Imagine that your hand or arm shakes so badly that you can’t write your name, get dressed or feed yourself. Or that your muscles freeze up when you try to get up out of a chair or walk across a room.

People with Parkinson’s disease, like 58-year-old Robert “Zeke” Turner of Huntsville, Ark., deal with the debilitating effects of this degenerative disease on a daily basis when the medications used to treat symptoms of Parkinson’s no longer work for them.

Turner, a retired professional land surveyor, was diagnosed with Parkinson’s shortly after an episode in 1998 when he couldn’t kick the head off a dandelion while working in his yard one afternoon.
“I just couldn’t initiate the kick … I got stuck,” he says.

He eventually had to retire early from his profession, a job that he loved.
“Medicine helped for awhile, but I developed a tolerance to it and it got so that I was afraid to drive, which I had to do a lot for my job,” he says.

A new procedure – called deep brain stimulation, or DBS, has proven to control the tremors, muscle stiffness and slowness of movement for patients like Turner with Parkinson’s, as well as for patients with dystonia and essential tremor. DBS can also be used for chronic pain and is being researched for the treatment of obesity and severe depression.

Dystonia refers to a group of complex muscle disorders that involve involuntary twisting, repetitive movements that cause abnormal, sometimes painful positions. Essential tremor refers to the rhythmic shaking of a body part, usually a hand or arm, especially when the person tries to do something like hold a pen or cup.

Earlier this year, Turner’s neurologist in Fayetteville, Ark., recommended Turner consider deep brain stimulation.
The Fayetteville neurologist referred Turner to St. John’s neurosurgeon Alan Scarrow, M.D., (below, left) who performed the procedure in June. DBS has been available at St. John's for about two years, he says.

“Accuracy is very important in this procedure because we have to have exact placement of the electrodes for it to work optimally,” Dr. Scarrow says. “We do a CT scan and an MRI before the procedure so we can target the problem area. The patient is awake during the procedure, but we have a movie playing on a laptop to distract them from the procedure as much as possible. With tremor patients, we can often see their response immediately because their shaking stops once we have the electrodes placed exactly where they need to go.”

Turner sees St. John’s neurologist Thomas Habiger, M.D., (below, right) regularly for adjustments to the neurostimulator and to his Parkinson’s medication.

While some patients may be able to stop taking medication for their Parkinson’s, most, like Turner, still need to take some, albeit a reduced amount from what he was taking before the DBS procedure.

“DBS is in essence 24-hour medication for Parkinson’s, dystonia and essential tremor patients. A part of their brain is hyperactive; the electrodes used in DBS stimulate and depolarize the cell membranes in the area of the brain where the problem is. The cells can’t fire anymore, so the tremors, involuntary movements or muscle stiffness disappear or are greatly reduced,” Dr. Habiger says.

Turner’s improvement after the surgery was immediate and he says he didn’t feel anything during the procedure and doesn’t notice the neurostimulator under his collarbone much. He sees Dr. Habiger every three to four weeks. The visits will become farther apart over time as Turner improves and requires fewer adjustments in stimulation and to his medication, Dr. Habiger says.