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Considering DBS for father almost 79 yrs


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#1 Stringer

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Posted 22 February 2012 - 05:55 PM

Hello, My dad is almost 79. He's had PD for almost 20 years. All his health conditions are PD-related. We recently saw a surgeon and movement disorder specialist both of whom evaluated dad for DBS. He still has to under go the psych testing. My question is, was your DBS worth it? Dad is almost 79. Initally he was able to function well with the meds. HOwever, these last few years the PD has grown more intesne despite meds. He takes Stalevo and carbo/levodopa every three hours. He often has bad dyskenesia.

The doctors told him that with DB he should expect a four percent increase in his best medecine times. Also,he could expect less extreme dips between on and off times.

One doc mentioned that there are better meds out there than what dad is taking but because he's prone to hallucinations he wouldn't recommend them - although he could take anti-hallucinogenes.

My question is to the community: can anyone say that DBS was a worthwhile procedure? How often following the procedure was follow up necessary? I've heard so many conflicting reports. Logistically, all of this is tough on dad - not to mention the stress of the appointments/evauations. I don't know whether I should just be more aggressive about getting his meds right.

Thank you!!!!!!!!!!!!!!

#2 Dr. Okun

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Posted 23 February 2012 - 06:30 PM

The most important thing is evaluation of risk-benefit ratios.

Over the age of 70 places him at risk and if he has a lot of brain atrophy he may be at risk.

The more co-morbidities, the higher the risk.

Only levodopa responsive symptoms, tremor, and motor fluctuations are likely to improve. Gait and balance are very tricky in someone that old.

We have operated on people over 80, so age is a relative risk factor, but he must have a completed an interdisciplinary evaluation. Typically this involved on/off UPDRS testing, a brain image, a neurologist, a neurosurgeon, a neuropsychologist and often a psychiatrist. Many time PT/OT/Speech are important. Once this team meets they can assess risk/benefit ratios.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips





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