5Before Surgery
People and families with Parkinson ’ s think about DBS for different reasons and at different times . Soon after diagnosis , some want to understand all potential treatment options . Others dig deeper at the suggestion of a physician , fellow community member or loved one . Many seek detailed guidance as they seriously consider DBS , a few years or more into life with Parkinson ’ s .
There ’ s no right or wrong time to gather information , and it ’ s never too early to start . You ’ re taking a positive step to make the best decision for you . That can feel energizing . But it can also feel scary or confusing . When thinking about DBS , many say they feel hope and optimism for how it may help , sadness about disease progression or an understandable hesitation about brain surgery . These emotions are perfectly normal .
Explore and discuss feelings . Talk with your family , loved ones and support system . Get a second opinion from a movement disorder neurologist who specializes in DBS , if needed . Talk with a DBS surgeon . Draw on the experiences of those who ’ ve had DBS . Ask lots of questions . Reflect on what you learn . Give yourself time , space and grace throughout the process .
What DBS Can and Can ’ t Do
For many people , DBS is very effective for treating motor symptoms , such as tremor , slowness and stiffness . DBS also can lessen dyskinesia ( involuntary movement ), dystonia ( muscle cramping ) and wearing off ( when medication stops working and symptoms return ). It can smooth out the day and even out ups and downs , often with less medication .
DBS typically helps symptoms that levodopa helps . If levodopa eases a certain symptom , DBS is likely to ease that symptom , too . But where levodopa does not help , DBS is unlikely to help either .
DBS likely to help
+ Slowness
+ Stiffness
+ Tremor , including “ medication resistant tremor ,” which is difficult or impossible to treat with levodopa and other drugs
+ Mild walking problems that improve with levodopa
+ Symptom fluctuations : “ on ” when symptoms are controlled , alternating with “ off ” when they aren ’ t
+ Dyskinesia : involuntary , uncontrolled movement
DBS unlikely to help
+ Significant walking problems , especially those that do not improve with levodopa
+ Freezing of gait
+ Balance problems and / or falls
+ Speech or swallowing changes
+ Thinking or memory ( cognitive ) changes
+ Mood problems , such as depression , anxiety or apathy ( lack of motivation )
+ Bowel , bladder or sexual function changes
+ Dystonia : muscle contraction