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Deep Brain Stimulation for Movement Disorders
Monday, July 28, 2014 - 12 Noon (Eastern Time)

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Darlene Lobel, MD

  • Neurological Institute
  • Center for Neurological Restoration
  • Cleveland Clinic

Cleveland Clinic ranks among the world’s leaders in innovative applications of DBS surgery. Having performed hundreds of DBS surgeries, our physicians and scientists continue to gain knowledge about the circuitry that contributes to the development of movement disorders and other neurological and psychiatric conditions.

The Food and Drug Administration (FDA) has approved DBS for the treatment of Parkinson’s disease and essential tremor. It is also approved for dystonia and obsessive compulsive disorder under a Humanitarian Device Exemption.

DBS uses advanced computer technology to pinpoint areas of the patient’s brain where faulty electrical signals are triggering symptoms. Guided by this information, a neurosurgeon makes a small opening in the skull and implants electrodes in targeted areas of the brain. Depending on the patient’s needs, this procedure is done on one or both sides of the body. In order to ensure that the implants are properly placed, the patient may be awake during part of the surgery so that he/she may communicate with the surgical team. Local anesthesia relieves any pain during this wakeful period.

The patient usually goes home two to three days following surgery and returns to the hospital one week later for a second step. At this time, general anesthesia is used as the surgeon implants a battery-powered pulse generator under the patient’s collarbone.

Thin wires placed beneath the skin connect this “brain pacemaker” to the electrodes implanted earlier in the brain. The pulse generator delivers stimulation to these targeted brain areas, blocking the abnormal signals that produce symptoms such as tremor, stiffness and slowed movement.

The patient goes home in less than 24 hours, and returns as an outpatient two to four weeks later to turn on and program the pulse generator. Several visits might be necessary to fine-tune the device to control a patient’s particular symptoms. This process is painless. At home, the patient has the ability to switch the stimulation on or off. The device’s batteries generally last three to five years.

Darlene Lobel, MD, is a Staff Neurosurgeon in the Center for Neurological Restoration in the Neurological Institute. Dr. Lobel performs DBS surgery for patients with Parkinson's disease, tremor, dystonia, and psychiatric disorders, as well as procedures for patients with intractable pain syndromes and spasticity.

Dr. Lobel received her medical degree from the Medical College of Georgia in 2000. She completed her residency in neurological surgery at the same institution in 2006. She then pursued fellowship training in stereotactic neurosurgery and radiosurgery at UCLA, and further training in functional neurosurgery and epilepsy surgery at Emory University, completing her fellowship there in 2007.

Dr. Lobel has many specialty interests including DBS for movement disorders, neuropsychiatric disorders, and emerging indications; frameless DBS; stereotactic neurosurgery; spinal cord stimulation for chronic pain disorders and the surgical management of spasticity.

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