Q: Is surgery beneficial for people with Parkinson’s disease?
A: Brain surgery may be very beneficial for an appropriate subgroup of patients with PD. There are two main surgical approaches to the management of PD: brain lesioning surgery and deep brain stimulation. Lesioning procedures involve destroying a small area of the brain that is involved in abnormal circuits causing symptoms of PD. Deep brain stimulation involves the placement of an electrode, on one or both sides of the brain, and electrical stimulation of specific brain areas involved in the circuits that are impaired in PD.
Not every patient will benefit from the surgical treatment, and appropriate patient selection is a crucial step in the process. Best candidates for the surgery are patients who developed disabling dyskinesias that can not be managed optimally with medication changes; patients with pronounced fluctuations in response to the medication regimen; and patients with severe tremors that can not be controlled with medications.
Patients with coexistent serious medical problems, dementia, psychiatric problems and advance age in general are not good candidates for surgery.
Therefore, each patient should be carefully evaluated for surgery, and those selected to be good candidates should be counseled about the risks and benefits of the surgery.
Dr. Aleksandar Videnovic is a Neurologist, specializing in Parkinson's disease and movement disorders. Read his full biography