high yeild

Question 1

Neuromodulation

Answer 1

Definition is the application of targeted electrical, chemical and biological technologies to the nervous system in order to improve function and quality of life.

Question 2

Primary goals of neuromodulation (4 points)

Answer 2

1. To attain a significant reduction in pain (greater than 50%)
2. To attempt to decrease or eliminate analgesic medications
3. To attempt to improve one’s quality of life
4. To increase the possibility of returning to work

Question 3

Advantages of neuromodulations (4 points)

Answer 3

1. Neuromodulation alleviates or lessens pain without putting patients into a “drug fog.
   2-Neuromodulation is administered via minimally invasive techniques
   3-Extensive research and clinical trials have documented neuromodulation’s ability to decrease chronic pain and improve the quality of life for patients.
2. Neuromodulation implants can be removed Once implemented, if the patient chooses to stop the treatment, the device can be removed. The procedure is reversible.

Question 4

Used in pathlogies like (7 points)

Answer 4

a) Spasticity
b) Parkinson’s disease, other movement disorders
c) Cortical stimulation for stroke
d) Pain
e) Epilepsy
f) Intractable nausea
g) Cochlear implants

Question 5

Neuromodulation comprises
____treatment modalities:

Answer 5

a) spinal cord stimulation,
b) spinal drug delivery system
c) brain stimulation by three different types
1. Deep brain stimulation (DBS)
2. Transcranial magnetic stimulation (TMS)
3. Vagal nerve stimulation
d) peripheral nerve stimulation

Question 6

DBS

Answer 6

is a surgical treatment which implants a medical device called a Brain Pacemaker.

Question 7

choice therapy for movement disorders

Answer 7

DBS

Question 8

Neuromodulation helpful in movement disorders like

Answer 8

A. Parkinson’s disease: STN stimulation may be superior to best medical management· because of similar efficacy to levodopa with fewer side effects (primarily dyskinesias)
B. dystonia:
C. tremor:

Question 9

Neuromodulation helpful in psychiatric disorders like

Answer 9

1. Tourette syndrome: thalamic & pallidal DBS
2. obsessive compulsive disorders: anterior capsule and STN stimulation and, recently, targets more posterior and rostral
3. depression: subgenual cingulate gyrus and anterior capsule stimulation

Question 10

DBS system consists of _____ parts

Answer 10

i)The IPG : is a battery-powered neurostimulator encased in a titanium housing, which sends electrical pulses to the brain to interfere with neural activity at the target site.
(ii)The lead: is a coiled wire insulated in polyurethane with four platinum iridium electrodes.
(iii)The Extension: it is an insulated wire. The lead is connected to the IPG by the extension.

Question 11

contraindication to DBS

Answer 11

1-Patients with a previous Surgical Ablation procedure
2-Patients who are pregnant
3-Patients under the age of 18 and above 75

Question 12

DBS electrod placement steps

Answer 12

planning and intraoperative

Question 13

6 steps in surgery

Answer 13

Step 1:Attachment of stereotactic frame.
Step 2: Take MRI or CT scan
Step 3: Skin and Skull incision
Step 4: Insert electrode in the brain
Step 5. Stimulate the brain cells
Step 6: Closure

Question 14

the battery placed to …

Answer 14

below the clavicle or in some cases the abdomen