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Deep brain stimulation: Tracy’s story

Brain surgery often has a negative stigma around it, and for good reason. The brain is the most complex organ in the human body and most of the time, brain surgery is a major procedure that carries with it the risk of complications that can terrify anyone who must undergo it. But, thanks to the beauty of modern medicine, not all brain surgeries have to be so invasive. Deep Brain Stimulation (DBS) is considered one of the safest and easiest brain surgeries and is widely recommended for those living with movement disorders such as essential tremor, Parkinson’s disease (PD) and dystonia.

DBS is an advanced surgical procedure used to treat the disabling symptoms of movement disorders by using a surgically implanted, battery-operated medical device called a neurostimulator to deliver electrical stimulation to targeted areas in the brain that control movement, ultimately blocking the abnormal nerve signals that cause tremor and other symptoms common in movement disorders.

This innovative treatment is recommended for those who have severe symptoms that cannot be treated with medication and is currently offered at several institutes in Las Vegas as well as Cleveland Clinic main campus. Here at the Lou Ruvo Center for Brain Health, we recently became a feeder location for Cleveland Clinic main campus and this past summer completed a highly successful procedure with one of our patients, Tracy Whitcomb, who flew to Cleveland to undergo a DBS correction procedure by world-renowned neurosurgeon Dr. Andre Machado, head of Cleveland Clinic’s neurological institute.

Whitcomb suffers from essential tremor, a movement disorder that causes involuntary and rhythmic shaking. Typically diagnosed later in life, Whitcomb’s case was unique as she was diagnosed at the in her early 30s and living with severe shaking in her hands. Unfortunately, it is common for essential tremor to not respond well to medication, and this was the case for Whitcomb. Fairly early on, it became clear that DBS was her best route for treatment and she underwent her first DBS procedure at an institute in Southern California in 2006.

One of the great things about DBS is that it has an overwhelming success rate for most patients — we’ve seen up to 50 percent reduction of symptoms for patients with essential tremor and 30 percent reduction for patients with PD. However, the surgery is not permanent and sometimes additional corrective surgeries are required. This too, was the case for Tracy as she suffered from complications after her initial DBS procedure that required her to have five more corrective surgeries.

By the time Whitcomb became a patient of Dr. Brent Bluett at the Lou Ruvo Center for Brain Health in February 2017, she had undergone six DBS surgeries and was suffering from a complication that caused her to have severe electrical surges daily, which she compared to “the feeling of sticking your finger in an electrical socket.”

As movement disorders specialists, we’ve truly never seen a case like Whitcomb’s before and immediately knew that something needed to be done to end these electrical surges, which were emotionally and physically debilitating. It is fairly uncommon for someone to need a corrective DBS procedure, let alone five like Whitcomb, so we wanted to get to the bottom of what was causing these symptoms as well as figure out how to prevent complications like this in the future.

While there are other institutes here locally that do perform DBS, we truly believed that Machado was her best option. She had undergone so much prior to becoming our patient and we wanted to ensure that the next procedure she had would not only correct the issue, but prevent further complications and ultimately, future procedures.

So, in July, Bluett flew with Whitcomb to the main campus to undergo the procedure. Bluett was responsible for all of Whitcomb’s pre-and post-surgery care so we felt it was best for him to travel with her for the surgery to understand the cause of the problem as well as the adjustments made during the procedure.

During surgery, Machado found a fray in the wiring of the implant which he was able to fix as well as reposition the placement of the “connector,” which was moved from her neck to a behind her head, and believes these were two contributing factors to Tracy’s electrical surges. The results of the procedure were truly unprecedented. Since her procedure, Tracy has not had one electrical surge and her tremors are under control and no longer inhibit her in daily life.

DBS is an FDA-approved procedure covered through insurance and we hope to be able to help more patients like Tracy right here in Las Vegas. Through enhanced collaboration between Cleveland Clinic main campus and Lou Ruvo Center for Brain Health, we are thrilled to give Nevadans another care option and provide our patients the ability to receive their DBS implants by one of the best DBS neurosurgeons in the world using state-of-the-art technology on main campus, while receiving all care before and after the procedure at the Lou Ruvo Center for Brain Health.

Having this new DBS option accessible to our patients is just another way the Lou Ruvo Center for Brain Health is continuing to innovate in Nevada. Those interested in learning more about DBS and their options can call 702-483-6000.

Dr. Brent Bluett is staff neurologist at Cleveland Clinic Lou Ruvo Center for Brain Health and Dr. Zoltan Mari is section head of the Nevada Movement Disorders Program and Lee Pascal Parkinson’s Disease Scholar at Cleveland Clinic Lou Ruvo Center for Brain Health.

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