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Life-changing surgery for Parkinson's tremors offered in Delray Beach

WPTV gets exclusive look at Deep Brain Stimulation
Posted at 12:42 PM, Jan 30, 2019
and last updated 2019-10-21 11:34:23-04

DELRAY BEACH, Fla. — Parkinson's disease and other movement disorders can be debilitating to a person's daily life, but a specialized surgery can change everything.

It's called Deep Brain Stimulation, and Delray Medical Center has the fastest growing program in the state.

WPTV had exclusive access inside the operating room as doctors performed this life-changing surgery on a patient.

57-year-old Waymond Richardson has an essential tremor movement disorder, similar to the symptoms of Parkinson's disease.

"This would be a life changer for me," Richardson said before going into surgery.

A tremor in Richardson's hands has impacted his life for decades, and he said it can be embarrassing depending on who is around him.

Richardson described people staring at him while in line at the buffet, when his tremor would cause his plate of food to shake. It was enough to lead him to the operating room for Deep Brain Stimulation surgery.

Neurosurgeon Dr. Lloyd Zucker and neurologist Dr. Arif Dalvi worked together in the operating room to map out Richardson's brain and find the cells that cause his hand to shake. Then, they inserted micro electrodes and send a current to that area in the brain to stop the tremor.


The doctors said it's all about being on target. It's a precise but predictable procedure, mostly for patients with Parkinson's disease or essential tremor movement disorders, like Richardson.

He was awake during the whole procedure, so doctors could test his tremor and adjust as they went until they found the perfect spot that stopped his shaking.

"I’ve been doing this for 20 years and I still choke when I see the patient go from this to this (shaking to not shaking)," said Dr. Dalvi. "It's just something amazing to see."

Dr. Dalvi has been performing the surgery at Delray Medical Center for four years.

"A simple way of describing it is about 80 percent of patients are about 80 percent better," said Dr. Dalvi. "We do this, not just for tremor but for those who have trouble with walking and balance for example, even postural changes. Some patients have involuntary movements called dyskinesias, so depending on the symptoms, we get different results."

Dr. Dalvi said the technology keeps improving.

"With our patient, for example, we are going to use a very sophisticated electrode that actually allows us to steer the current in different directions where we can minimize side effects and really steer the current toward the tremor cells without spreading to other areas of the brain," said Dr. Dalvi. "So that's one reason you hear more about it, and the second reason is there’s a greater need for it. With the baby boom population reaching the age group where these diseases become more common, there’s more and more need for these procedures."

Dr. Dalvi said the procedure is not for everyone, but it's very beneficial to a specific group of patients.

"We don’t offer the procedure to someone newly diagnosed with Parkinson’s, but someone who we’ve tried medications, have done well for a number of years, and now they’re not having a good response," Dr. Dalvi said. "You should not wait until all else fails when the disease progression has gone to such an extent that these patients have trouble with cognitive issues and the like, and then we cannot offer them them surgery. On the other hand, I do not offer it to patients who are just a year or two after diagnosis because there is so much we can do with medications. So in between is the therapeutic window, as we call it, when we offer the surgery."

Dr. Dalvi added they do offer Deep Brain Stimulation to patients with Parkinson’s who deal with rigidity or poor posture or balance because the surgery can improve their response to medication.

If you think the surgery may benefit you, Dr. Dalvi said be sure to have that conversation with your doctor.

"If you feel your medications are not doing an adequate job controlling your symptoms, at least discuss it with your neurologist," said Dr. Dalvi.

Weeks after his surgery, Richardson had a follow-up appointment with Dr. Dalvi to fine tune the device. In between, he had a pacemaker-type device inserted under his skin in his chest, which is now connected to the wires in his brain.

Richardson told WPTV it feels good not to shake anymore and almost brings him to tears when he realizes all the things he can now do without the tremor.

"No shaking," said Richardson. "It feels good when I can just do this (holding hand up). No shaking at all. I’ve been to the buffet, I couldn’t wait to check that out."


You can learn more about Deep Brain Stimulation by visiting the Palm Beach Neuroscience Institute's website, or by calling Dr. Arif Dalvi's office at 561-882-6214.