“I’ve heard about surgery
but apparently it’s only suitable for a few people”
drugs became available for Parkinson’s disease (PD), surgical operations
on the brain were common. They were not always effective and were largely
abandoned. In recent years, the limitations of drug treatment have been
recognised and brain scanning and surgical techniques have much improved.
Interest in surgery for PD has revived.
is reserved for a few people with PD, whose symptoms are severe and
disabling and who do not respond or are intolerant to drug treatment. It
provides little benefit to patients in the vary late stages of the
for PD is carried out in only a few specialist hospital centres and there
are a number of different techniques available. These involve either
inactivating or stimulating particular brain areas.
involves inactivating a small area of the brain called the globus
pallidus. This is done by means of temporarily introducing a small electrode
into the brain and then passing a small electric current to inactivate the
nerve cells. It can be effective in people who are having sudden extra
involuntary movements associated with their drug therapy.
involves inactivating the part of the brain called the thalamus. As with
pallidotomy, a temporary electrode inserted into the brain is used to do
this. Thalamotomy is very
effective at reducing tremor on the opposite side of the body, but has
little influence on other symptoms of PD. Surgery on both sides of the brain
to reduce tremor on both sides of the body is associated with more risk of
brain stimulation involves an electrode being inserted into the globus
pallidus, thalamus or subthalamic nucleus and left there. The brain can then
be intermittently stimulated by passing of a small electric current.
This temporarily inactivates the stimulated part of the brain and can
stop involuntary movements or tremor. It can be carried out on both sides of
the brain and is easily reversible if there are unwanted side effects.
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Your specialist doctor should
be able to answer your questions about any possible benefits of surgery.
Useful books include:
‘Parkinson’s Disease: A
Guide for Patient and Family’, by Jacob Sage and Roger Duvoisin, published
in 2001 by Lippincott, Williams and Wilkins.
ISBN 0 781 729777
Useful websites include:
Worldwide Education and
Awareness for Movement Disorders
University School of Medicine: Parkinson’s index
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