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Neuroscience (SNI) Blog

'Neuroscience Institute' Neuroscience (SNI) posts

Study Makes Waves in Treating Essential Tremor

The treatment of neurologic disease took a major step forward this past week with the publication of a clinical trial that used ultrasound waves to treat Essential Tremor.  Essential tremor affects about 10 million people in the USA and can be extremely disabling. For patients that fail medical therapy invasive surgical options are considered, including deep brain stimulation (DBS). DBS surgeries involve drilling a hole in the skull and implanting an electrode into structures deep in the brain to turn off the unwanted signals that cause the tremor.

A study of 15 patients lead by Dr. Jeff Elias (University of Virginia) was published in the New England Journal of Medicine this week and describes how researchers used ultrasound waves to effectively treat Essential tremor non-invasively – no cutting or drilling:

 

Treating Arteriovenous Malformations to Remove the Risk of Rupture

An arteriovenous malformation (AVM) in the brain is a relatively rare condition – occurring in less that 1 percent of the population. It can, however, be neurologically morbid in young adults ages 15 to 20, who are at the greatest risk for hemorrhage and least likely to exhibit symptoms. About 2 to 4 percent of all AVMs each year hemorrhage.

An AVM’s tangled mass of blood vessels, which forms in utero, produces multiple direct connections between arteries and veins without the normal, intervening capillaries. Symptoms often are not present until later in life or until after the AVM ruptures.

A small number of congenital syndromes, such as Sturge-Weber, Rendu-Osler-Weber, ataxia telangiectasia, and Wyburn-Mason, are associated with AVMs. Once formed, extrinsic factors, such as arterial shunting, growth factors and intracranial hemorrhage, may alter the size and shape of an AVM.

The most common types of AVMs are:

Carotid Stenosis: What you need to know

Carotid stenosis is a build of up plaque in the large arteries that supply the brain with blood. This buildup of plaque increases the risk of transient ischemic attack (TIA) and stroke. Risk factors for carotid artery stenosis include hypertension, hyperlipidemia, obesity, and tobacco use. Symptoms of carotid artery stenosis include facial droop, weakness or numbness on one side of the face and body, slurred speech, garbled speech, gait instability, dizziness, and visual disturbances including blurred vision, loss of vision and double vision.

Carotid artery stenosis can be diagnosed with several diagnostic studies including carotid ultrasound, MR angiography (MRA), CT angiography (CTA), and cerebral angiogram.

Treatment options for carotid artery stenosis vary depending upon the severity of stenosis, history of TIA or stroke, and...

Dystonia Forum at Swedish Cherry Hill

We are excited to offer our annual Dystonia Forum coming up this Thursday at the Swedish Cherry Hill Campus. Click here to see the event flyer. It is not too late to register for lunch and a session that is sure to be informative and supportive. Hope you can join us!

The benefits of DBS and neuromodulation: helping patients

After working in the field of neuromodulation for the past 25 years, I have seen many advances in the field; both in our understanding of the nervous system, and new technology designed to target specific neuronal pathways that will offer the best outcome for patients. It is an exciting field with new investigations that lead to ever expanding knowledge. However, what really keeps me interested in the field after all these years is the opportunity and privilege to be a part of our patients lives on a daily basis. The picture and comment shared below from a grateful patient who had DBS with us two years ago says it all…

"I look back on my experience at Swedish with a grateful heart... thankful for every day I've been given.."

How much tremor is too much?

Tremor is a normal physiologic reaction to anxiety or stress, but it is not normal to have a tremor when performing typical daily activities.

People who develop a tremor while eating, drinking, writing or doing other common activities may have a movement disorder called Essential Tremor. This is actually the most common movement disorder, and can affect up to 4% of people over age 40. People who have this disorder can take medications to help minimize the tremor, but they don't often reduce the tremor by more than about half. Deep brain stimulation (DBS) is an excellent treatment option for people with severe tremor, and can nearly eliminate the tremor in many patients. Many patients aren't sure when their tremor is severe enough to warrant surgery, and much of our conversation in the office is to help answer this question.

There is no one answer that is right for everyone, but for me it has to do with how well someone is actually doing in their daily life:

New considerations given about when to refer for Deep Brain Stimulation

Every year in the fall, our Swedish DBS Team has a table in the exhibit area at the Hope Conference for Parkinson's Disease. It is a wonderful opportunity to meet people in the PD community, and spend time chatting with our other neuroscience colleagues from centers in the area.

I am always surprised by the numbers of people who come by and say, “I am not ready, my disease is not bad enough, I am too young, or I haven't had PD long enough”...

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