Parkinson’s syndrome at age 62–a new surgical treatment for DBS

(Disclaimer: This article is only for scientific purposes, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: This case is a 62-year-old male patient, the patient said that three years ago there was no obvious reason for slow movement, accompanied by involuntary shaking of the right upper limb, which is prone to occur when it is quiet, and disappears after activity or after falling asleep, and came to the hospital for examination and was considered to be Parkinson’s syndrome. The effect of medication was poor, and after DBS surgery, the symptoms of limb shaking were significantly relieved. Basic information] Male, 62 years old [Disease type] Parkinson’s syndrome [Hospital] Shandong Third Hospital [Date of consultation] January 2022 [Treatment plan] DBS surgery + intravenous drugs (cefoperazone sodium sulbactam sodium injection + tetrahexasaccharide monosialic acid ganglioside sodium injection + methylcobalamin injection) + oral medication (dobasic hydrazide tablets + pibefedil delayed-release tablets + cazodibarb controlled-release tablets) [Treatment cycle] DBS surgery + intravenous drugs (tetracosan monosialate sodium injection + tetracosan sodium injection + methylcobalamin injection) Treatment cycle] 10 days of hospitalization, 1 month follow-up [Treatment effect] Stable condition, obvious improvement of symptoms I. Initial consultation When the patient came to the outpatient clinic, the hand shaking was particularly serious, it was impossible to control, and the action was very slow, the patient’s child complained that the history of the disease has been 3 years, the effect of the long-term use of anti-Parkinson’s medication was not good, and the symptoms of limb shaking have recently worsened, the patient was very painful, and he specially came to the hospital to seek a solution. He came to the hospital to seek a solution. Neurological examination suggests right upper limb resting tremor, high muscle tone in the limbs, ataxic gait. At present, the patient’s diagnosis of Parkinson’s syndrome is clear, the effect of long-term medication for 3 years is poor, no special discomfort, there is no contraindication to surgery, detailed communication with the patient’s condition, suggesting that surgical treatment, hospitalization as soon as possible, the patient expressed understanding and active cooperation. After the patient was admitted to the hospital, he was examined in detail on blood routine, liver and kidney function, cardiac enzymes, blood lipids, blood sugar, electrocardiogram, lung CT and so on. We excluded contraindications to surgery and communicated with the family about the surgical process and risks. The patient was a little nervous, preoperative blood pressure was high, in the encouragement of doctors and family members the mood finally calmed down, blood pressure also dropped to normal, given arrangements for deep brain electrical stimulation (DBS surgery), the electrode implanted in the nucleus pulposus, the operation was about 30 minutes, the operation progressed smoothly, postoperative injections were given to the cefoperazone sodium sulphadoxine sodium, tetrahexylsalicylate ganglioside sodium monosialic acid injection, methylcobalamin injection and other anti-infective, Nutritional nerve and rehydration drugs, the patient had no special discomfort, and his condition was stable. On the first postoperative day, there was no obvious pain in the chest, and the patient’s tremor and stiffness were significantly relieved, and his slow movement was improved. On the 7th day of hospitalization, the patient’s vital signs were stable, the muscle strength was improved from grade 3 to grade 5, the wound healed well after the operation, there was no special discomfort, the symptoms improved significantly, the operation was successful, and the patient was discharged from the hospital, and the patient was advised to continue to take the anti-Parkinson’s medication Dobazepine tablets, Pibedil delayed-release tablets, and Cazolodibar controlled-release tablets for a period of time, and it was recommended to pay attention to the protection of the wound after the hospital discharge, to prevent the infection, to avoid touching the water, and to give regular wound care, and to go to the hospital for follow-up on time. Wound care, go to the hospital on time for follow-up to assess the neurological function. If the condition is stabilized, the dosage of the drug can be gradually reduced until the drug is stopped. 1 month later, the patient had no special discomfort in the outpatient clinic of the Department of Neurology. The patient is glad that the disease is under good control after active treatment. It is recommended that the patient should take medication regularly after discharge from the hospital, take appropriate activities, and ensure a good work and rest. Family members should pay attention to the tremor of limbs, whether there is a decrease in muscle tone and muscle strength. If there is a significant aggravation of the symptoms, it is necessary to go to the hospital regularly for follow-up to assess the neurological function and whether the medication needs to be adjusted. The patient should pay attention to a light diet, monitor blood pressure and heart rate, and eat foods that are easy to digest and absorb to avoid constipation. V. Personal Insights Parkinson’s syndrome is mostly found in middle-aged and old-aged patients, such as this patient, who suffers from the disease seriously affects the life and self-care ability. Therefore, family members should pay attention to the health of the elderly, once memory loss, slow reaction, limb tremor, movement difficulties, etc., should come to the hospital to avoid delays in the condition, usually like the patient, after active drug treatment, can effectively alleviate the symptoms, and in the period of taking medication should be regularly to the hospital for follow-up, blood tests to understand the physical condition, to avoid the side effects of medication, through the neurological examination to determine whether the need to adjust the medication, should not be adjusted, and should not be used as an alternative to the treatment. To clarify the need to adjust the medication, do not blindly take the medication or self-addition of drugs, otherwise it will lead to aggravation of the symptoms.