ESIC Nursing Officer -2019 (Shift -1)
Medical & Surgical Nursing
Easy
The minimally invasive technique by which thin, insulated lead wire with electrodes (neurostimulator) is surgically implanted in the brain is called:
Appeared in: ESIC Nursing Officer -2019 (Shift -1)
Explanation
- Deep brain stimulation (DBS) is the only option that involves the surgical implantation of a thin lead wire with electrodes into the brain.
- The procedure is described as minimally invasive and is used to deliver electrical impulses to regulate abnormal brain activity, matching the question's description.
- The implanted device consists of the lead wire with electrodes in the brain and a neurostimulator (pulse generator) typically placed in the chest, as shown in the provided image.
- DBS is a treatment modality, primarily for movement disorders like Parkinson's disease, essential tremor, and dystonia, and is also being explored for psychiatric conditions.
Why Other Options Were Wrong
- Option A: Functional MRI (fMRI) is a neuroimaging technique used for diagnosis and research to map brain activity. It does not involve any implantation or therapeutic stimulation.
- Option B: Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic fields from a coil placed on the scalp to stimulate the brain. No surgical implantation is required.
- Option C: Electroconvulsive therapy (ECT) involves applying an electrical current to the scalp to induce a seizure for therapeutic purposes. It is non-invasive in terms of surgical implants.
Related Visual
- Visual 1: Diagram - A detailed illustration showing the three main components of a DBS system: the implanted pulse generator (IPG) in the chest, the extension lead tunneled under the skin, and the electrode lead inserted into a specific target in the brain. This helps visualize the complete setup described in the question.
- Visual 2: Comparison Chart - A chart comparing DBS, TMS, and ECT on key features like invasiveness, mechanism, primary indications (e.g., Parkinson's for DBS, Depression for TMS/ECT), and whether an implant is required. This clarifies the distinctions between the options.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Brain Stimulation Techniques as background academic context rather than a clinical decision trigger.
- Nurses play a vital role in the care of patients undergoing DBS, including pre-operative education, post-operative monitoring for complications like infection or neurological changes, and managing the neurostimulator settings in collaboration with the medical team.
- Patient education is crucial. Nurses must teach the patient and family how to manage the handheld controller for the neurostimulator, recognize signs of device malfunction or battery depletion, and understand activity restrictions post-surgery.
- What if? If a patient with a DBS implant presents with new-onset confusion, muscle twitching, or mood changes, the nurse's first action should be to assess for potential device-related complications or side effects of stimulation, in addition to other medical causes. The neuro-team should be notified promptly as the device may need reprogramming or evaluation.
How to Approach the Question
- First, read the question carefully and identify the key phrases: 'minimally invasive,' 'surgically implanted,' 'lead wire with electrodes,' and 'in the brain.'
- Analyze the provided image. Notice the device in the chest, the wire running up the neck, and the electrode tip inside the brain. This visual directly corresponds to a surgical implant.
- Evaluate each option against the key phrases and the visual evidence.
- Option A (fMRI) is an imaging scan, not a surgery. Eliminate it.
- Option B (TMS) uses external magnets. No implant. Eliminate it.
- Option C (ECT) uses external electrodes to induce a seizure. No implant. Eliminate it.
Concept Tested & Keywords
- Concept Tested: Brain Stimulation Techniques
- Stem keywords: minimally invasive, thin, insulated lead wire, electrodes, neurostimulator, surgically implanted, brain
- Lead-in keywords: is called
- Negative lead-in flag: false
Question ID
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Practise the full ESIC Nursing Officer -2019 (Shift -1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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