Deep Brain Stimulation Gives “New Lease on Life”

Drs. Daniel Kremens and Ashwini Sharan

After shooting an 80 on a round of golf, Steve Probst had had enough.

For most of us 80 would be a good, if not fantastic, score. But Steve, a local golf pro, wasn’t close to satisfied. He knew that his long game – his drives and approach shots – were good enough for him to shoot 70.

“I couldn’t chip or putt,” he says.

Steve had unexplained shaking – essential tremor – and it was negatively affecting every aspect of his life, not just his golf game. Essential tremor is a type of involuntary shaking for which no cause can be identified.

“Try eating a bowl of soup or shaving, when you can’t control the shaking,” he expressed.

Just going out for dinner and drinks was an ordeal for him.

“If I ordered a drink, I had to use a straw,” he says.

And it was becoming difficult, even embarrassing to teach golf. He recalls the frustration of being unable to place a ball on the tee for students, undermining his ability to do his job.

Steve is hardly alone. An estimated 10 million Americans have essential tremor.

“The first thing that is really important is getting the correct diagnosis, because often times it is mistaken for Parkinson’s disease,” says neurologist Daniel Kremens, MD, JD, co-director of Jefferson’s Movement Disorders Program. “Once a diagnosis is made there are medications that are very helpful to treat the tremors.”

Deep Brain Stimulation Therapy

Unfortunately for Steve, and many other patients, the tremors can progress and be resistant to medical therapy, Dr. Kremens notes. The good news is that deep brain stimulation (DBS) can be an effective treatment for these patients.

Steve, who had tried different medicines without any improvement, had seen a TV news magazine piece on DBS and wanted to have the procedure.

The purpose of DBS is to deliver controlled electrical signals to precisely targeted areas of the brain through a tiny, implanted wire. The electrical stimulation helps control the tremors by shutting off the hyperactivity in the portion of the brain that controls this movement.

Steve met with neurosurgeon Ashwini D. Sharan, MD, director of the Jefferson Functional Neurosurgery and Neuroimplantation Center, who works very closely with Dr. Kremens.

“It is a team approach: The surgeon does the surgery and then returns to the neurologist to do the program in the stimulator,” Dr. Kremens explains.

The process of fine-tuning the simulator takes place over the course of three to six months, but Dr. Kremens says the good news is that after this process patients don’t need as many appointments, and they have much better control over the tremors.

“I said, ‘just do it,’” Steve recalls about his decision to undergo the operation. “During the operation they woke me up, and Dr. Sharan asked me to pick up a cup and drink. I was shaking like a leaf. Then he did something and asked me to try again. I did it without shaking at all.”

About three weeks after the procedure – long enough to give his brain time to recover – Steve was back at Jefferson to have the battery implanted to operate the wire that now controls the electrical signals. A couple of weeks later, he went back to Dr. Kremens so the doctor could activate and adjust the stimulator.

The tremors stopped. It’s not perfect, when Steve draws the putter back it can be a little shaky, but the change has been dramatic.

“I have a new lease on life,” he says. ” I can eat. I can have soup. I can shave. And golf, I don’t play as much, but I can chip and putt and I’m doing a lot of teaching.”

Steve is not off all his medications, and if the tremors progress, they can make adjustments to control the problem.

“A lot of people think a tremor is just part of getting old,” says Dr. Kremens. “Many stop socializing or stop going out to restaurants, because they are embarrassed in social situations. For many people deep brain stimulation can significantly improve or eliminate those problems.”

Steve Probst says, “My quality of life has improved tremendously.”

Jefferson’s Movement Disorders Program

The Movement Disorders Program serves as a center for the Philadelphia region’s most complex cases of chronic neurological diseases that include Parkinson’s disease, tremors, dystonia, Huntington’s chorea, Tourette’s syndrome and gait disorders.

Specialists within the Movement Disorders Program work closely with Jefferson’s Department of Neurological Surgery to offer deep brain stimulation surgery for those patients whose conditions don’t respond to medications.

To make an appointment with a Jefferson physician, call 1-800-JEFF-NOW or request an appointment online.

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