Functional Neurosurgery

Banner Brain & Spine’s neurologists are experts in treating patients suffering from neurological conditions and our functional neurosurgery team focuses on restoring quality of life to our patients. We take a compassionate, collaborative and highly personalized team-based approach to your care. Our experienced doctors are dedicated to getting you answers and solutions quickly, so you can start feeling better and experiencing relief.

What is functional neurosurgery?

Functional neurosurgery consists of various neurosurgical treatments that are aimed to help with chronic neurological disorders such as Parkinson’s disease, dystonia or essential tremors. Our functional neurosurgery team focuses on restoring neurological function and quality of life to patients dealing with chronic conditions affecting mobility and movement.

Chronic conditions treated by our functional neurosurgery team

• Parkinsonian tremor and Parkinsonism: Most patients with Parkinson’s disease experience tremors. Parkinson’s tremors are rhythmic (3-6 times per second, continuous), tend to start on one side of your body and happen when your muscles are still. Other symptoms may include “on” and “off” periods, rigidity and difficulty starting movements. Many of these symptoms can now be relieved through deep brain stimulation (DBS) surgery. Our multidisciplinary team carefully evaluates patients with Parkinson’s disease and can offer surgery to select individuals which can greatly improve quality of life.
• Essential tremor: Essential tremor is a neurological disorder that causes involuntary and rhythmic shaking or trembling of certain parts of the body, most commonly in the hands, head and voice. It is the most common type of tremor and affects millions of people worldwide. Essential tremor can occur at any age, but it typically develops in people over the age of 40. The exact cause of essential tremor is unknown, but it is thought to be related to problems with certain brain areas that control movement and often runs in families. Symptoms of essential tremor can vary from person to person. They may include tremors that occur when the affected body part is at rest, tremors that get worse when the body part is used and tremors that improve with movement or with other activities. It differs from Parkinson’s disease as essential tremor occurs without other neurological symptoms. Treatment options for essential tremor may include medications to control tremors and lifestyle changes (such as avoiding caffeine and alcohol). Some patients may be candidates for deep brain stimulation, which can be very effective in controlling symptoms in selected patients. 
• Trigeminal neuralgia: Trigeminal neuralgia, also known as tic douloureux, is a chronic pain disorder that affects the trigeminal nerve (fifth cranial nerve), which is one of the largest nerves in the head. It is characterized by sudden, severe facial pain that may feel like an electric shock. The pain is often triggered by normal activities such as speaking, eating, brushing the teeth or touching the face. It can last for several seconds to a few minutes at a time. It can happen repeatedly throughout the day. Trigeminal neuralgia is a rare condition that typically affects people over the age of 50 and it is more common in women than in men. The exact cause of trigeminal neuralgia is not fully understood, but it is often associated with compression of the trigeminal nerve by blood vessels or other structures or by multiple sclerosis. It is usually treated with medications and procedures that aim to block the pain signals from the nerve. Stereotactic radiation therapy, direct therapy to the nerve with a needle through the face and microvascular decompression (brain surgery) can all relieve the symptoms. Microvascular decompression (MVD) is the most effective treatment. MVD involves placing a cushion between the trigeminal nerve and the affecting blood vessel. 
• Hemifacial spasm: Hemifacial spasm is a neurological disorder characterized by involuntary contractions of the facial muscles on one side. These contractions can range from mild twitching to severe spasms and may occur frequently or infrequently. It usually starts with twitching of one eyelid and then spreads to the lower face. The eye can be forced closed and the mouth may be pulled to one side. Hemifacial spasm is usually caused by irritation or compression of the facial nerve (seventh cranial nerve) and can sometimes be associated with an underlying condition such as a brain tumor or an abnormal blood vessel. Treatment options for hemifacial spasm may include medications, botulinum toxin (Botox) injections, and surgery. Surgery for hemifacial spasm is very effective and, like microvascular decompression for trigeminal neuralgia, involves placing a cushion between the facial nerve and the affecting blood vessel. 
• Glossopharyngeal neuralgia: A rare disorder causing severe pain in the tongue, throat, larynx, ears and tonsils. It is often caused by a blood vessel pushing on the glossopharyngeal nerve and can be relieved by microvascular decompression.

What is a functional neurological disorder?

Functional neurosurgery (as discussed above) is completely distinct from a functional neurological disorder (FND), which refers to a particular form of brain problem, often called a conversion disorder, in which abnormal brain function causes neurological problems that cannot be explained by a known neurological disorder or other disease. FND initially may be diagnosed by neurologists, then is often treated by psychiatry. 

Psychiatric diseases

More and more, psychiatric diseases are being thought of as disorders of the networks in the brain. Many of these diseases, such as obesity, anorexia nervosa, substance abuse, obsessive compulsive disorder, Tourette’s syndrome, treatment resistant depression, and some others, have been treated with deep brain stimulation. The research on the treatment of these diseases with stimulation is advancing every day and more patients are experiencing good outcomes with this treatment.