Photo essay at the Regional University Hospital of Lille, Salengro Hospital, department of neurosurg Treatment of Parkinson’s disease by bilateral thalamic stimulation.
The patient is awake. A neurophysiologist uses five test probes so as to stimulate the targeted area (subtalamic region) until the obtention of an optimum neural signal. The latter will be chosen for the implantation of the definitive electrode. A neurologist physically stimulates the patient in parallel so as to precise the physical benefits of this signal. It is an electrical stimulation undertaken through an electrode placed at the level of a thalamic nucleus, the Ventral Intermediate Nucleus (VIM). This electrode is set up surgically, thanks to a nanopositioning system, after neuroradiological spotting, undertaken under 3D MRI, and neurophysiological by detection and recording of cellular activities. The electrode is linked to a programmable subcutaneous stimulator. The intervention can be bilateral. A quadripolar electrode, proposed after the initial notice of the CEDIT(Comitee for Evaluation and Diffusion of Innovative Technologies), has rapidly imposed to different teams using this technique ; the evacuation protocole has been amended accordingly.