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Functional Neurosurgery

Functional neurosurgery involves precise surgical targeting of anatomic structures in order to modulate neurologic function. The ultimate aim is to improve the symptoms and quality of life of patients suffering from chronic neurologic disorders; this demands minimal risk of inflicting morbidity and mortality. Patient selection is a key aspect of ensuring satisfactory outcome.


It deals with chronic neurological disorders that interrupt a person's day-to-day function or abilities. This broad term can refer to several conditions, including chronic pain and movement disorders such as:

  • Movement disorders, including Parkinson’s disease , essential tremor, dystonia, Tourette’s and hemifacial spasm

  • Epilepsy

  • Spasticity of cerebral origin (MS and spinal cord injury)

  • Neuropsychiatric conditions, including obsessive-compulsive disorder and treatment resistant

  • Depression

  • Chronic pain from neuropathic injuries or diseases, as well as malignant causes

  • Trigeminal neuralgia, post herpetic neuralgia and nerve injuries.


In the last 20 years, there have been considerable advances in the techniques, technologies, and approaches devoted to functional neurosurgery. These advances have led to improved stereotactic accuracy, better outcomes, a lower rate of complications, and an increasing number of patients benefiting from this neurosurgical approach. 

 

 

The stereotactic technique remains central to the discipline. However, as with other neurosurgical specialties, advances in medical technology have heavily influenced the practice of functional neurosurgery. The technologic advances of magnetic resonance imaging (MRI) and deep brain stimulation (DBS) are driving the resurgence of functional neurosurgery, making it one of the most rapidly expanding neurosurgical fields. The modern practice of DBS for movement disorders cannot be properly understood without an appreciation of the historical evolution of functional neurosurgery.

 

Treatment options includes:

  • Open surgical and minimally invasive approaches

  • Frameless and robotic solutions

  • Focused ultrasound

  • Deep brain stimulation

  • Laser ablation

  • Responsive neurostimulation

  • Sacral Nerve Stimulation

  • Intrathecal Pumps

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