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This is how a pacemaker helps patients

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Neurologist Dr. Thomas Kugelberger with Parkinson's patient Marianne Wenzel, her husband Karl-Heinz and Director of Neurology at the Grosshadern Clinic, Prof. Günter Höglinger.
Two weeks after the insertion of the pacemaker, Parkinson's patient Marianne Wenzel is able to stand again, and her husband Karl-Heinz provides additional support. LMU Chief Neurologist Professor Günter Höglinger (right) and Dr. Thomas Kugelsberger (left) are pleased that the patient is now feeling well again and that the pacemaker is reducing her Parkinson's symptoms. © Martin Hangen

Parkinson's disease is the second most common neurodegenerative disease of the nervous system after Alzheimer's disease. It develops gradually and is often detected late. However, tremendous progress has now been made in diagnosis and treatment.

It has only been two weeks since the operation when Marianne Wenzel met our editorial team in Grosshadern for an interview. She is radiant. She can walk again and control the spasms and cramps in her right leg. The florist from Schwabmunchen is one of 50 patients who receive a so-called pacemaker implanted at the LMU clinic each year. “The Deep brain stimulation Could you For many patients, quality of life improves dramatically for two decades or more.A pacemaker is an option for many of Germany's approximately 400,000 Parkinson's patients, especially when medication cannot improve symptoms permanently, says Professor Günter Höglinger, director of the Neurology Clinic at LMU Hospital. But only a small proportion of sufferers opt for deep brain stimulation, the neurologist regrets. Because at some point, medication is no longer enough to combat the symptoms. Statutory health insurance companies also cover the costs of a pacemaker.

Marianne Wenzel is happy that she had the courage to have a pacemaker fitted: “I have already noticed a lot of progress.” The 53-year-old was a florist by profession. She particularly loved making beautiful bouquets of flowers. But in 2014 it became increasingly difficult for her. “My hands were shaking and I didn’t have enough strength to hold the bouquet,” she says. In addition, her hands increasingly felt as if they had fallen asleep. “It was up and down for two years,” she says. Sometimes she would feel better, then the symptoms would get worse again. She often had difficulty sleeping at night because her legs were so restless. The family doctor diagnosed the so-called restless legs syndrome. “I hoped that these problems would go away,” says the woman from Schwabmünch. The neurologist prescribed dopamine tablets. In 2016, he advised her to undergo an MRI scan to accurately diagnose the cause of her symptoms. Parkinson’s disease was diagnosed during the accompanying neurological examination.

Neurologist Dr. Thomas Kugelberger (left) with Professor Günter Höglinger, Director of Neurology at the Grosshadern Clinic.
Leading experts on Parkinson's disease: Neurologist Dr. Thomas Kugelsberger (left) with Professor Günter Höglinger, Director of Neurology at the Grosshadern Clinic. © Martin Hangen

She was given medication. However, the symptoms worsened. She could no longer drive or cycle, and walking became difficult. “My husband would sometimes carry me, and I could no longer get out of bed on my own. In the morning I was stiff as a board,” says the 53-year-old. She also found it increasingly difficult to speak.

Two holes are drilled into the skull and electrodes are implanted deep into the head.

So Marianne Wenzel decided to use a pacemaker. For this reason, LMU PD neurosurgeon Dr. Jan Merkens had two electrodes permanently inserted into her brain. The implanted electrodes stimulate specific areas. This makes it possible to treat movement disorders. In the first operation on April 10, two small holes were drilled in Marianne Wenzel's right and left skull and two electrodes were implanted deep into her head. The 53-year-old was awake during the operation, but felt no pain or fear thanks to painkillers and sedatives. Thanks to high-resolution MRI, the neurologists at the LMU Clinic can now also perform this operation under general anesthesia.

The pacemaker will be adjusted in the weeks following the operation. “It works. I no longer have bad, painful cramps in my right foot,” says Marianne Wenzel happily. She is very confident that she will soon be able to fully control her motor difficulties. “There is still some fine-tuning to be done here,” explains neurologist Kugelsberger. Using a specialised smartphone, he can adjust the pulse strength so that the patient is sufficiently active but not overly active. He can also adjust the pacemaker during a virtual consultation – a telemedicine consultation where the patient and doctor see each other on the screen and the patients do not have to go to the clinic.

Parkinson's patient Marianne Wenzel and her husband Karl-Heinz at the Michaelismarkt in Schwabmunchen in 2018.
Their love survives every illness: Marianne and Karl-Heinz Wenzel in 2018. © Karl-Heinz Wenzel

Significant advances in treatment have greatly improved the quality of life of patients.

After decades of research into Parkinson's disease, there has finally been a breakthrough in medications and technology to help patients. “It is true that Parkinson's disease remains serious and incurable. illness“But in many cases it no longer leads to a reduction in life expectancy, and if motivated patients work closely with experienced doctors, it is also possible to maintain quality of life,” says chief neurologist Höglinger. “It gets better and better. Read on the right to find out which complaints can be early warning signs.”

Deep Brain Stimulation: This Is How Electrodes Help

During deep brain stimulation (DBS). Electrodes deep in the brain Implanted. They stimulate specific areas there, making it possible to treat movement disorders in patients, for example. They are activated by a battery that is placed near the collarbone. About 50 pacemakers are used in the LMU clinic each year. About 500 DBS patients are followed by neurologists at the LMU. In the weeks following the procedure, the timing of stimulation is adjusted to help the patient better control their symptoms. Background: The left side of the brain controls the right side of the body.

This article contains only general information on the health topic in question and is therefore not intended for self-diagnosis, treatment or medication. It does not in any way replace a visit to a doctor. Our editorial team is not authorized to answer individual questions about medical conditions.