in the world.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the widest range of surgical interventions for the treatment of diseases of the central and peripheral nervous system, including stereotactic surgery and endoscopy. With more than 2,400 operations every year, the department has a unique experience, which allows it to provide the high-quality medical care even in extremely complex clinical cases. The key focus of the department is pediatric neurosurgery. In addition to the high professionalism of doctors, the treatment success is facilitated by exclusively advanced medical equipment, for example, neuronavigation systems and intraoperative fluorescence navigation.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of modern services in this medical field. The high level of technical equipment in the department allows for the performance of all highly specialized surgical interventions to treat pathologies of the central and peripheral nervous system. The clinical practice mainly focuses on the diagnostics and surgical treatment of diseases, injuries of the brain, spine, spinal cord, intervertebral discs, nerve plexuses, functional neurosurgery and the treatment of neurosurgical pathologies in children.
Department of Neurosurgery
The Department of Neurosurgery offers the full range of diagnostics and surgical treatment of diseases of the nervous system. All operating rooms are equipped with the cutting-edge technology, which provides the most reliable and effective treatment of neurosurgical pathology. The department employs competent neurosurgeons with rich clinical experience and deep expert knowledge, who have in their arsenal many modern therapeutic methods.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the central and peripheral nervous system. The priority focuses of clinical practice are the treatment of tumors of the brain, skull base, pituitary, spine, spinal cord, as well as the treatment of spinal disc herniation, spinal canal stenosis, vascular diseases of the brain and spinal cord, pediatric neurosurgical diseases, peripheral nerve disorders, injuries of the head, brain, spine and etc. As one of the largest and leading medical facilities in the field of its specialization at the national level, the department provides each patient with an optimal individual treatment.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of services in the field of diagnostics and surgical treatment of diseases of the nervous system in patients of all age groups. The department was founded in 1947 and during this time it has won the reputation of one of the largest and leading neurosurgical medical institutions in Germany. It performs about 3,000 surgical interventions every year. Also, the department treats and examines more than 15,000 inpatients and outpatients annually.
Prices for Deep Brain Stimulation in Turkey start from 20,000(€). The cost of treatment depends directly on the clinic as well as the method of treatment. Among many hospitals in Turkey, you are sure to find the right one for you.
DBS is a neurosurgical procedure that includes electrical stimulation of certain brain areas with electrodes placed in the brain.
A special device is placed in the chest and it sends electrical impulses to the brain via wires. This stimulation blocks the pathological signals that cause negative symptoms (motor disorders).
Among the ten modern clinics for DBS in Turkey we can highlight the Medipol Mega University Hospital. Surgery here is at a high level and at affordable costs.
Dystonia is the third most common form of movement disorders after Parkinson's disease and essential tremor. Dystonic syndromes are characterized by a disabling painful motor defects with violent movements and the formation of pathological postures. Cervical dystonia causes muscle cramps in the cervical region.
The pathology sharply limits personal adjustment, performance and social activities. It is very difficult to treat. The symptoms of the focal form of the disease can be eliminated by the injections of botulinum toxin. When treating generalized forms, drug therapy is usually ineffective. Only rare forms of cervical dystonia can be treated using levodopa.
Therefore, deep brain stimulation becomes the best option for many patients. It allows achieving a long-term alleviation of symptoms with minimal traumatization during the surgical procedure.
What is deep brain stimulation?
When performing a surgical procedure, a surgeon places an electrode in the target area of the brain. The intervention is performed using a stereotactic method. This means that the surgical procedure requires special equipment that sets the exact coordinates of a certain area of the brain followed by the necessary manipulations – in this case, the implantation of a device for brain stimulation becomes such a manipulation.
Deep brain stimulation (DBS) can be used not only for the treatment of cervical dystonia, but also for movement disorders of a different origin. Depending on the disease diagnosed in the patient, the peculiarities of the clinical picture and the data of instrumental studies, the area of the brain that should be subjected to stimulation DBS is determined.
Here are some of the main areas of the brain, in which the electrode is usually placed to stimulate the brain:
- Internal segment of the globus pallidus
- Ventral lateral nucleus of the thalamus
- Zona incerta
- Subthalamic nucleus
Deep brain stimulation modulates activity of the extrapyramidal system. It normalizes connections between different areas of the brain. As a result, a positive effect of stimulation DBS for movement disorders is achieved due to the normalization of the "brain rhythm". DBS actually imposes on the neurons (nerve cells) a new, correct rhythm.
DBS effects on target areas of the brain are achieved through stereotactic devices, atlases, and navigation programs. They allow to accurately localize the target in a three-dimensional coordinate system and reach it with using minimally invasive surgical techniques, without affecting the nervous tissue.
Deep brain stimulation is considered a functional treatment method for cervical dystonia. Unlike destructive operations, brain stimulation usually does not cause severe complications and neurological disorders. DBS is a sparing, but at the same time effective treatment for cervical dystonia.
How is brain stimulation performed?
Deep brain stimulation involves a surgical procedure to place an electrode. It is placed in subcortical structures.
The electrode is fixed to the bones of the skull. It is connected by a connector to a pulse generator. It is also called a neurostimulator. It is this device that generates impulses for deep brain stimulation. A neurostimulator for DBS is placed under the skin, in the area of the clavicle.
The device must be adjusted. The brain stimulation program is selected individually. The doctor performs the initial setup of deep brain stimulation device. In the future, the DBS program will be adjusted to achieve a better result. Modern brain stimulation devices can be adjusted even by the patient himself. This makes the fight against the disease more effective and more convenient, because if a person is undergoing treatment abroad, he usually cannot visit the hospital, where an electrode for stimulation DBS was implanted, too often. A doctor will teach him how to set up a program. The patient can independently adjust some parameters of deep brain stimulation, such as pulse amplitude, frequency and duration.
How does the procedure alleviate symptoms?
The mechanism of the therapeutic effect of deep brain stimulation is still not understood fully. It is assumed that DBS works by imposing the correct "brain rhythm" on neurons. Thus, stimulation DBS acts as an artificial pacemaker. It provides desynchronization of the pathological rhythm in sensorimotor circles.
Here are some of the additional mechanisms of the influence of deep brain stimulation on the function of the central nervous system:
- Increased synthesis of adenosine triphosphate followed by the accumulation of adenosine, which activates A1 receptors and inhibits the exciting neurotransmission in the thalamus
- Releasing peptide growth factors under the influence of DBS
Is brain stimulation dangerous?
Any surgical procedure on the different areas of the brain is more or less dangerous. Deep brain stimulation involves a neurosurgical intervention, and therefore it can cause complications.
However, if you are undergoing treatment abroad, in the best clinics in the world, then the health risks are minimal. The patients who are candidates for deep brain stimulation are selected carefully. They are examined, and in case of a high surgical risk DBS will be canceled. It is important that a person’s state of health allows him to undergo surgery and effectively interact with doctors when he wakes up from anesthesia during test brain stimulation.
Here are some diseases and conditions that may become contraindications for deep brain stimulation:
- Anticoagulant therapy or coagulopathies that increase the risk of bleeding
- Immunodeficiencies or taking immunosuppressive drugs
- Diabetes mellitus
- Atrophy of the substance of the different areas of the brain
- Implanted pacemaker (reduces the effectiveness of DBS due to the resonance effect during brain stimulation)
- Age over 70 years
Most of these pathologies are relative, and not absolute contraindications to the use of DBS. This means that even this category of patients can undergo deep brain stimulation, but only under certain circumstances. Nonetheless, the surgical risks of DBS will be higher for them. Some patients can undergo deep brain stimulation only after a course of therapy and compensation of the existing chronic diseases.
Peculiarities of brain stimulation for dystonia
The focal forms of dystonia can be alleviated with botulinum toxin, but severe segmental and generalized forms require the use of bilateral deep brain stimulation. In fact, DBS remains the only method of real medical help to such patients who have impaired walking and self-care skills.
The main targets for deep brain stimulation are:
- Internal segment of the globus pallidus
- VIM of the thalamus – in the case of a predominance of dystonic tremor
Internal pallidum deep brain stimulation for dystonia should be intensive. This DBS quickly depletes the battery, which requires replacement or recharging every 2-3 years.
Some patients with dystonia suffer from tremor. They have deep brain stimulation in the VIM of the thalamus, accompanied by a complete regression of this symptom. However, tremor will occur again after DBS completion. Some patients with this disease turn off the device to stimulate the brain for most of the day. They turn it on only in case of the necessity to perform work requiring fine motor skills.
Benefits of brain stimulation abroad
Deep brain stimulation is now performed in many countries around the world. Brain stimulation in the best clinics is more efficient and safe. Some patients from developed countries go abroad in search of an affordable cost of treatment, because the price of deep brain stimulation in their own country may be too high.
The main benefits of brain stimulation abroad:
Diagnostics. The doctors at the best Neurology Centers will carefully examine you to see if deep brain stimulation will be safe and effective.
Selection of patients. The doctors will not perform surgery, if they decide that it can lead to complications or brain stimulation will not be effective enough.
Safety. The doctors conduct test brain stimulation, use state-of-the-art technology to determine functionally important areas of the brain, use minimally invasive methods for implanting electrodes, and use drugs to prevent complications.
Efficiency. The specialists from the best clinics in the world have vast experience in conducting deep brain stimulation. Therefore, they achieve better results in the treatment of dystonia with this surgical procedure.
Cost of treatment. The price of the procedure is significantly different in various countries. You can go to a country where the cost of treatment for dystonia with deep brain stimulation will be affordable for you.
How to undergo brain stimulation abroad?
To undergo treatment abroad for cervical dystonia or other forms of the disease, you can use the services of Booking Health. We will reduce the cost of treatment for you, help you choose a clinic for DBS, and make treatment abroad not only affordable, but also comfortable. You will not have to deal with the organization of a trip abroad to have deep brain stimulation – we will take care of all the organizational issues.
When cooperating with Booking Health, you will get many benefits:
- Selection of the best clinic for treatment abroad, which specializes in deep brain stimulation
- Direct communication with the doctor who conducts DBS
- Reduced waiting time for the start of treatment abroad, appointment for brain stimulation on the most suitable dates
- Reduced cost of treatment abroad – prices will be reduced due to avoiding additional coefficients for foreign patients
- Price control and return of unspent funds
- You will get an insurance, so the cost of treatment will not increase even in case of complications of brain stimulation
- Preparation of deep brain stimulation program without the need to repeat previous diagnostic examinations
- Buying and forwarding medicines
- Communication with the hospital upon brain stimulation program completion
- Organization of additional diagnostics, treatment or rehabilitation for dystonia or other diseases of the nervous system
The Booking Health specialists provide high quality services. We will book a hotel and airline tickets for you, meet you at the airport and take you to the hospital by car, where you will undergo deep brain stimulation for an affordable price.