Parkinson's%20disease%20-and-%20parkinson's%20disease%20dementia Treatment
Surgical Intervention
Neurosurgery
- Considered in patients unresponsive to pharmacological therapy
Pallidotomy
- Unilateral pallidotomy has been shown to be effective in treating symptoms of dyskinesia when administered with oral Levodopa
- It is unfavorable because of its irreversible nature
Deep Brain Stimulation (DBS)
- Deep brain stimulation using implanted pulse generators in precise brain locations may be performed with specific indication
- Both subthalamic nuclei (STN) and globus pallidus pars interna deep brain stimulation have shown efficacy in management of Parkinson's disease general/systemic motor symptoms (eg motor fluctuations, dyskinesia) when administered with oral Levodopa
- Thalamic stimulation may be considered as an option in people with Parkinson's disease who predominantly have severe disabling tremor and where subthalamic nuclei stimulation cannot be performed
- Good candidates for deep brain stimulation include patients whose motor symptoms are not well-controlled by medications or who cannot tolerate side effects of medications, and those who do not have significant active psychiatric or cognitive problems
- Infection is the most commonly reported side effect of deep brain stimulation