I. What are the main symptoms of Parkinson’s disease?
Parkinson’s disease is a chronic neurodegenerative disease of the middle-aged and elderly, manifesting symptoms such as tremor, muscle rigidity and slow movement, with symptoms gradually worsening.
What are the indications for Parkinson’s disease surgery?
Stereotactic surgery is more effective for tremor and rigidity, but less effective for slow movement. The indications for surgery are generally considered to be: (1) those who are generally under 70 years of age, with long-term medication ineffective or with obvious side effects, and whose ability to work and live is greatly restricted; (2) those who are clinically graded II to IV, and have no obvious contraindications to surgery.
For those who are older than 70 years old, usually in good health without other diseases, and can tolerate surgery as assessed by the doctor, surgery can also be considered. Patients with serious heart, liver, kidney and lung diseases cannot be operated.
What are the surgical treatment options for Parkinson’s disease?
Surgical treatment modalities for Parkinson’s disease, namely stereotactic surgery, include.
① Stereotactic nucleus destruction by radiofrequency;
Deep Brain Stimulation (DBS), commonly known as “brain pacemaker”.
What is deep brain stimulation for Parkinson’s disease? Are brain stimulator and deep brain stimulation the same concept?
Deep brain stimulation, abbreviated as DBS, is a method of implanting electrodes into the deep nuclei of the brain to deliver high-frequency electrical stimulation to control the symptoms of Parkinson’s disease and other diseases. This method has the advantages of less brain damage, fewer side effects, recoverability, adjustability and the possibility of bilateral surgery. The difference between DBS and RF therapy is the reversibility of DBS.
Deep brain stimulation is commonly known as “brain stimulator”, both are one concept.
V. How to choose the surgery for Parkinson’s disease?
Stereotactic surgery for Parkinson’s disease is mainly based on the patient’s symptoms to choose the appropriate treatment modality. For some patients, stereotactic nucleus destruction can be performed on one side first, and deep brain nucleus stimulation (“brain pacemaker”) can be chosen on the other side. Deep brain stimulation (brain pacemaker surgery) can also be chosen on both sides.
VI. Is the application of microelectrode recording helpful during surgery for Parkinson’s disease?
The purpose and significance of microelectrode recording technique applied in Parkinson’s disease surgery are.
① To understand the boundaries of certain nuclei in the deep brain and the major structures around them (such as the optic tract, internal capsule, etc.).
(2) Since cells in different parts of the deep nuclei have different forms of firing, microelectrode recording techniques are valuable in locating nuclei during surgery.
How to choose to treat Parkinson’s disease with “brain pacemaker”?
Parkinson’s disease is not treated by medication or the side effects of medication are too great to continue to take; tremor with speech impairment; bilateral Parkinson’s disease symptoms, one side has been destroyed, the other side needs “brain pacemaker” treatment; patients who need bilateral surgery, etc. are all “brain pacemaker” treatment targets. Patients who need bilateral surgery, etc., are candidates for “brain pacemaker” treatment.
What is the effect of “brain pacemaker” in treating Parkinson’s disease?
”Pacemakers have significant therapeutic effects in the treatment of Parkinson’s disease.
(1) It can control the symptoms of Parkinson’s disease, such as tremor, rigidity, slow movement or inability to move, and balance disorder;
②Some patients can reduce the dose of oral medication;
③Improve the quality and ability of patients’ daily life.
9. Is there any danger in Parkinson’s disease surgery?
Parkinson’s disease surgery, like other neurosurgical procedures, has certain surgical complications and risks, but as long as the surgical indications are selected appropriately, the incidence of surgical complications is low. A common complication is intracranial hemorrhage leading to hemiparesis.
What are the common complications after Parkinson’s disease surgery?
Complications after Parkinson’s disease surgery are rare, but complications such as intracranial hemorrhage, hemiparesis, speech disorders, swallowing difficulties, numbness of one limb, balance disorders, and postoperative infections may occur.
Do I need to take medication again after Parkinson’s disease surgery?
Parkinson’s disease surgery only relieves most of the patient’s symptoms, not the root cause, so it is still necessary to take medication after surgery, but individual patients can reduce the amount of medication.
Can Parkinson’s disease be completely cured by surgery?
Surgery for Parkinson’s disease can only improve symptoms, not cure them. At present, there is no complete cure for Parkinson’s disease, but it is believed that in the future, brain tissue transplantation and gene therapy are expected to cure Parkinson’s disease.
XIII. What diseases can be treated by “brain pacemaker”?
The “brain pacemaker” can be used to treat Parkinson’s disease, primary tremor, chronic pain, dystonia, etc. It is a better stereotactic surgery method to treat these diseases.
XIV. What should I pay attention to after the implantation of the “brain pacemaker”?
Most medical devices are safe for examination, but the following points should be noted.
(1) Thermal therapy should not be given directly to the implantation site of the pulse generator;
② Direct radiation therapy is not recommended;
③It is not safe to have strong magnetic field;
④Do not pass through the security check lanes of special departments such as airports.
Most household appliances do not affect DBS, such as TV sets, refrigerators, microwave ovens, short-wave radios, etc.
Do I need close follow-up after the implantation of a pacemaker?
It is very important to follow up after the implantation of a pacemaker, as the stimulation frequency, current and voltage are adjusted to achieve the best disease control and the least side effects. Follow-up visits are carried out 1-3 times a year for programmed testing. Since this treatment is not an etiologic treatment for PD, patients with Parkinson’s disease are still progressing and deteriorating naturally, so close follow-up is needed.
What should I do if the battery is dead several years after the implantation of the pacemaker?
”When the battery of the pulse generator of the pacemaker is dead, it is only necessary to replace the subcutaneous pulse generator, but not the intracranial electrodes. Rechargeable pulse generators have been used clinically to extend the battery life.