Key criteria in selecting patients eligible for surgical treatment of Parkinson's disease
DOI:
https://doi.org/10.47924/neurotarget2011324Keywords:
Parkinson‟s disease, DBS, patient selectionAbstract
The selection of candidate patient for surgical treatment of Parkinson's disease represents a crucial step to ensure maximum efficiency and the lowest possible incidence of adverse effects.
Predictive clinical criteria most relevant to Parkinson's disease (PD) are mainly represented by: an accurate diagnosis, a response to L-dopa more than 30%, age less than 70 years, absence of signs including cognitive- behavioral impairment (according to different clinical rating scales), as well as depression and suicidal ideation.
The denominated axial symptoms, including freezing when walking and speech and gait troubles, with inadequate response to dopaminergic therapy, probably would not be modified by surgery greatly.
In relation to the motor fluctuations and dyskinesias associated with replacement therapy, such as biphasic dyskinesias, peak-dose dyskinesias and ON-OFF dystonias, irrespective of the magnitude and duration, regardless the magnitude and duration, all of them will present an adequate and sustained response; this combined with the beneficial effects on the cardinal symptoms, would indicate that deep brain stimulation (DBS) is a safe and effective method, although it does not avoid in any way the progression of the disease.
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Copyright (c) 2011 Darío Adamec
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