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Surgery for Parkinson's disease

 

“I’ve heard about surgery but apparently it’s only suitable for a few people”
 
  • Before 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.

  • Surgery 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 condition.

  • §Surgery 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.

  • §Pallidotomy 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.

  • §Thalamotomy 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 side effects.

  • §Deep 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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FURTHER INFORMATION
Your specialist doctor should be able to answer your questions about any possible benefits of surgery.

 

The Parkinson’s Disease Society (telephone 020 7931 8080) can also provide information http://www.parkinsons.org.uk
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

Wake Forest University School of Medicine: Parkinson’s index


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This site has been established for the dissemination of information. While every effort is made to ensure that information on this site is accurate and current we accept no liability for any omissions or inaccuracies that may have crept in. If in any doubt please contact your doctor for further advice.

Last Modified 13 August 2004
Maintained by Matthew Harris