Parkinson's Surgery

Brain surgery may be considered when medication fails to control symptoms of Parkinson's disease or causes severe or disabling side effects.

Deep brain stimulation(DBS) is a fairly new technique for treating Parkinson's disease. It affects movement by using electrical impulses to stimulate a target area in the brain. The electrical impulses are generated by wire electrodes surgically placed in the brain. Deep brain stimulation may be used in addition to therapy with levodopa or other medication when medication alone does not control symptoms adequately. This technique is the preferred surgical method of treating most cases of advanced Parkinson's disease. It does not destroy brain tissue and has fewer risks than older, more destructive surgical methods.

Most people with Parkinsons Disease find they can significantly reduce their medications after DBS but few have been able to eliminate medications completely.

Pallidotomy is a surgical procedure that involves the precise destruction of a small area (the globus pallidus) in the deep part of the brain that causes symptoms. The effects of pallidotomy usually can be seen immediately. Thalamotomy is a similar procedure in which part of the thalamus is destroyed. With the increasing availability and success of deep brain stimulation (a nondestructive procedure), these higher-risk, tissue-destructive procedures are being done less often.

Neurotransplantation surgery is an experimental type of surgery being studied for the treatment of Parkinson's disease. It involves implanting cells that produce dopamine into the brain. These cells may come from fetal brain tissue, although the use of fetal tissue is controversial. Future neurotransplantation approaches may include the transplantation of nerves from other areas in the affected person's own body or from genetically altered cells. Neurotransplantation has only been done on a few people and is available in only a few major medical centers. It is not a realistic option for most people at this time.

Parkinson's Surgery (continued)