Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
When lumbar disc patients present late with established foot weakness or bladder control loss, surgery can stop further damage but cannot restore what is already lost. The Surgical Window: Why Timing Matters as Much as Skill | Functional Surgery Minute #05 · 0:42
Stereotactic Principles3 items
Functional Neurosurgery Explained: 1mm Matters in DBS | Amr Moursi posted on the topic
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1 millimetre. That can be the difference in DBS between therapeutic and side effects In functional neurosurgery, precision is not a goal. It is the treatment itself. 🎙️ Episode 1 of my new video series is now live: "Functional Neurosurgery,
article · Jul 2026
Finding 1mm in the Brain | Functional Neurosurgery Explained – Episode 1
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How do brain surgeons find a deep target only a few millimetres wide, buried more than 10 cm inside the brain – and hit it with less than 1 mm error?
Welcome to Episode 1 of “Functional Neurosurgery, Explained”.
In this episode, I break d
video · Jul 2026
The Geometry of Precision | Frames in DBS – Functional Neurosurgery Explained – Episode 2
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How do brain surgeons turn the head into a stable 3D coordinate system so we can place a DBS electrode within 1 mm of the target?
Welcome to Episode 2 of “Functional Neurosurgery, Explained”.
In this episode, I break down the core tools t
video · Jul 2026
Neuromodulation Fundamentals2 items
Neuromodulation vs. Neuroablation | Functional Neurosurgery Explained – Episode 3
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Why did brain surgeons stop destroying tissue to treat Parkinson's disease — and what do they do instead?
Welcome to Episode 3 of "Functional Neurosurgery, Explained".
In this episode, I trace the full evolution from neuroablation to neur
video · Jul 2026
How Electrical Stimulation Changes Brain Circuits | Functional Neurosurgery Explained – Episode 4
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When you switch on deep brain stimulation — what actually happens inside the brain?
Welcome to Episode 4 of "Functional Neurosurgery, Explained."
In this episode, I use S‑T‑N D‑B‑S in Parkinson's disease as a model to trace exactly what a
video · Jul 2026
Surgical Timing and Decision-Making1 item
The Surgical Window: Why Timing Matters as Much as Skill | Functional Surgery Minute #05
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In neurosurgery, there's a right moment to operate — not too early, not too late. We call it the surgical window. From lumbar disc prolapse to Parkinson's and DBS, here's why timing can decide whether surgery changes a life or causes harm.
video2:03 · Jul 2026
Exclusion criteria for deep brain stimulation include dementia, untreated depression or psychosis, and atypical Parkinsonism like progressive supranuclear palsy and multiple system atrophy. Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics · 4:29
Parkinson's Disease3 items
3 Eras of Parkinson's Surgery: Destroy → Modulate → Respond
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From ablation, to DBS (Grenoble 1987), to adaptive stimulation that reads the brain's beta oscillations in real time. One section from Episode 3 of Functional Neurosurgery Explained — full episode: https://www.rfr.bz/yd06ce5f5 #shorts
video2:08 · Jul 2026
Awake DBS: Why We Test the Patient in Real Time | Functional Surgery Minute #03
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In awake deep brain stimulation for Parkinson's, the target isn't found on a scan — it's found in the patient, awake on the table. Here's how intra-operative testing guides us to the optimal stimulation depth, and why the whole team (and th
video1:38 · Jul 2026
Decoding DBS Target Selection in Parkinson's Disease | Functional Neurosurgery Explained – Episode 5
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#Parkinsons #neurosurgery #DBS
More than thirty percent of all D‑B‑S failures trace back to one mistake — the wrong patient, or the wrong target, chosen long before the operation even began. Welcome to Episode 5 of "Functional Neurosurgery,
video · Jul 2026
Exam Preparation1 item
Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics
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Preparing for functional neurosurgery exam questions can be challenging, especially when the subject includes movement disorders, patient selection, surgical targets, stimulation, and clinical decision-making.
In this new series, we will g
video9:40 · Jul 2026
Clinical Evaluation and Outcomes1 item
Epilepsy Surgery Outcomes Explained 🧠
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How do surgeons evaluate outcomes after epilepsy surgery?
The Engel Classification provides a standard framework for describing postoperative seizure outcomes. In this short reel, I break down its key categories simply and quickly.
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video2:16 · Jul 2026
Exam Preparation1 item
Epilepsy Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics - part 1 out 3
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Epilepsy surgery has a reputation for being one of the hardest functional topics in the exam.
It is not impossible—it is simply long.
The best way to understand it is to follow the same structure used when working up a real patient:
Diag
video · Jul 2026
Laser Interstitial Thermal Therapy1 item
How LITT Reaches Deep Brain Tumours Through a 3-mm Hole | Functional Surgery Minute #04
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We used to open the skull to reach deep brain tumours. LITT — Laser Interstitial Thermal Therapy — reaches them through a tiny burr hole, guided by a real-time MRI thermal map, without cutting through healthy brain. Here's how it works, wha
video2:18 · Jul 2026
Featured picks for families are being prepared — the summaries above are written for you.
Expert statements from the recordings in this collection.
Epilepsy Surgery Outcomes Explained 🧠
Before the 1980s, surgical outcomes for epilepsy were reported simply as improved or not improved, with every center using its own definition, preventing meaningful comparison.
In 1993, Jerome Engel and colleagues proposed a single standard scale for epilepsy surgery outcomes.
The Engel classification quickly became the international standard for reporting epilepsy surgery outcomes.
The Engel classification grades how close the patient is to complete seizure freedom, not raw seizure counts.
Engel Class 1 means the patient is free of disabling seizures and essentially seizure-free.
Engel Class 2 means rare disabling seizures with long seizure-free stretches, representing almost seizure-free status.
Engel Class 3 represents worthwhile improvement where seizures still occur but far less than before, with both patient and clinician agreeing the change was worth it, though epilepsy remains active.
Engel Class 4 means no worthwhile improvement, with seizures continuing at similar frequency or worse, indicating surgery did not achieve meaningful control.
Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics
Functional neurosurgery is under-taught in basic training and most units don't do much of it.
Expert opinion0:29
Examiner expectations for functional neurosurgery are low and basic knowledge is sufficient.
Expert opinion0:36
Functional neurosurgery splits into three exam topics: movement disorders, pain surgery, and epilepsy.
Bradykinesia is mandatory for the diagnosis of Parkinson's disease.
Tremor responds best to deep brain stimulation in Parkinson's disease.
Gait freezing, speech, and cognition respond poorly to deep brain stimulation.
Cognition can be worsened by deep brain stimulation.
Balance, speech, and postural instability all respond poorly to deep brain stimulation.
The subthalamic nucleus is the first choice target for deep brain stimulation in Parkinson's disease.
Cites a guideline2:25
The globus pallidus internus is the second choice target for deep brain stimulation in Parkinson's disease.
Cites a guideline2:29
When dyskinesia dominates in Parkinson's disease, the globus pallidus internus is the preferred target because it smooths dyskinesia directly.
When tremor dominates in Parkinson's disease, the ventral intermediate nucleus of the thalamus is the preferred target.
The anterior limb of the internal capsule is an obsessive compulsive disorder target, not a Parkinson's disease target.
Inclusion criteria for deep brain stimulation include disease over 5 years, a meaningful levodopa response, disabling fluctuations, or refractory tremor.
Cites a guideline4:12
Exclusion criteria for deep brain stimulation include dementia, untreated depression or psychosis, and atypical Parkinsonism like progressive supranuclear palsy and multiple system atrophy.
Cites a guideline4:29
The levodopa challenge predicts the response to deep brain stimulation, not severity of disease.
Stimulation of the subthalamic nucleus roughly reproduces the patient's best medication on state.
A good levodopa response predicts a good stimulation response to deep brain stimulation.
Atypical Parkinsonism does not respond to deep brain stimulation and is a contraindication.
At the subthalamic nucleus, medial spread of stimulation hits the third cranial nerve and red nucleus, causing diplopia.
At the subthalamic nucleus, lateral spread of stimulation hits the internal capsule, causing contralateral twitching and dysarthria.
At the globus pallidus internus, ventral spread of stimulation hits the optic tract, causing phosphenes (flashes of light).