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balance & speech


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#1 kbachn

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Posted 22 January 2013 - 08:44 PM

Balance and Speech are common new symptoms post DBS. I have severe Balance
problem post DBS (pre DBS I had good balance) 2 MONTHS AGO.

Is there a solution to either one of these two symptoms (1) specific programming
settings or recommendation (2) advice (exercise) OR (3) Something that I simply
have to live with.

Thank You

#2 Dr. Okun

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Posted 25 January 2013 - 05:07 PM

This is tough. We usually shut the device down in clinic and observe whether the programming os affecting the balance. We first determine if it is programming related or surgically related. Then, in many cases we do a post-op scan to look for bleeding, strokes and other causes.

Many times physical therapy, speech therapy and occupational therapy are then done aggressively. If reprogramming can help we also try that (but if it doesn't change when off DBS there is not a lot of enthusiasm that this approach will help).

The other thing is that you are only 2 months out from the surgery-- and there could be swelling, bleeding or other causes that may slowly improve. If it persists at 6 months this is less rehab-able.
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

#3 zackabenie

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Posted 01 July 2013 - 03:30 AM

I have just discovered this for and am very thankful.. Unfortunaltly I do not have better news, I am now 1 year out for dual lead placement dbs surgery (June 2012). My speech and balance are still much worse than pre-dbs suregery. I have difficulty finding words, and my balance is shot to $#^. I am only 58 and have had PD for 7 years. At this time I am on Simunet, Comtan, Azilect, Requip XL and Lexapro. I exercise (pool for aqua-aerobics, was my gift from self and hubby) to try to exercise. I researched the surgery for several months prior to decision to undergo the procedure. In all the info, the dvd from my neuro and surgeon did not address the terrible fatique (for me lasted 5 months post surgery), the depression, or the frustration of now using a cane. But, on the bright side, I can have my cup of tea in the morning in a regular cup now and not worry about scalding myself!! Keep smiling and remember that you are master of this.
Joelene -
Smile every day and laugh at least once at something the PD is now causing you to do. I personally love the "left" turns that happen as I walk. The smile really works - it makes everyone worry what you have been up to!

#4 Dr. Okun

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Posted 01 July 2013 - 07:38 AM

Walking, talking and thinking can all worsen post-DBS. Additionally, fatigue can be worse. You may consider a sleep study. Also, make sure they assess whether these symptoms persist when you turn the device off (could it be stimulation induced). Also, be sure they assess the lead position as it is possible that it could be suboptimally placed.

In a minority of cases we can re-program devices--sometimes in bipolar to improve the symptoms.
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

#5 zackabenie

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Posted 08 July 2013 - 11:13 AM

I am so glad to see this post from Dr. Okum. I had the DBS surgery one year ago and have been confused by my speech issues and balance problems, thinking they were just me. The doctors have reprogrammed my unit but nothing seems to help. Some days I feel my speech is that of some one who has drank several cocktails and my balance is so bad that when I am out of the house where I can use the furniture and walls as balance assistance I must use a cane. I am adopting a positive attitude about this and accepting these problems as a tradeoff of the dyskinesia and tremors.
Joelene -
Smile every day and laugh at least once at something the PD is now causing you to do. I personally love the "left" turns that happen as I walk. The smile really works - it makes everyone worry what you have been up to!

#6 Dr. Okun

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Posted 09 July 2013 - 02:09 AM

Thanks for the comments.
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

#7 tinnytots

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Posted 22 November 2013 - 01:03 AM

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#8 Dr. Okun

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Posted 23 November 2013 - 08:02 AM

Thanks you are free to use any of our blogs or the What's Hot monthly posting on the NPF website.


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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