Surgical options for Parkinson's disease

Surgical options for Parkinson’s disease are typically considered when medication and other therapies no longer provide adequate control of symptoms. These procedures are generally aimed at reducing motor symptoms, such as tremors, rigidity, and dyskinesias (involuntary movements). The two main surgical options for Parkinson’s disease are deep brain stimulation (DBS) and ablative procedures.

Deep Brain Stimulation (DBS) involves implanting electrodes into specific areas of the brain that control movement. These electrodes are connected to a device similar to a pacemaker, called a neurostimulator, which is placed under the skin near the collarbone. While DBS is generally safe and effective, it’s important to undergo a thorough evaluation to determine whether a patient is a suitable candidate for the procedure.

Ablative procedures involve the surgical destruction of specific brain tissue using techniques such as radiofrequency ablation, gamma knife radiosurgery, or focused ultrasound. These procedures are less commonly performed than DBS and are typically reserved for patients who are not suitable candidates for or do not respond adequately to DBS. Common targets for ablative procedures in Parkinson’s disease include the thalamus (thalamotomy) or the globus pallidus (pallidotomy). Ablative procedures can provide similar improvements in motor symptoms as DBS but are irreversible, as they involve the permanent destruction of brain tissue.

Not all individuals with Parkinson’s disease are suitable candidates for surgery. Patient selection is crucial in determining the potential benefits and risks of surgical interventions. Candidates for surgery typically undergo a thorough evaluation to assess their medical history, symptoms, and overall health status to determine whether they are appropriate candidates for surgery.

Surgery for Parkinson’s disease can be considered relatively safe and effective when performed by experienced neurosurgeons in specialized centres. However, like any surgical procedure, it carries certain risks and potential complications that need to be carefully considered and discussed with healthcare providers. Expertise of the Surgical Team, Patient Selection, Postoperative Care and Monitoring are important in the success of the procedure.

Dr. Ajay Hegde,
Consultant – Neuro-Spine Surgery,
Manipal Hospital Sarjapur