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MIVEGO

Gpi dbs resurgery?

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Dear Doctor,

Hello I´m male, 54 yrs., dx. PD since 2002 almost 16 yrs, in 2010 I had my dbs durgery in GPI bilaterally, because diskinesia, distonia, etc. which disappear after the surgery but now I have other problems, in OFF without sinemet  my voice is low volume, I shuffle my right foot, I feel a lot of weakness I get tired quickly, constipation (controlled),shortness of breath, urinary frecuently, and in ON my speech worsen and is not intellegible but my gait improves somehow, but sometimes is festinating, balance problems.

 

At present I would ask your advice in the following situation : The rechargable battery of my Brio St Jude neurostimulator is coming to the end of his useful life in about 1 year, for these I have two options : one is that here in Mexico the Institute of Social Security (IMSS) only offers me the possibility with no cost for me to re-surgery me completely I mean to put me a complete new Medtronic system (new electrodes implanted in the same place Gpi, new wires, new neurostimulators) these is because the Institution only have by contract as unique supplier to Medtronic (the Medtronic battery is not compatible with the St Jude Brio system) and the other option is to spend aprox. $12500 usd in buying a new ST Jude battery neurostimulator, I don't have all this money at present but I hope I can get support of my family members in case this was a more recommendable option for me, that's why I wrote to you, to please give me your advice considering what is best decision for me considering risks, all pros and cons.  

Thanks for all your help.

 

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Moderator,

Please I need the medical advice of the surgical team of my last post I will appreciate your approval. Thank you.

 

 

 

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First, I am very sorry for the delay in response to your question.  The system underwent an upgrade and the software change captured some questions which we have now located. Please accept our sincerest apology.

This is a tough one.  One option would be to go to Monterrey and see Daniel Martinez the PF Foundation's former Ask the Spanish Doc and he can work you up and help with a decision.  If the leads are suboptimally placed it may be worth a repeat brain surgery.  If the leads are well placed I do not know if I would take the risk of repeat surgery.

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