This health video will explain about Neurostimulation the symptoms and how to manage the pain.
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What is Neurostimulation? Dr. Ken Follet: Neurostimulation involves, what we refer to as modulation of the nervous system. We use a small device that's very much like a cardiac pacemaker, Heart Pacemaker, that's attached to a small wire that can be placed over one of the nerves in the arm or the leg or over the spinal cord. Dr. Nagy Mekhail: So, simply it has an electrode, multiple electrodes on a wire, that we insert on the spinal cord and that can be operated by a battery that can be implanted into the body. When this is turn it on, it does several things, that we understand now and there are several things that we really don't understand yet. Dr. Ken Follet: This device electrically activates nerves in the body or in the spinal cord and somehow seems to block the transmission of pain signals to the brain. So patients will typically feel a light vibration or tingling sensation that, in essence masks the pain, after 20 or 30 minutes they began to forget about the tingling sensation, so they simply left with no pain. Dr. Nagy Mekhail: Some of the things that happens right away, that it blocks the pain processing. So, a patient will feel some tingling sensation in the area of the pain but the painful impulses are blocked from reaching the central nervous system. Dr. Ken Follet: And where we implant it, is based on the location to pain. So we want to place the stimulator over the nerves that are somehow responsible for the pain, if it's on an arm or a leg, or we can very easily place the wire in Spinal canal gently just through a needle which allows us to stimulate nerves in both legs or both arms, give us a much broader area of coverage. The intensity is strictly based upon what the patient feels as comfortable. Patients have their own small remote control device and they can adjust the strength of the stimulation to whatever is comfortable. Dr. Nagy Mekhail: Another added function or benefit after a while is, it stimulates the body to secret the endogenous morphine like substance, Endorphins. It improves the circulation especially in the Periphery and that's why we use it for Peripheral Vascular disease or most recent indication for Intractable Angina. Dr. Ken Follet: There are two different types of Neurostimulation systems. One involves the use of a completely implantable battery pack, very much like a heart pacemaker. Everything is implanted underneath skin, the patient can turn the device on and off and make adjustments using a small remote control device, that sends signals through the skin to the battery pack. The other type of stimulation system involves what's called an External Transmitter. The patient has a small pack inserted under the skin about the size of the pacemaker which is a receiver. The patient then has a small device that he or she would wear on the belt or tuck in a pocket that's attached by a wire to a sticky patch, which goes on the skin over the receiver. This external system actually sends signals through the skin to activate the stimulation system. It's a little bit like the electric tooth brushes, that recharge, when they are placed in the plastic base. The advantage of the external system even though, it's a little more cumbersome for the patient is that it uses run of the mill 9 volt battery, when the battery goes dead they can pop back up and put in a new battery. The completely implantable system, the internal system is much more convenient for the patient because there's nothing to wear on the belt or in the pocket. But on the other hand when the battery becomes depleted which is typically 3-5 years depending on use, we need to replace the battery pack through a simple surgery. Dr. Nagy Mekhail: It is very good modality to treat chronic pain but it has to be applied in the right patients setting. As any technique and medicine, if you could apply it in the right patient, was proper patient selection, patient education, it is like a miracle. I'll never forget a patient I tried Neurostimu