Surgery for Parkinson's Disease - Who is an ideal candidate ?

Surgery for Parkinson's Disease - Who is an ideal candidate ?

Dr Guruprasad, Consultant Neurologist, Columbia Asia Hospitals, gives insights into how Parkinson’s disease affects normal life and who is the ideal candidate for surgery

How does Parkinson’s disease progress?
This disease invariably progresses with time. The rate of decline in movement is greater in those with less impairment at the time of diagnosis, while cognitive impairment is more frequent in those who are over 50 years of age at the onset of the symptoms. Untreated cases are expected to lose their ability to be mobile after an average of eight years and be bedridden after ten years. Medication has improved the prognosis of motor symptoms but it is hard to predict what course the disease will take for a given individual.

How does it affect the patient’s life?
The quality of life of patients is affected as they may find it difficult to perform routine tasks like holding a cup of tea due to tremors. Activities once performed quickly and easily such as washing or dressing may take several hours. Postural instability causes patients to fall easily. 

Depression is very common and may be undiagnosed before the symptoms occur. They may not want to travel, attend parties, or socialize with friends.  Some lose their motivation and become dependent on family members.

Memory loss and slow thinking may occur, although the ability to reason remains intact. Some of them actually suffer intellectual loss also known as dementia later in the course of the disease. Sleep related problems like insomnia, drowsiness, etc during the day is common some of which may be due to the medications.

When do you recommend surgery?
Surgery is not the first option when treating Parkinson’s patients. However, if a patient is in the advanced stages of the disease and the symptoms are poorly controlled with medical treatment then based upon the type and severity of symptoms, the deterioration of his quality of life and the overall health of the patient, surgery may be recommended.

It must be kept in mind that surgery for Parkinson’s disease in its present form is not curative, but can relieve the symptoms of the disease to a significant level. It is possible to reduce the dosage of medication to around 50 percent in most cases after Deep Brain Stimulation.

There is a rigorous selection process whereby patients are put through a series of clinical evaluation tests before being identified as candidates for surgery.

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