Thursday, July 30, 2015

My father was diagnosed with Parkinson's last year. His medication controls the tremors, but when he forgets his pills, he shuffles and suffers. Would deep brain stimulation zap his disease?

My father was diagnosed with Parkinson's last year. His medication controls the tremors, but when he forgets his pills, he shuffles and suffers. Would deep brain stimulation zap his disease?

My father was diagnosed with Parkinson's last year. His medication controls the tremors, but when he forgets his pills, he shuffles and suffers. Would deep brain stimulation zap his disease?

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My father was diagnosed with Parkinson's last year. His medication controls the tremors, but when he forgets his pills, he shuffles and suffers. Would deep brain stimulation zap his disease?

Dr. Meredith Spindler is a professor of neurology at the Parkinson's Disease and Movement Disorders Center of the University of Pennsylvania.

A: Deep brain stimulation is a surgical option; a neurostimulator, implanted in the chest, delivers electrical signals to the brain, much like a pacemaker. In Parkinson's, the device is linked to electrodes that are implanted in the areas of the brain that control movement.

This is a great treatment for some patients, but not all. It does not cure the disease or stop the progression; it just helps control some of the symptoms. Stimulation is helpful for patients who have a tremor that is not controlled well enough with medication, or who have side effects from medicine. It does not alleviate other symptoms, such as balance and memory problems, and can even worsen them.

In general, we make sure to exhaust all drug options before referring to surgery, since all surgeries entail risk. Every case is different; a decision to operate should be made with the guidance of a specialist who knows the patient well.

Since your father responds well to pills, but has trouble remembering them, use an alarm to ensure he does not forget. Also, do thorough memory testing before choosing surgery, as people with significant memory problems tend to do poorly with surgery.

- Dr. Meredith Spindler, with Inquirer staff writer Leila Haghighat

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Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Michael R. Cohen, R.Ph. President, Institute for Safe Medication Practices
Daniel R. Hoffman, Ph.D. President, Pharmaceutical Business Research Associates
Hooman Noorchashm, M.D., Ph.D. Cardiothoracic surgeon in the Philadelphia area
Amy J. Reed, M.D., Ph.D. Anesthesiologist and Surgical Intensivist in the Philadelphia Area
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