Surgical Options Increasingly Effective for Many Parkinson’s Patients
Originally published Fall 2000

Of the approximately 1 million people in the United States living with Parkinson’s disease, an increasing number are seeking surgical treatment for relief. This is due to advancements in surgical techniques as well as the fact that more patients are building up a resistance to medications which once proved effective for them.

“To a large degree, Parkinson’s disease still remains a mystery, “said Anthony Asher, M.D., F.A.C.S., of Carolina Neurosurgery & Spine Associates, “but we continue to make strides in helping patients lead active and productive lifestyles. We’re proud to offer patients surgical options that can make a profound impact on their lives.”

A Debilitating Disease
The cause of Parkinson’s disease is still unknown. This chronic, progressive, nervous system disorder occurs when neurons in the deep brain structure called the substantia nigra, die or become impaired. These damaged neurons are then unable to produce dopamine, a chemical needed to transmit signals between the substantia nigra and other message centers of the brain. The lack of dopamine results in a neurochemical imbalance, which can lead to tremors in the hands, arms, legs and jaw, stiffness in the limbs, slowness of movement and impaired balance and coordination.

The Search For Relief
Parkinson’s disease, which occurs most commonly in the elderly and middle-aged individuals, is usually treated effectively with medications. These drugs relieve symptoms by restoring the brain’s neurochemical balance. However, these medications can have significant side effects and may lose effectiveness over time. In these instances, some patients may benefit from surgery.

Surgical Options
Surgical treatment for Parkinson’s disease includes pallidotomy, thalamotomy and deep brain stimulation. These procedures help relieve symptoms by either stimulating or destroying targeted deep brain cells that involve motion control.

With pallidotomy, a wire probe is inserted into the globus pallidus (in the corpus striatum) of the brain. Radio waves are then transmitted to heat the highly targeted area and destroy it. Thalamotomy uses the same energy to destroy a small area in the thalamus.

Deep brain stimulation involves implantation of small electrodes in the brain which are connected to a pacemaker-like device implanted beneath the skin. This device sends continuous, high frequency electrical stimulation to the electrodes. This stimulation acts as a lesion and helps the thalamus “rebalance” the motor control messages in the brain and suppress tremors.

“In many cases, surgery can definitely contribute to a patient’s quality of life,” said Dr. Asher. “But it’s not for everyone. Each patient is unique and surgery should only be considered if medications are either ineffective or cause unacceptable side effects.”

For more information, call Carolina Neurosurgery & Spine Associates at 800-344-6716 or click here.

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