In this lesson from our Parkinson’s Masterclass: Advanced Therapeutics, we use a case to illustrate how to determine when to use deep brain stimulation for the treatment of Parkinson’s and what the patient needs to try first before being eligible for device-assisted or lesioning procedures.
Candidates for DBS should have motor fluctuations and / or dyskinesia that cause disability despite optimal medical management.
This means the patient should
- Be taking at least 4 doses of levodopa
- Have tried at least one dopamine agonist
- Have tried an extending agent
- Have tried amantadine (if dyskinesia is present)
If the patient is still symptomatic, they meet the medication criteria for device-assisted or lesioning procedures.
Using the Movement Disorder Society revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), candidates should have at least a 30% improvement in symptoms going from the OFF to the ON state to qualify.
If you would like to learn more about DBS, head over to chapter 3 in our course.
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