For Referring Physicians
The DBS and Epilepsy Surgery programs within Providence Brain and Spine Institute are a collaborative effort between Providence and The Oregon Clinic. For further program information or assistance with the referral process, please contact Theresa Harczo.
Providence Brain and Spine Institute is building its movement disorders program to better serve patients with Parkinson’s disease, essential tremor and dystonia. Deep brain stimulation (DBS) uses a small device placed under the skin, much like a pacemaker, to send electrical signals to targeted areas of the brain. These electrical signals prevent the abnormal brain messages that cause symptoms of certain movement disorders. DBS therapy can offer improvements in quality of life, activities of daily living, movement control and medication reduction. Most commonly, patients become candidates for DBS once medication alone does not effectively control their symptoms.
At the Providence Brain and Spine Institute we value our network of referring physicians and makes every effort to partner with providers and tailor DBS surgery to the patient. Communication before and after surgery, tailored to the individual needs of the patient, ensures a streamlined preoperative evaluation process, minimizes perioperative stress and discomfort, and facilitates recovery. While the goal is usually to transition the patient back to the referring physician, PBSI neurologists can also assume patient management before and/or after DBS. Arrangements can also be made for device representatives to assist in-person with initial DBS programming sessions. And for patients traveling a significant distance to Portland, PBSI seeks to minimize transportation burdens by coordinating appointments across disciplines in one visit.
It is our preference to perform DBS lead implantation with patient participation in the procedure. We typically use intravenous sedation during headframe placement and drilling, then gently awaken the patient for physiologic testing. This testing provides the highest level of confidence that the patient will have therapeutic benefit from stimulation without intolerable side effects. We further combine physiologic testing with intraoperative CT imaging to achieve excellent accuracy and safety for DBS procedures. We routinely are able to do so while keeping the patient very comfortable. However, for a small subset of patients who are unable to tolerate this process, we are also offer asleep DBS under general anesthesia.
For patients traveling a significant distance to Portland, our goal is to minimize their transportation burden. We can help direct local presurgical evaluations and coordinate appointments across disciplines when a visit to Portland is necessary. While we typically stage DBS procedures (with DBS lead and neurostimulator placement spaced several weeks apart), we will perform single-step procedures for patients who have traveled to Portland for surgery whenever it is reasonable to do so.
At the Providence Brain and Spine Institute we value our network of referring physicians, and make every effort to tailor epilepsy surgery to the patient and to the practice of their managing neurologist. We strive to actively communicate before and after surgery regarding the individual needs of patients undergoing epilepsy surgery. We make it a priority to streamline the preoperative evaluation process, to minimize perioperative stress and discomfort and to facilitate recovery after surgery.
It is our goal to be your partner as your patient goes through epilepsy surgery, and to transition the patient back to your care once appropriate. However, if you would prefer, our epileptologists can also assume patient management before and/or after epilepsy surgery. For device implantation surgeries such as Neuropace or VNS we can also make arrangements for device representatives to assist you in person for the initial programming sessions as necessary.
For patients traveling a significant distance to Portland, our goal is to minimize their transportation burden. We can help direct local pre-surgical evaluations and coordinate appointments across disciplines when a visit to Portland is necessary.