Stony Brook Medicine Neurosurgeons Advance Movement Disorder, Epilepsy and Brain Tumor Treatments

By Robert Murphy
Thursday, November 15, 2018
Specialty: 

Charles Mikell, MD, a neurosurgeon specializing in movement disorders and Co-director of the Stony Brook Movement Disorders Center, along with his colleagues, relies heavily on minimally invasive treatments for managing disorders and diseases of the brain.

Stony Brook Medicine neurosurgeons use a strong multidisciplinary approach to treating brain tumors and neurological diseases such as epilepsy and Parkinson’s disease. What’s more, with an eye toward research and new techniques, they are pioneers of promising treatments.

Dr. Mikell specializes in functional neurosurgery, which employs a range of minimally invasive and highly effective treatment options for disorders and diseases of the nervous system — particularly Parkinson’s disease, epilepsy and essential tremor, which cannot be effectively managed through other methods of medical treatment.

“We employ a thoughtful, comprehensive approach to individualized treatment for each patient,” Dr. Mikell says. “After evaluating patients, we ask them about their goals — better quality of life and mobility — and then we customize the treatment to help our patients meet their goals. It is a tailored approach to surgery that takes into account the functional abilities and deficits of each patient.”

Treating Brain Tumors and Epilepsy

A minimally invasive treatment, laser ablation uses heat to destroy pathologic tissue in otherwise inoperable brain tumors. This technology can also be used to treat epilepsy.

“I can get very precise targeting of tissue in the brain by coupling laser ablation with real-time MRI guidance,” Dr. Mikell says. “While using the laser fiber, I can watch the temperature of the targeted tissue using MRI thermography, ensuring the diseased tissue is destroyed and the healthy brain tissue remains intact.”

As a functional neurosurgeon, Dr. Mikell treats both brain tumors and epilepsy with the laser. Due to these advanced technologies and techniques, Dr. Mikell and his colleagues continue to obtain excellent outcomes.

“I am pleased with the outcomes we have seen in using laser ablation,” Dr. Mikell says. “This recent advancement is seen as less invasive than traditional cranial surgery.”

Using a laser is more patient-friendly because it poses less risk of serious complications and a speedier recovery, often requiring just one or two nights in the hospital, after surgery.

Treating Tremors and Parkinson’s Disease

Directional deep brain stimulation is a recently developed procedure that Dr. Mikell and his colleagues use to treat essential tremor, dystonia and Parkinson’s disease.

“We were the first on Long Island to do directional deep brain stimulation,” Dr. Mikell says. “We use electrodes in parts of the brain that are overactive and try to lessen the activity. The electrodes stimulate in different directions rather than just one direction. This allows you to increase the benefit while avoiding side effects from stimulation in places where you do not want it. I think it is especially beneficial for treating essential tremor.”

An experienced nurse navigator helps guide patients through follow-up and also provides resources for patients both before and after their surgeries. All patients receive an evaluation one week after the procedure and again at the one-month mark. Then, follow-up appointments are scheduled every three or six months, depending on the condition being treated.

Stony Brook Medicine’s Movement Disorders Center team also includes a social worker to further identify resources for patients.

“Laser ablation is easier on patients than open craniotomy. The minimally invasive procedure allows for a shorter hospital stay — usually one or two nights — and reduced recovery time.”
— Charles Mikell, MD, a neurosurgeon specializing in movement disorders and Assistant Professor of Neurosurgery at Stony Brook Medicine

Research and Clinical Trials

Research is an important element of Dr. Mikell’s work, and much of his effort has focused on traumatic brain injury and coma.

“I find this area of care to be very difficult,” Dr. Mikell says. “The standard of care is that you have a patient with a serious brain injury in a coma, and the patient may never wake up. At Stony Brook Medicine, we are devising new surgical techniques for improving arousal after severe traumatic brain injury.”

Surgery to treat depression is another research project in which Dr. Mikell is involved.

“We use electrodes in parts of the brain that are hyperactive in depression to decrease activity,” Dr. Mikell says. “A longer period of follow-up with patients revealed that the trial may have helped.”

New developments are being tested in many research facilities worldwide, and Dr. Mikell is optimistic about the many promising surgical techniques on the horizon.

“There is a lot of advancement in neurosurgery,” Dr. Mikell says. “I enjoy participating in clinical trials that can provide a better quality of life to patients.”

Rewards of the Clinic

Dr. Mikell also finds the collegial atmosphere at Stony Brook Medicine rewarding.

“We have an excellent team,” Dr. Mikell says. “That is one of the reasons why I like working at Stony Brook. We collaborate and work together so patients can experience the best possible outcomes.”


Visit neuro.stonybrookmedicine.edu to learn more.