Parkinson's Disease Surgery

There are a variety of operations possible for a patient undergoing Parkinson's disease surgery. However, undergoing one of these procedures should only occur when all other possibilities have been exhausted. Although there is no cure as of yet for Parkinson's disease, neurostimulation and drug treatments that aim at preventing deterioration are alternatives to surgery.

Parkinson's disease is a disorder that affects the primary motor functions of the body. It is caused by the degeneration of the substantia nigra, an area of the brain that controls movement. Elderly people are especially at risk for developing Parkinson's. The condition causes tremors or stiffness in the body, difficulty in walking and performing simple body movements, a reduced sense of smell, insomnia, stomach cramps and even dementia.

Medications for Parkinson's disease can help replace dopamine with levodopa. Since the disorder is caused by the degeneration of neurons that release dopamine, such medication can help with the ease of movement. Regular exercise is also a common therapy for those who suffer from Parkinson's.

Two operations available to those with Parkinson's disease are pallidotomy and thalamotomy. Both of these surgeries deal with destroying a very precise part of the brain and are performed only as a last resort for advanced conditions of Parkinson’s. Pallidotomy concentrates on an area of the brain called the globus pallidus internus. During the surgery, this part of the brain is destroyed, reducing the tremors that are so crippling for Parkinson's victims and restoring mobility.

The operation usually takes about four hours and the patient is typically discharged from the hospital the following day. It should be warned, however, that possible negative side effects include infection, loss of vision, loss of limb/movement coordination or balance and hemorrhage.

Thalamotomy involves the destruction of the thalamus, an area of the brain that controls movement. During this surgery patients are kept awake but are numbed with a local anesthetic. A probe is inserted through a small hole made in the skull. An area of the brain identified through an MRI before surgery is destroyed with the use of liquid nitrogen. This surgery is quite rare nowadays and is usually conducted for only extreme cases of Parkinson's where paralyzing tremors affect patients who do not respond to medications.

Alternatives to surgery include acupuncture, techniques in relaxation (such as yoga, meditation and massage) and also neurostimulation or deep brain stimulation. Neurostimulation involves the use of electrical pulses that control the symptoms related to Parkinson's. An electrode is implanted in the brain with a generator connected via a wire beneath the skin leading from the skull to the chest. Whenever the patient activates the generator connected to this implant, an electrical pulse is applied blocking the tremors associated with Parkinson's. The benefit to neurostimulation is the fact that it is reversible, unlike surgery, where parts of the brain are affected permanently.

Surgery is only recommended to those patients who suffer from advanced Parkinson’s disease. In such patients, all other therapies and medications have failed and surgery is the only option left for them. Due to the irreversible nature of brain surgery, making the decision to undergo an operation for Parkinson’s should be well founded and guided by an experienced physician.