When uncontrollable trembling affected his arms and hands, Kevin Dickerson, an electrician, feared for his ability to continue to work. When the trembling worsened, even performing everyday tasks like eating and drinking became a significant challenge.
Kevin has a neurological condition called essential tremor, which can cause rhythmic shaking of the hands, head, voice, legs and trunk. Frequently confused with Parkinson's disease, essential tremor is about 8 times more common. Kevin wasn't unfamiliar with it, as his mother had been diagnosed with it years before, but the disease seemed to affect him more severely and at a younger age.
"I noticed the symptoms 10 to 12 years ago, but they grew much worse in the last 4 or 5 years," he says. "It became really tough to do anything involving fine motor skills. The day to day, like eating and drinking was difficult, and working as an electrician became downright risky. If you cross wires, cross a positive and a negative, that can make for a real mess."
Kevin – who lives in Topeka, Kansas, with his wife, Debbie, son, Riley and daughter, Elizabeth – visited his local doctor. He tried a variety of medications, but wasn't satisfied.
"By the time I was taking enough that I was feeling relief from the tremors, I had too many side effects," he says. "I was extremely drowsy and fatigued. I didn't even feel like myself. I thought the tremors were just something I was going to have to live with."
But then Kevin discovered another option.
New technology, new hope
Kevin saw a television commercial that introduced him to a new possibility. The commercial described a procedure called deep brain stimulation (DBS) offered at The University of Kansas Health System. The DBS system delivers electrical pulses to the area of the brain that causes the symptoms of essential tremor. A neurosurgeon implants wires called leads into the brain. They connect to a generator implanted in the body. The generator sends pulses to the leads, which stimulate the affected area of the brain, blocking the signals that cause involuntary movement.
"When I saw this, I was eager to learn more," Kevin says. "I'm getting older, I suppose, but I'm only 50. I'm not that old! It was extremely encouraging to find out there was something I could do."
Kevin scheduled a visit with neurologist Vibhash Sharma, MD. Dr. Sharma conducted a thorough evaluation, including testing Kevin's ability to perform various functions like writing his name and bringing a cup to his mouth.
"He said we would try additional medicines or proceed to surgery," Kevin says. "I was game to move forward with the DBS."
Kevin received a DBS implant in November 2016, a procedure on the left side of his brain to control the right side of his body. He remained awake and aware during the surgery – an option he chose over general anesthesia – as his response to various instruction such as raising his arm helped neurosurgeon Jules Nazzaro, MD, precisely pinpoint the ideal locations for the DBS leads. Dr. Nazzaro performs more of this type of DBS surgery than almost any other physician in the country.
"While DBS has been in use for more than 20 years, the latest technology with its additional leads allows us to be more exact than ever in placing leads into the brain," explains neurologist and movement disorder specialist Rajesh Pahwa, MD, program director of The University of Kansas Health System's nationally recognized Parkinson's Disease Center of Excellence. "We used to view the brain in 4 quadrants, but the new technology allows us to view it in 8 sections, better targeting the area of the brain causing the tremor and avoiding delivering electricity to healthy tissue. We have unprecedented control and focus."
Kevin says it was a unique experience to play an active role in the success of the procedure.
"Being awake during surgery was strange, but there was no sensation and no pain," he says. "It was very interesting to actually help the team determine exactly where to place the electrode to give me the greatest benefit."