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Surgery for Parkinson's Disease |
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Parkinson's disease is a progressive neurodegenerative illness that
affects about one percent of men and women over the age of 50. Despite
tremendous advances in drugs and techniques to manage the symptoms of
Parkinson's disease, not everyone is able to benefit from these
improvements. Parkinson's disease is a highly individualized condition
that attacks each patient differently. With the promise of stem cell
therapy on the horizon, coupled with 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, a number of cases of rapidly-progressing or unusually severe
Parkinson's that necessitate surgery as the best treatment option. Like
drug therapy, surgery may decrease the effects of symptoms such as tremors
and mobility problems, but is not a cure.
Is surgery for
Parkinson's the best option for you? There is no simple answer.
Parkinson's surgery is brain surgery, which by its very nature is highly
risky. There is always the very real potential for permanent brain damage.
If, however, all other non-invasive treatment options have been
ineffective, doctor and patient may determine that surgery is the best
available option to manage the Parkinson's symptoms.
A pallidotomy
may be required for Parkinson's patients with an especially aggressive
case of the disease. It may also be selected for those among the small
percentage of patients who do not respond to medication. If the latter is
the case, it might be worthwhile to get a second opinion for your
Parkinson's diagnosis before going ahead with surgery. It is worthwhile to
note that there are several conditions that have similar characteristics
to Parkinson's but that do not respond to ant-Parkinsonian drugs. During
the course of surgery, a small hole will be drilled in the skull and an
electric probe inserted. The probe is used to destroy a small part of the
portion of the brain known as the global pallidus. Parkinson's experts
think that an overactive global pallidus affects people who suffer from
the disease, and that by destroying it, medication-induced rigidity and
dyskinesia may be reduced. Pallidotomies have been used since the 1990s. A
similar procedure, called a thalamotomy, is used to destroy cells in the
thalamus. This surgery can be helpful in treating debilitating hand and
arm tremors. A less destructive, but nonetheless risky, surgical option is
called deep brain stimulation. In deep brain stimulation an electrode is
implanted into the brain. The electrode transmits electrical pulses to
stimulate the brain while also blocking the signals that cause Parkinson's
symptoms. Think of it as a sort of pacemaker for the brain. Compared to
other surgical options, deep brain stimulation is a relatively new
procedure that has been found to be helpful in improving motor function.
Surgery
is not the answer for everyone. It is risky and therefore should be used
as a last alternative. In addition to the health aspects and risks,
prospective Parkinson's surgical patients may also have to weigh financial
considerations when deciding whether or not to have surgery. All of the
surgical procedures are costly to administer and may not be covered by all
health care insurance plans.
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