Several members of the LSU faculty have made themselves available to answer your questions through this site, so take advantage of it! post your question in any of the comment areas, and we'll get it to an expert right away. Feel free to send us an email adress, or we may post the answer for everyone to benefit!


This is NOT a site for specific medical consultation
No physician will be able to diagnose or provide specific treatment advise through this site.
See your physician with specific questions about what is best for you!

Thursday, October 8, 2009

LSU Becomes a New Center for the Treatment of Obsessive-Compulsive Disorder

Medtronic ReclaimDBS therapy is becoming available at the LSUHSC-NO Department of Neurosurgery as an FDA approved procedure under a Humanitarian Device Exception for the treatment of chronic, severe, treatment-resistant OCD.

Saturday, June 20, 2009

A Question about Cyberknife for Trigeminal Neuralgia

"I did not know where to put this. I had a question about Cyber Knife. Has it been used at West Jefferson/LSU to treat TN successfully?I'm post Gamma Knife and am considering Cyber Knife as my next move."

Great question. Radiosurgery in general has gotten quite a bit of attention over the past several years as a treatment for Trigeminal Neuralgia (TGN), a severe disorder of facial pain.

Unfortunately, the information isn't always unbiased, and the companies that make and buy the radiosurgery units have often done a really good sell job.

That's not to say that radiosurgery isn't an important option, just that many people have chosen it out of a fear of surgery, with an unrealistic expectation from the radiosurgery.

To make things more complicated, people aren't even really clear on the term "trigeminal neuralgia" and they aren't always talking about the same thing.

Traditionally, neurosurgeons have limited the term "trigeminal neuralgia" or "classical trigeminal neuralgia" to a very specific disorder in which the pain is "lancinating" or stabbing. In classical trigeminal neuralgia, the rest of the time everything is completely normal. There is no constant pain. There is no numbness. This kind of pain usually responds fairly well to medications, particularly a seizure medicine called Tegretol. Many people, however, have side effects on the doses that they need to stop the pain. In these people, we offer surgery. There are two main kinds of surgery -- usually the cause is a small artery bumping up against the nerve, so we tend to offer "Microvascular Decompression" (MVD) where we make a small hole in the back of the skull and put a tiny foam pad alongside the nerve to protect it. This cures better than 8 out of 10 people, tends to last pretty well, and rarely causes any numbness in the face. Most of us really find this to be the best option in young healthy people.

In those who are older or not healthy enough to undergo anesthesia, the other primary options are different ways of passing a needle into the nerve under xray guidance to burn it or crush it. This leaves the face somewhat numb, but stops the pain in the high ninety percents.

Radiosurgery is more like the latter. The disadvantage over the needle procedures is that it can take up to 6 months to take effect. Since the effect typically lasts for less than 2 years, the difference is substantial. It can leave the face numb, and can lead to a condition called "anesthesia dolorosa" in which the face is numb and in pain at the same time, which is extremely difficult to treat. The biggest problem we've seen is that people get radiosurgical treatment for face pain that does not meet the criteria for classic TGN, but is now being called TGN type II. Unfortunately, the success rates in type II are very poor, essentially no benefit by 2 years.

Cyberknife and Gamma Knife each have their strong adherants who think one is better than the other, but there's essentially no data to back that up. The Cyberknife provides a comfort advantage, as you don't have to have your head pinned in a frame for the procedure.

For the type II pain, the most successful procedure appears to be none of the above, but something called motor cortex stimulation.

All in all, the answer depends on the specifics of your case. Your best bet is to talk to an expert in all the treatments for TGN, both radiosurgical and otherwise. Because of our affiliation with WJMC and the Cyberknife unit, most LSU neurosurgeons see their patients now at the Cullicchia Clinic in Marrero. We'd be happy to make an appointment and talk about your options in detail.

Friday, June 5, 2009

Neuromodulation for dystonia - moving forward!

Dr. Erich Richter has performed deep brain stimulation to treat a patient with severe dystonia. The case was performed at West Jefferson Hospital with great results! The electrode was implanted with the use of stereotactic head frame attached to the patient's skull. (This guidance system allows for accurate placement of electrode, which delivers stimulation to affected area of the brain). Patient's symptoms, that included extreme pain and muscle spasms, significantly improved. As a matter of fact, the benefits of DBS may take several months to achieve its full effect. The result achieved by neurosurgeon at LSUHSC at New Orleans looks promising and gives new hope to prospective patients!

Friday, May 22, 2009

Brodmann area 25 deep brain stimulation to control depression symptoms

An ongoing study (BROADEN™) supported by St. Jude Medical, Inc., shows promising results in the treatment of major depressive disorder. The study is based on a model of depression proposed by Helen Mayberg, in which Brodmann area 25 appears to be overactive in depressed people. 21 patients involved in this study demonstrated 92% improvement in depression symptoms at one year follow-up.

Visit for full article.
Usefull links:;

Sunday, May 10, 2009

New Resident Physician to Join LSU Neurosurgery

The LSUHSC-NO Department of Neurosurgery is pleased to announce that Dr. Durga Sure will join the housestaff on July 1st. Dr. Sure is currently completing a two year pre-residency fellowship in neurosurgery at Harvard. We look forward to his arrival and seeing his academic development over the years to come.

Monday, April 27, 2009

Deep brain stimulation slows progression of Parkinson's disease in animal models

Researchers at the Neuroscience Institute at the University of Cincinnati and University Hospital showed that DBS not only alleviates symptoms of Parkinson's disease, but also delayes disease progression. In DBS, high-frequency stimulating electrodes can promote the release of specific neurotrophic factor, which prevents the death of dopamine-producing cells in the brain.

Please refer to the original article by clicking on the link below.

Friday, April 24, 2009

Neurosurgery at Children's Hospital

The Institutional Review Board (IRB) has approved Children's Hospital as a second performance site to treat people suffering dystonia with the Humanitarian Use Device, known as Medtronic Active® Dystonia Therapy, an FDA-approved under Humanitarian Device Exemption (HDE).
Dr. Richter will be performing a DBS on a patient suffering severe dystonia at Children's Hospital in the near future.

Saturday, March 28, 2009

Mold-induced seizures?

"Mold" is the common term for multicellular fungi that grow in a mat. Generally, they are not pathogenic to immunocompetent patients. Molds may negatively affect humans through developing the following processes: allergy, infection, and toxicity. Allergic response to indoor molds is mediated via production of specific molecules, called immunoglobulins, and is associated with development of atopic reactions, such as atopic asthma, rhinitis, and dermatitis. Other uncommon allergic reactions include bronchopulmonary aspergillosis and allergic sinusitis. Infections are potentially dangerous for individuals with weak immune system, such as cancer patients, AIDS, etc. In addition, molds are capable of producing mycotoxins. In fact, an inhalation exposure or eating moldy foods may adversely affect health. It is commonly referred as organic dust toxic syndrome which is characterized by a flu-like symptoms. Interestingly, sick building syndrome is a set of symptoms that seems to be linked to occupancy in a building. While specific causes of this syndrome remain unknown, some believe that mold contamination may be contributing factor. A critical review of literature, including a case-control study, did not show any significant correlation between exposure to mycotoxins and human disease. To address the indoor mold-induced seizure, a case control study would be needed.

Wednesday, March 25, 2009

A new hope for patients suffering from obsessive-compulsive disorder

The U.S FDA gave its approval for Reclaim™ Deep Brain Stimulation under a Humanitarian Device Exemption. An Humanitarian use device is a device that is intended to benefit patients by treaing a disease that affects fewer than 4,000 individuals in the U.S. per year. 
OCD is an anxiety disorder characterized by unwanted thoughts and repetitive behaviors. The DBS of specific area of the brain, called ventral striatum,  may offer therapeutic promise for alleviating symptoms of OCD.
Dr Richter has  initiated approval process for performing this procedure at WJMC.

Sunday, March 22, 2009

Neuromodulation for Dystonia

The U.S. Food and Drug administration approved a Humanitarian Device Exemption for Activa® Deep Brain Stimulation for Dystonia. Dr. Richter has received an approval for the clinical use of the device in Louisiana, West Jefferson Medical Center, in particular. The first patient with severe form of dystonia will undergo the procedure in the near future.

Dystonia is a disorder characterized by involuntary spasms and muscle contractions. It is estimated to affect approximately 250,000 Americans. Currently medical treatment and various surgical procedures are available to relieve symptoms. However, the cure has yet to be found. Deep brain stimualtion gives new hope to sufferers of dystonia. The procedure involves the implantation of an electrode that delivers electrical impulses to specific areas of the brain. With neuromodulation, abnormal signals from nerve cells go away.

If you are interested in getting more information about the procedure and would like to get an opinion as to whether you may potentially be a candidate fir surgery, just call our office and make an appointment with Dr. Erich Richter.

Monday, February 16, 2009

Dr. Richter visits the Westwego Rotary

Dr. Richter recently presented an overview of new programs and community partnerships that LSU neurosurgery is bringing to the New Orleans area. He highlighted the new Movement Disorders and Deep Brain Stimulation Programs at West Jefferson Hospital, the Epilepsy Unit, which completes the only level 4 Epilepsy Center in the state, and the complex pain surgery program, which complements the existing pain services throughout the region.

If you would be interested in having an LSU faculty member speak to your community group, let us know!

Wednesday, January 7, 2009

CNN gives other doctor's and researcher's opinions on DBS surgery for treatment of PD

In this artcle, CNN discusses the largest study (led by Frances Weaver, Ph.D., director of the Center for Management of Complex Chronic Care at the Hines VA Hospital, in Hines, Illinois) that has been done on deep brain stimulation surgery for the treatment of Parkinson's disease.

Other researchers and doctors agree that this treatment option looks very promising.