Is Parkinson's Disease curable with surgery?

Dr.Amit Srivastava, 3 mins read

Is Parkinson's Disease curable with surgery? 
Surgical intervention is an effective approach when:

• Medicines are unable to control Parkinson’s disease
• The patient has more side effects from medication
• The patient develops on-off phenomena after medicines
• The symptoms worsen on increasing the dose of anti-Parkinson’s medication

Surgery may help control the symptoms and improve the quality of life.

Currently, there are three types of surgery available for Parkinson’s disease, which we will discuss here.

Deep brain stimulation (DBS):
When Parkinson’s motor fluctuations symptoms return even after taking medicines for years, this procedure is usually recommended. DBS surgery provides effective control of this complex disease with a very low dose of added medication.

The surgery is believed to be beneficial for:

• Providing relief from tremors, stiffness, and other problems
• Reducing or halting involuntary movements called dyskinesia
• Improving movements
• Controlling changing responses to levodopa therapy (on-off phenomena)

If you decide to undergo the procedure, the doctor will evaluate your condition through a series of exams and tests.

After this, you will be taken to an operation theatre where you will receive anaesthesia. During the procedure, electrodes will be implanted in specific parts of your brain. These electrodes are connected to a battery implant placed below the collarbone.

The DBS system is similar to a pacemaker that controls heart rhythm. The system sends electrical pulses to the brain to restrict the impulses that cause the symptoms. The setting of the implant can be regulated to treat your specific condition.

The success rate of deep brain stimulation is good. Many people report improvement in their symptoms up to 80%. About 73% of people reported improvement in tremors. Between 50% and 78% of people got independence in doing daily errands.

Please make a note that DBS doesn’t cure or reverse the disease. It just lessens the symptoms. If it works well, it definitely improves the quality of life of patients.

However, DBS is not suitable for everyone. Discuss the pros and cons of the procedure with your doctor. Sometimes there is a risk of infection, stroke, or haemorrhage.

Ablative surgery:
This is another approach wherein the surgeon locates, targets, and then destroys or ablates the part of the brain affected by Parkinson’s. The aim is to destroy the tissue that produces chemicals or electrical impulses that cause symptoms of Parkinson’s.

Pallidotmy and thalamotomy are common ablative surgeries. However, both are done in very selective cases due to the risk of side effects.

Pallidotomy: This is done when the problem is associated with the globus pallidus, a triangular-shaped structure in the brain that regulates voluntary movements. Doctors believe Parkinson’s happens when the globus pallidus works too hard, making it harder for the body to move. In pallidotomy, the surgeon destroys this structure to make you feel better. It is an option for those in the advanced stage as it also makes medicine work better.

Thalamotomy: Problems with the thalamus, a part in the centre of the brain that relays motor signals and regulates consciousness, can also cause tremors. To ease the symptoms and tremors, doctors use thalamotomy surgery. During the procedure, the surgeon destroys the part of the thalamus.

Takeaway!
Surgery is considered an option in some cases of Parkinson’s disease when:

• Medication is not very effective or gives side effects
• There is an on-off phenomenon
• Quality of life is poor

In many cases, surgery improves the symptoms and quality of life. For best results, doctors usually combine different treatment options like therapy, meditation, medications and surgery (if required). Discuss with your doctor what option will work best for you.