Deep Brain Stimulation (DBS) in Orange County, CA (Mission Viejo)
Deep brain stimulation, or DBS, is a highly successful therapy for patients suffering from Parkinson’s disease and essential tremors. Dr. Taghva is a regional expert in DBS and is unique among neurosurgeons because he has specialized fellowship training in this procedure. Call now to schedule your appointment:
Whereas many practitioners of DBS do not have specialized training and are lacking options they can offer patients, Dr. Taghva has performed hundreds of DBS implants and was the first neurosurgeon in Orange County to perform DBS for epilepsy. He has experience with and routinely implants devices from Abbott, Boston Scientific, and Medtronic and is able to help patients choose the device that may be right for them. Dr. Taghva is a leading surgeon advocate for “directional lead placement,” where highly specialized DBS leads that can steer electrical stimulation are implanted. He has found that this gives patients better results with fewer side effects.
In addition, Dr. Taghva is Orange County’s top implanter of “asleep” DBS for Parkinson’s disease, where patients can be comfortable under anesthesia, and DBS lead placement is completed with highly sophisticated intraoperative imaging. Because of this multimodal approach, the accuracy of DBS placement in his hands exceeds those of traditional awake lead placement – where patients are awake during the DBS procedure.
Dr. Taghva’s DBS patients are among the happiest in his practice and are regional advocates for the therapy. Magazines such as Health Matters have featured his patients as success stories for DBS. Medicare and most private insurance cover DBS.
Dr. Taghva received his medical degree at Johns Hopkins University School of Medicine and his residency at the University of Southern California with fellowship training at The Ohio State University. He is a board-certified neurosurgeon and has been voted by his peers as an Orange County Physician of Excellence consecutively for the past six years and a Super Doctors Rising Star.
Board-certified neurosurgeon Alexander Taghva, M.D., F.A.A.N.S., offers a unique corrective surgical treatment to directly target problematic brain impulses with DBS in Mission Viejo, CA. Patients who have not experienced symptom relief using more conventional treatment methods for conditions such as Parkinson’s or epilepsy may be candidates for the procedure.
- What is Deep Brain Stimulation?
- When will you need Deep Brain Stimulation?
- Who is a Candidate for Deep Brain Stimulation?
- A Deep Brain Stimulation Consultation
- Preparing for Deep Brain Stimulation Surgery
- The Day of Deep Brain Stimulation Surgery
- Deep Brain Stimulation Recovery
- Tips To Keep Your DBS Recovery On Track
- What Are the Possible Side Effects or Risks of DBS Surgery?
- Frequently Asked Questions About Deep Brain Stimulation
What is Deep Brain Stimulation?
DBS is a form of neurosurgery that treat certain medical problems by providing electrical stimulation to a specific region of brain tissue. The method, often referred to as a “pacemaker for the brain,” usually occurs over two different operations.
During DBS surgery, a stimulator device system is inserted into the brain through a small opening in the skull. The surgeon is guided with a type of imaging provided by magnetic resonance imaging (MRI), CT scanning, or a computer program. Dr. Taghva implants wire electrodes into the side of the brain on both the left and right, targeting parts of the brain where abnormal nerve signals are generated, creating a roadmap of your brain with images obtained from MRI. The electrodes are held in place by small disks that are secured on top of the brain.
At a later date, wire leads are connected to the electrodes and placed below the skin, following the curvature of the head and neck. There is a connection between the wires and a pulse generator in the chest wall below the collarbone.
Local anesthesia is an option for patients who want to stay conscious during the procedure. This allows neurosurgeons to observe the real-time effects of their surgery; however, since the brain has no pain receptors, some neurosurgeons choose to perform a different version of DBS surgery while patients are fully asleep.
Three to six weeks later, patients will return to the operating room to undergo the placement of the pulse generator. The surgeon will typically complete this procedure on an outpatient basis. During another appointment, the surgeon programs the patient’s DBS system to deliver the type of electrical signals that will be most beneficial for the patient’s condition.
When will you need Deep Brain Stimulation?
The FDA has granted approval for DBS as an effective treatment option after successful clinical trials for various neurological disorders which can have a major impact on patient’s lives:
- Parkinson’s disease and essential tremor – 1997
- Dystonia – 2003
- Obsessive-compulsive disorder – 2009
- Epilepsy – 2018
For those who have not had positive outcomes from other forms of treatment and for whom symptoms are greatly impacting their day-to-day life, DBS surgery is a suitable option. DBS offers relief from these symptoms, delivering electrical stimulation to the interfering brain cells without causing the side effects associated with medication.
Researchers are currently exploring the potential of DBS to treat various other medical issues, such as multiple sclerosis, and psychological treatments, like major depression. It is possible that in the future, DBS will be an effective option for these conditions.
Who is a Candidate for Deep Brain Stimulation?
Dr. Taghva examines everyone to determine the most suitable treatment course for them. Typically, candidates for DBS in Mission Viejo fall within two types: patients with movement disorder symptoms or mental health problems.
A range of movement disorders results from a neurological issue like Parkinson’s disease, which creates involuntary movement and motor symptoms that disrupt a patient’s regular abilities and daily activities. Parkinson’s disease symptoms include tremors, bradykinesia (slower-than-normal movements), muscle rigidity, and poor balance or posture.
A patient’s quality of life diminishes significantly when they show uncontrolled movement. DBS of the globus pallidus internus or subthalamic nucleus can treat isolated dystonia (uncontrolled muscle contractions) with or without tremors and with no additional neurological issues.
Certain neuropsychiatric conditions, such as obsessive-compulsive disorder (OCD) and Tourette syndrome, can manifest as mental disorders originating from the nervous system. Electrical impulses help to manage symptoms associated with these disorders.
Those with dementia and severe untreated depression are not candidates for DBS in Dr. Taghva’s Mission Viejo practice. DBS can worsen memory problems and lead to suicidal ideation. After treating depression, surgery may be a good treatment option.
A Deep Brain Stimulation Consultation
In his private consultation with patients in Mission Viejo, CA, Dr. Taghva thoroughly evaluates each case to determine if DBS or an alternative treatment is the best option for complete pain relief. He will recommend this advanced surgical procedure for individuals whose symptoms of an approved DBS condition are moderate to severe, who have tried other treatments that were not successful, and who would benefit from fewer side effects from medications. Qualifying patients must also meet the general requirements for being viable candidates for surgery.
The DBS consultation is lengthier than other procedures because preoperative evaluations are typically conducted as a series of tests. In many cases, patients may need to be evaluated both on and off their medications. Because DBS can treat numerous conditions, the prerequisites for surgery will differ from one patient to the next. Assessment may involve consulting with several healthcare providers.
During a consultation with Dr. Taghva, the neurosurgeon works with the patient to prepare an optimal treatment plan. In some cases, the recommendation may include DBS surgery.
Preparing for Deep Brain Stimulation Surgery
DBS in Orange County may require a series of tests prior to treatment. Your physician will recommend you cease any medications for the duration of testing. If discontinuing medications isn’t an option, sedation DBS may be a feasible solution.
DBS candidates should have a physical exam conducted by their primary care physician, blood tests, an electrocardiogram (EKG), and a chest X-ray. This helps Dr. Taghva determine that the patient is healthy enough for the procedure. Before the procedure, you should discuss chronic illnesses and related medications.
The Day of Deep Brain Stimulation Surgery
Patients are typically awake during DBS surgery in Orange County. However, there is a newer technique while the patient is asleep during the procedure.
The doctor carefully puts on a frame to the head of the patient, who is conscious yet calm so that they can perform surgery. Dr. Taghva administers topical anesthetic (numbing) as pins penetrate the forehead and the posterior of the skull with the framing device. With this frame in place, patients will have an MRI, or CT scan revealed for Dr. Taghva and his surgical team to observe the brain in correlation with pin placement in the frame.
Computerized equipment, a mobile X-ray unit, and a robot ensure the accurate placement of the electrodes in the brain. Different pieces of equipment, like an arc, can be fitted to the frame on the head to aid precision.
Once the electrodes are in place, the surgeon will activate the deep brain stimulator system. Dr. Taghva will be able to view symptom changes and any side effects while adjusting the impulses. After the placement of the electrodes, there will be more captured images to confirm proper placement.
Call today to schedule your consultation
The surgeon performs DBS while the patient is fully asleep. The procedure begins inside an MRI machine, which provides real-time visualization. While X-rays take still snapshots of the brain and can offer image guidance on the area before and after each change, an MRI provides continuous imaging to check brain performance.
An aiming device is placed on the scalp, which enables visibility and adjustments to be made while the patient is in the MRI machine. The deep brain stimulation device creates points that will show up on computerized equipment. This allows the neurosurgeon to plot the correct points for electrode placement.
Deep Brain Stimulation Recovery
After DBS, patients will undergo a healing process that is unique to their situation.
After surgery, patients may experience slight discomfort in the area of their incision and pin sites where the doctor administered anesthesia. However, since the brain has no pain receptors, it will not feel pain. To ensure your comfort during this process, Dr. Taghva will provide you with the necessary pain medications before your operation.
Patients may also feel some discomfort at the site of the pulse generator for a period of time. With an adjusted medication regimen and the initial programming of the stimulator device, patients may notice different sensations or muscle involuntary movements.
Four to six weeks postoperatively, the team can begin programming the system. It can take a few to several months to adjust the settings of the DBS generator for the best results. Patients must adhere to any restrictions provided by Dr. Taghva for the safest recovery and best results.
Tips To Keep Your DBS Recovery On Track
The following are some ways to keep your brain surgery rehabilitation on the right track. Depending on your specific recovery plan, you will benefit in different ways.
Attend your DBS follow-up appointments
Your neurosurgeon will likely want to see you in various increments after your surgery. Be sure to make these appointments a priority. Your doctor will use these to catch any issues and recommend further action.
Ask for help during your DBS recovery
Over 1.5 billion individuals suffer from a chronic pain condition. However, they should not have to go through this on their own. If your body cannot carry out particular tasks due to physical discomfort, do not be afraid to seek assistance.
Follow your DBS specialist’s instructions
You may attend physical therapy or see a speech-language pathologist following your surgery. If they give you exercises to perform at home, be sure to stick with these. Your progress may depend on it.
Even after this minimally-invasive procedure, patients may take time to heal. Know that progress will come, and be patient with your body.
Call your doctor about post-DBS issues
If you experience seizures, chronic pain symptoms, numbness, or other neurological complications, call 911 or your doctor immediately. This depends on the severity of the situation.
What Are the Possible Side Effects or Risks of DBS Surgery?
While Dr. Taghva takes every precaution possible, DBS has inherent risks. Patients can discuss any concerns about this treatment at Orange County Neurological Associates with Dr. Taghva during their consultation. Deep brain stimulation risks may include:
|Stroke||Hemorrhage||DBS system malfunctions|
|Adverse effects of stimulation||Worsening memory||Suicidal ideation|
Why Choose Dr. Taghva for Deep Brain Stimulation?
Alexander Taghva, M.D., F.A.A.N.S. is board certified in neurosurgery and is an expert in deep brain stimulation surgery to treat Parkinson’s disease and minimally invasive spine surgery orange county.
The doctor completed his undergraduate education at the University of Southern California and graduated summa cum laude with a biochemistry degree. He attended Johns Hopkins University School of Medicine and completed a neurological surgery residency program at the University of Southern California. Dr. Taghva went on to complete a fellowship in neuromodulation and functional neurosurgery at Ohio State University.
The doctor maintains memberships in a number of professional groups and practices modern neurological surgery techniques. Read more about Dr. Taghva here.
Frequently Asked Questions About Deep Brain Stimulation
DBS is reversible. Older techniques used heat to treat patients, which could lead to permanent tissue damage; however, technological advancements have allowed this method to be a reversible yet permanent medical therapy.
Younger patients are generally better candidates for any surgery, and DBS is no exception. Some patients may opt to undergo the procedure when they have moderate effects, knowing that they have a progressive disease.
Healthy older individuals with moderate to advanced conditions might also determine that DBS surgery would benefit them. Each patient should discuss the timing of the procedure with Dr. Taghva, as each individual situation is unique.
DBS should not be thought of as a means to cure or slow the progress of a condition or disease but rather as a way to manage its symptoms. Most patients will need to continue their medication regimen, but their dosages can be adjusted based on the efficacy of the deep brain stimulation systems. With some conditions, full relief can be noticed after 3-6 months.
Even with advances in medicine, there is still much we do not know about brain anatomy. Previously, it was thought that the signals in the brain were entirely blocked during DBS, but it is now suggested that neurons continue to fire, but the signal of information is somehow prevented from completing the transfer of electrical information that leads to certain symptoms.
The thalamus, subthalamic nucleus, and globus pallidus are three common areas of the brain that can be targeted for tremors and other symptoms brought on by Parkinson’s.
Mission Viejo neurosurgeon Dr. Alexander Taghva specializes in DBS treatment and minimally invasive spine surgery known as spinal cord stimulation, or SCS. Using the same technology, electrodes affect nerve structures in the spinal cord to manage ongoing pain, and a controllable pulse generator is implanted in the chest wall below the collarbone.
Rather than delivering electricity to pace the heartbeat, these devices deliver electrical pulses to interfere with nerve signals. Both the SCS and the DBS systems are highly customizable by experts with patient feedback.
If you live near Mission Viejo, CA, Dr. Taghva offers Deep Brain Stimulation surgery among its services, and is conveniently located at 26732 Crown Valley Pkwy Suite 541, Mission Viejo, CA 92691
Dr. Taghva is proud to offer patients innovative treatments like deep brain stimulation in Mission Viejo, CA, to improve their quality of life. To schedule an appointment, call (949) 388-7190 today.