Frequently asked Online Design Questions
DBS
When is it too late for DBS?
-
You must have had symptoms for at least 4 years; -
Have responded well to the medication levodopa; -
Still benefit from medication, but it’s becoming less effective or causing intolerable side effects; -
Require multiple medications, higher dosages, or more frequent doses to manage your symptoms. -
Ability to remain calm and cooperative during an awake neurosurgical procedure lasting 1-3 hours per brain side.
-
Your symptoms no longer respond to medication; -
Your mobility has deteriorated. Good mobility, with the ability to walk, in the best "on-medication" state is important for a good outcome. In general, surgery makes the "off" medication state more like the "on" state but rarely does better than the best "on" state, so a patient with poor function in best "on" (for example, unable to walk at any time) is a poor surgical candidate. -
You develop medical conditions that prevent surgery such as cognitive impairment, gait and balance problems. Dementia (significantly impaired memory or thinking) is a major contraindication to surgery, since such patients have great difficulty tolerating the surgery, may have further loss of intellectual function due to the surgery, deal poorly with the complexity of DBS therapy, and realize little overall functional benefit; -
You become severely disabled. DBS is a poor procedure to rescue someone with end stage Parkinson's disease who is wheelchair bound or in a nursing home, although these are the most desperate patients. It is an excellent procedure for Parkinson's patients who are still employed but may be just at the point where disability would stop them from working; -
Serious cardiac disease, uncontrolled hypertension, or any major other chronic systemic illness increases the risk and decreases the benefit of surgery. Also, an MRI of the brain should be free of severe vascular disease, extensive atrophy, or signs of atypical parkinsonism. -
Patient age. The benefits of DBS for PD decline with advancing age, and the risks go up. Rarely is surgery offered to a person over 80 and would only be considered if they are in otherwise excellent health, are cognitively intact, and have good function in the on state. For patients over 75, the benefits are likely to be modest.
Web Site
Why is the Deep Brain Thoughts web page not displaying properly?
What's the difference between signing up for your mailing list vs. sign up in the blog page?
Very good question! The 'Sign up for mailing list' simply adds your email to my list of folks who get emails from me - mostly letting them know that a new blog entry is available. This is a very good option if you DON'T use Facebook, since every new blog posting I will announce via Facebook. (And I will NEVER sell your ID nor spam any of my users!)