7Before Surgery
Benefit from levodopa , but have complications Over time , many people continue to respond to levodopa , but experience complications or side effects that impact quality of life . For example , medication might work , but only for a short time , forcing you to take levodopa every two or three hours . Or , you could have extreme ups and downs , or “ motor fluctuations ,” throughout the day , where time with few or no symptoms (“ on ”) alternates with symptom return (“ off ”), like a rollercoaster ride .
DBS generally works as well as your best “ on ” time with levodopa . For this reason , some doctors call DBS “ electric levodopa .” The regular electrical stimulation of DBS can often provide a smoother , more even , predictable day .
One important exception to the requirement of levodopa benefit is tremor that does not get better with levodopa or other medications . DBS can help in this situation .
Do not have significant memory or mood changes DBS can worsen memory and thinking ( cognitive ) abilities . This is generally temporary but , in rare cases , may be permanent . People who have significant problems with memory and thinking are at greatest risk for worsening with surgery . Because of this , all potential DBS candidates undergo detailed memory and thinking tests ( neurocognitive testing ) as part of the screening process . If results are below normal , there is a higher risk of cognitive worsening and lower chance of a good outcome with DBS . Those with milder cognitive changes often are still eligible for surgery .
People with uncontrolled depression or anxiety may have trouble with the DBS process , procedure and programming , and they may be at risk for increased mood changes following surgery . Those with well-managed mood symptoms are typically able to have DBS .
Are generally in good health Doctors consider your overall health and suitability for surgery when evaluating for DBS . Certain heart diseases , blood pressure or clotting problems , or other medical conditions might make the procedure more risky .
There is no absolute age cutoff for DBS . Some medical centers find that people who are 70 or older may not experience as robust a response as younger people . But other factors such as Parkinson ’ s symptoms , levodopa responsiveness , mood , cognition and other health conditions , are probably more important than age alone .