The Parkinson’s Protocol™ By Jodi KnappThus, the eBook, The Parkinson’s Protocol, educates you regarding the natural and simple ways to minimize the symptoms and delay the development of Parkinson’s effectively and quickly. It will also help your body to repair itself without following a specific diet plan, using costly ingredients or specific equipment. Its 60 days guarantee to return your money allows you to try for once without any risk.
How do patients qualify for Deep Brain Stimulation?
Patients typically become candidates for Deep Brain Stimulation (DBS) if they have some refractory neurological diseases, and if they meet certain medical criteria. A summary of the most critical factors that determine whether a patient is a candidate for DBS is as follows:
1. Neurological Condition:
Parkinson’s Disease: DBS is used most often in Parkinson’s disease (PD), particularly in patients with motor symptoms (e.g., tremor, stiffness, and slowness) that cannot be best managed with medication or who have awful drug side effects (e.g., dyskinesia). The patients should normally be in mid- to late-stage Parkinson’s, but a few patients who are in an early stage of the disease and have significant symptoms will also be helped.
Essential Tremor: DBS can be useful for those with severe unmanageable essential tremor (ET). It is especially useful when tremors are interfering with activities of daily living and quality of life.
Dystonia: Dystonia patients, particularly primary generalized dystonia, can be candidates for DBS if their symptoms are severe and refractory to other interventions like medications or botulinum toxin injections.
Obsessive-Compulsive Disorder (OCD): In severe cases of treatment-resistant OCD (e.g., medications and therapy), DBS may be considered, but this is typically a more experimental use of the procedure.
Other Disorders: DBS is sometimes used for tremor-predominant multiple sclerosis, Tourette syndrome, or idiopathic Parkinsonism, but these uses are less common.
2. Severity and Duration of Symptoms:
Inadequate Medication Response: Test recipients typically have symptoms that are inadequately controlled with medications. This can include motor fluctuations, irreducible tremors, or dystonic movements that interfere with daily function despite using a variety of drug regimens.
Long-Duration of Disease: For Parkinson’s disease or essential tremor, patients with the condition for a certain number of years (usually at least 4-5 years for Parkinson’s) and still having disabling symptoms could qualify for DBS.
3. Age and Health Status:
Age: Although there is no rigid age criteria, very elderly patients may have a greater chance of postoperative complications. Traditionally, below 75 years of age the patients are most suitable candidates. However, being old is not always an exclusion factor, and elderly patients fit enough for the surgery can even be treated with DBS.
General Health: The patient should be overall in good health, not having significant cardiovascular disease, intellectual disabilities, or other significant medical illness that would complicate surgery or recovery. Those who have uncontrolled infection, serious psychiatric illness, or uncontrolled medical disease are not always the best candidates for DBS.
4. Cognitive Function
Cognitive Health: For individuals with Parkinson’s disease, the presence of severe cognitive impairment (e.g., dementia or Parkinson’s disease dementia) may make them ineligible for DBS because on occasion cognition can decline after surgery. Candidates should have adequate cognitive function to understand the procedure and complications and to be able to provide postoperative follow-up care.
Psychological Assessment: A psychological assessment is typically included in the qualification process to determine mental and emotional well-being. Extreme psychiatric illness (e.g., untreated depression, psychosis, or unstable mental status) may render a patient ineligible for DBS.
5. Response to Previous Therapies:
Trial with Medications: The patient is generally supposed to have already received a course of medications (e.g., levodopa in Parkinson’s or propranolol in essential tremor) and not have responded or tolerated inadmissible side effects.
Botulinum Toxin Injections (for dystonia): Botulinum toxin injection failures in dystonia patients are candidates for DBS if they have disabling symptoms.
6. Motivation and Realistic Expectations
Patient Motivation: DBS is a chronic, complex treatment, and patients need to be motivated and have realistic expectations about what the procedure can achieve. DBS can significantly reduce some symptoms but does not cure the underlying disease. Patients should be informed about the risks and benefits.
Family Support: The patient must have a good support system in place after surgery for recovery and adjustment to the device, as the procedure requires frequent follow-up and adjustment.
7. Multidisciplinary Evaluation:
Team Evaluation: A collective decision to undergo DBS is made by a team of medical professionals that may include neurologists, neurosurgeons, neuropsychologists, and occupational or physical therapists at times. The team will assess whether the patient would be a proper candidate for the procedure based on his/her own condition, symptoms, and state of health in general.
8. Specific Criteria for Parkinson’s Disease:
Motor Fluctuations: Those Parkinson’s patients with motor fluctuations, such as “on-off” effects (where the drug effects suddenly cease unpredictably), dyskinesias (spontaneous movements), or bradykinesia (slow movement), can be benefited from DBS if these are poorly controlled with medications.
Symptom Severity: Those individuals with severe to moderate motor symptoms (most notably tremor, rigidity, and bradykinesia) impairing their daily functioning and are refractory to medications are generally the best candidates for DBS.
Adequate Response to Levodopa: Candidates must maintain an adequate first response to levodopa (the primary therapy for Parkinson’s disease) because DBS is most appropriate for those who are responsive to this medication but whose symptoms are no longer optimally managed by it.
9. Necessary Tremor Criteria:
Severe, Refractory Tremor: DBS might be considered for patients with severe and significantly life-altering tremor, which is resistant to drugs, alcohol, or other therapies like injections of botulinum toxin.
Unilateral vs. Bilateral Tremor: DBS is most commonly used to treat unilateral tremor (tremor on one side of the body) and will be effective even for individuals with resistant essential tremor that has not responded to other therapies.
10. Special Considerations for Dystonia:
Generalized or Focal Dystonia: DBS may be an option for patients with generalized dystonia (involves more than one body area) or focal dystonia (involves one body area) who are medically refractory (fail to respond to medication or other treatments).
Young-Onset Dystonia: DBS is highly effective in patients with young-onset dystonia, a subtype of dystonia that begins in childhood or adolescence.
Conclusion:
Typically, only candidates for DBS will possess a non-responsive neurological disorder to medication, good cognitive and psychological condition, and be in reasonably healthy physical condition generally to be operated on. Decision to undergo DBS is arrived at after rigorous evaluation by an interdisciplinary team, taking into consideration the patient’s symptomatology, history of diseases, and earlier response to therapy.
The Parkinson’s Protocol™ By Jodi KnappThus, the eBook, The Parkinson’s Protocol, educates you regarding the natural and simple ways to minimize the symptoms and delay the development of Parkinson’s effectively and quickly. It will also help your body to repair itself without following a specific diet plan, using costly ingredients or specific equipment. Its 60 days guarantee to return your money allows you to try for once without any risk