Deep brain stimulation in Kazakhstan

The whole procedure is divided into two conditional stages:
Stage 1 - bilateral implantation of deep electrodes;
Stage 2 - implantation of a permanent pulse generator and extension cables, followed by connection of the system.
In some clinics, both stages are carried out on the same day, in others - on different days. In addition to the neurosurgeon, a neurologist, a neurophysiologist, an anesthesiologist, an anesthetist nurse, an operating room are involved in the process of installing the stimulation system.
nurse, x-ray laboratory assistant, technical staff.
In our clinic, the implantation procedure is carried out simultaneously in the general neurosurgical operating room, equipped with the necessary anesthetic and operating equipment. Operating table
equipped with a head fixation system, has the ability to change the position up-down, right-left. Sufficient illumination of the surgical field with a regular ceiling lamp is a prerequisite, because the procedure does not use a microscope with illumination. As mentioned above, taking levodopa and other antiparkinsonian drugs is canceled 12 hours before the start of the procedure, because. clinical symptoms of Parkinson's disease are required for intraoperative clinical testing. In special cases, when the abolition of levodopa causes difficulties in the installation of a stereotaxic frame due to severe tremor, medication may be taken in order to relieve symptoms and properly prepare the patient. Below is a description of the procedures and manipulations with a stereotaxic system manufactured by Elekta (Sweden), as well as implantable devices for DBS Activa PC, manufactured by Medtronic (Minneapolis, USA), which are used in our clinic.