Is Surgery for Parkinson’s an Option for You?

Despite tremendous advances in drugs and techniques to manage the symptoms of Parkinson’s disease, a progressive neurodegenerative illness that affects about one percent of men and women over the age of 50, not everyone is able to benefit from the improvements.
Parkinson’s disease is a highly individualized condition that attacks everyone differently. With the promise of stem cell therapy on the horizon, and the general effectiveness of existing drug treatments including the commonly administered levodopa, most Parkinson’s sufferers are able to cope with their disease. There are, however, cases of rapidly progressing or unusually severe Parkinson’s that necessitate surgery as a treatment option. Like drug therapy, surgery may lessen the effects of symptoms such as tremors and mobility problems, but does not act as a cure.
So is surgery for Parkinson’s an option for you? There’s no easy answer. Surgery for Parkinson’s disease is brain surgery, which by its very nature is extremely risky, with the very real potential for permanent brain damage. If, however, all other avenues of non-invasive treatment have been ineffective, doctor and patient may decide that surgery is the best available option to manage Parkinson’s symptoms.
A pallidotomy may be performed on Parkinson’s patients with an especially aggressive case of the disease or who are among the small percentage of patients who do not respond to medication (note: if the former is the case, it might be worthwhile to get a second opinion of Parkinson’s before going ahead with surgery as there are several conditions that have similar characteristics of Parkinson’s and that do not respond to antiparkinsonian drugs). During the course of surgery, a small hole is drilled in the skull and an electric probe is inserted. The probe is used to destroy a part of the section of the brain known as the global pallidus. Parkinson’s experts think the global pallidus is overactive in people who suffer from the disease, and that by destroying it, rigidity and dyskinesia caused by medication may be reduced. The procedure has been used since the 1990s.
A similar procedure, called a thalamotomy, can be used to destroy cells in the thalamus, which can be helpful in treating debilitating hand and arm tremors.

A less destructive but still risky surgical option is deep brain stimulation. Deep brain stimulation involves the implantation of an electrode into the brain. The electrode sends electrical pulses that stimulate the brain while also blocking the signals that cause symptoms of Parkinson’s disease. Think of it as a pacemaker for the brain. Compared to other kinds of surgical treatment, deep brain stimulation is a relatively new procedure that can be helpful in improving motor function.

Surgery is not for everyone. It is risky and should be used as a last alternative. In addition to the health considerations, prospective Parkinson’s surgical patients may also have to think about finances when making their decision about whether or not to have surgery. The procedure is costly to administer and may not be covered by all health care insurance plans.