NeuroRestorative Program Helps Patients Regain Function Lost to Pain, Movement Disorders and Epilepsy

George Mandybur, MD, left, and at right performing deep brain stimulation surgery at the UC Medical Center. Photos by Mayfield Clinic.

A new neurosurgical program at the University of Cincinnati Gardner Neuroscience Institute is helping restore function needed for everyday living in patients who have been plagued by chronic pain, facial pain, epilepsy and movement disorders.

“This much-needed program is helping restore patients back to a higher level of function,” says Program Director George Mandybur, MD. “In contrast to a rehabilitation program, in which the patient strives to get better by improving the condition of his or her body, our NeuroRestorative Program improves patients’ functionality by giving them something they cannot get with rehabilitation. This improvement comes in many forms, from decreased pain to eliminated tremors or seizures.”

Surgical changes can involve additions, such as the implantation of electrodes, spinal stimulators and pain pumps. Or, in the case of facial pain (trigeminal neuralgia) and epilepsy, surgical restoration can involve a subtraction, such as the numbing or severing of a nerve that is causing excruciating pain or the removal of an area of the brain that is causing seizures.

Dr. Mandybur is Associate Professor and Director of the Division of Functional and Stereotactic Neurosurgery at UC.Restorative procedures are varied, and many have been available for years.

•    Patients who have lost quality of life because of tremor may be given the chance to eat, drink and write again with the help of deep brain stimulation (DBS) surgery, which involves the implantation of a neurostimulator under the collarbone and electrodes deep within the brain. Patients with Parkinson’s disease who undergo DBS surgery often are able to decrease their medication and experience an improved quality of life.

•    Patients with temporal lobe epilepsy – epilepsy in the part of the brain just above the ear – may experience a complete reduction in their seizures if the source of their seizures (the seizure focus) can be surgically removed.

•    Patients who suffer chronic pain in the spine, or limbs (arms or legs) may benefit from implanted pain pumps or spinal stimulators that interrupt pain signals and prevent them from reaching the brain.

•    Patients with trigeminal neuralgia typically experience life-changing relief after surgical treatment for their searing facial pain, which occurs when the facial nerve is compressed by an artery, vein or tumor. The NeuroRestorative Program offers many different treatments for this facial pain, which can be tailored to the individual patient.

The NeuroRestorative team collaborates closely in an integrated, multidisciplinary fashion with specialists from the UC Epilepsy Center, the James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders, the Neurosensory Disorders Center and the Waddell Center for Multiple Sclerosis.

The team also works with the UC Health Pain Medicine Center, and it has been given the green light by UC’s Institutional Review Board (IRB) to offer DBS surgery as a treatment for people with obsessive-compulsive disorder.

“We’re the hub of a wheel,” Dr. Mandybur says. “We work with multiple groups. Our skills can be used to serve patients who are treated for mood disorders, movement disorders, epilepsy and pain. Sometimes you have a tool – such as DBS – that has many different applications.”

Research that benefits the Gardner Center as well as the NeuroRestorative Program will get a boost from a tennis round robin and wine-tasting event, “Serve an Ace for Parkinson’s,” to be held from 6 to 10 p.m. Saturday, Jan. 19, at Five Seasons Sports Club in Symmes Township. Proceeds from the fundraiser will support the purchase of computer hardware and software that will give the surgical team new capabilities.

“The computer upgrades will give us insight into what’s going on in the brain,” Dr. Mandybur says. “The new equipment will be used in research to improve the effectiveness of DBS in Parkinson’s disease.”

Dr. Mandybur, who is listed in the 2013 Best Doctors in America®, has seen his prominence rise internationally. In September he spoke at the First China Forum of Pain Medicine in Beijing and gave seven additional lectures and a demonstration lab during a 10-day tour of China. Dr. Mandybur’s tour lectures, which covered pain, epilepsy and movement disorders, were sponsored by Medtronic.

— Cindy Starr

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