Parkinson's Disease
Treatment Options
by Dr. Patrick Sweeney

There are now a number of safe and effective surgical options available for the treatment of Parkinson's disease. Generally, surgery is only considered for patients when medication cannot provide adequate control.

Deep brain stimulation involves placing an electrode permanently in one of three locations deep in the brain. The electrode is then connected to a type of pacemaker implanted under the skin on the chest. Once activated, the device sends continuous electrical pulses to the targets, blocking the impulses that cause tremors.

Deep brain stimulation has many significant advantages. First, it does not require purposeful destruction of any part of the brain and therefore, has few complications. Deep brain stimulation is adjustable and can be changed as the patient's disease or response to medications change.

If deep brain stimulation is causing excessive side effects, the stimulator can be turned off and the effects reverse, which is not the case with older destructive surgeries.

Older surgeries required the purposeful destruction of parts of the brain and had a higher risk of complications. They are rarely done today.

In pallidotomy, a small section of the brain that is overactive due to Parkinson's disease is permanently destroyed using surgical techniques. This treatment can eliminate rigidity and significantly reduce tremor, bradykinesia, and balance problems. Pallidotomy can also smooth the effects of Parkinson's disease medications in patients with an advanced form of the disease.

Thalamotomy is a similar procedure where a section of the thalamus, the part of the brain that controls messaging, is destroyed using surgical techniques. This treatment is used only to control tremors and is not generally recommended.