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Your Surgical Options for Treating the Symptoms of Parkinson's Disease

As there is no known cure for Parkinson's disease, the main treatment has been medications like levodopa and dopamine agonists to control the symptoms. Many patients find that quality of life improves once they start on a specific drug treatment. However, when the disease progresses far beyond what medications can treat or the medications simply do not work, there are surgical options.

Lesioning

One of the first surgical options for Parkinson's is a technique called brain lesioning. There are several different versions of this procedure but the gist of it is this - the surgeon uses a probe that conducts heat to destroy a special part of the brain that is abnormally active, a part that should not be showing such activity. This procedure of course is a permanent one and not one that is recommended in most cases.

Deep Brain Stimulation

Deep brain stimulation is a recent surgical development that has brought some relief and normalcy to Parkinson's patients. There are several types of deep brain stimulation such as Vim, GPi and STN. Deep brain stimulation involves the placement of a thin metal electrode less than the diameter of a spaghetti noodle into special targets of the brain which is then attached to a pulse generator that is implanted just under the skin, sort of like a pacemaker. Using a computer, the doctor can make adjustments during an office visit as needed. The good news is that deep brain stimulation does not seem to irreparably damage the brain at all.

* Vim deep brain stimulation refers to the area where the electrode is placed. VIM stands for ventro intermediate nucleus, a particular area of the thalamus gland which plays a crucial role in movement and coordination. Manipulation in this area helps reduce tremors only.

* GPi deep brain stimulation refers to the globus pallidus, an integral part of the basal ganglia system of the brain that is responsible for virtually all motor coordination and movements. Manipulation of this area helps with tremors, limb rigidity, and shuffling and balance issues.

* STN stands for subthalamic nucleus and is another location site for the electrode placement. It too is part of the basal ganglia area of the brain. Manipulation of this area aids in rigidity of limbs, tremors, posture and slow movement.

The ultimate goal of deep brain stimulation is to reverse the negative trend of motor coordination. This means the abnormal function of the brain must be targeted accurately for electrode placement for the deep brain stimulation to work. Doctor visits help tweak the settings via computer until the patient exists in the most optimal fashion.

Deep brain stimulation is a recent surgical development, only being performed for the last five or six years. This means, there are many advances in store for this procedure and can expect to be even more effective in the future. There are some risks - typically 2-3% has difficulties - but for the most part, no ill effects occur afterward. Just recently Medicare has started paying for the procedure so that says a lot about the validity of it!