Sunday, September 9, 2007

When to have Surgery?

Posted: Wed Aug 29, 2007 5:57 pm Post subject: when to have surgery

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I have been researching DBS and reading whatever i can. It seems that there are different thoughts on when to "go for it", In Europe they are doing it much earlier than here. When is it optimum and can there be a time when it is too late to do it?

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Dr. Okun



Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Sep 01, 2007 9:06 am Post subject:

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All great questions. There are ingoing early intervention studies at Vanderbilt and also in Paris/Kiel. I would advise not going early until there is data to support it---or alternatively doing a clinical trial.

The surgery STN or GPi, works best for medication responsive symptoms. As long as symptoms stay med responsive you are ok. If you want a non-medication (levodopa responsive symptom) then STN or GPi may not be useful (except for dyskinesia and tremor).

The risk is less under the age of 70 and that should factor into your decision.

If you are well controlled on meds I would not rush into surgery.

If you are seeing a specialist and getting to 3 hour or 2 hour intervals then surgery may be reasonable to start talking about.
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Michael S. Okun, M.D.

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