DBS works miracle for young-onset patient of Parkinson’s
Parkinson’s disease is a progressive disorder of the nervous system that affects body movement. It progresses gradually and usually starts with no symptoms or barely noticeable ones in either hand. Often, tremors in the hands may indicate the presence of Parkinson’s, but it can also be accompanied by stiffness, slowing down, or reactive movements.
During the early stages, the face may show little or no expression, arms may not swing while walking, and speech may become soft or slurred. These symptoms worsen as the disease progresses. In such situations, it is important to consult an experienced neurosurgeon immediately.
How to Identify the Symptoms?
Depending on the individual, the signs and symptoms of Parkinson’s disease may vary. Early signs may be mild and go unnoticed. Symptoms often begin on one side of the body and usually remain worse on that side, even after both sides are affected.
Common signs and symptoms of Parkinson’s disease include:
– Tremors or shaking in a limb
– Slowed body movement (bradykinesia)
– Muscle stiffness, restricting the range of motion
– Impaired posture and balance
– Loss of involuntary movements
– Speech or writing difficulties
What Causes Parkinson’s Disease?
In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many symptoms are caused by the loss of neurons that produce a chemical messenger called dopamine. When dopamine levels decrease, abnormal brain activity occurs, leading to the symptoms of Parkinson’s disease.
The exact cause of Parkinson’s disease is unknown, but several factors seem to play a role, including:
- Genetics: Some genetic mutations may increase the risk of Parkinson’s disease.
- Environmental Triggers: Exposure to certain toxins or environmental factors may also contribute.
How Is Parkinson’s Disease Diagnosed?
It is best to consult an experienced neurosurgeon for testing. Diagnosis is typically based on medical history, a physical examination, and a review of the signs and symptoms.
Imaging tests—such as MRI, ultrasound of the brain, SPECT, and PET scans—may be used to rule out other disorders, though they are not particularly helpful for diagnosing Parkinson’s disease itself. Sometimes, it takes time to diagnose Parkinson’s disease. Doctors may recommend regular follow-up appointments with neurosurgeons trained in movement disorders to evaluate symptoms over time.
How Is Parkinson’s Disease Treated?
Deep Brain Stimulation (DBS):
In DBS, surgeons implant electrodes into specific parts of the brain. The electrodes are connected to a generator implanted in the chest near the collarbone. This generator sends electrical pulses to the brain and may help reduce Parkinson’s symptoms.
DBS is often offered to people with advanced Parkinson’s disease who have unstable medication responses. It can:
– Stabilize medication fluctuations
– Reduce or halt involuntary movements (dyskinesias)
– Reduce tremors and rigidity
– Improve slowed movement
However, DBS is not effective for symptoms that do not respond to medication, apart from tremors. Even if tremors are not very responsive to medication, DBS may still control them.
Why Is DBS Preferred Over Medications?
Medications provide only temporary relief from Parkinson’s symptoms. When the medication is effective, it is known as the “on-phase,” and when it wears off, it is called the “off-phase.” Over time, the effectiveness of medication decreases, leading to more frequent doses.
For example, if a patient initially needs medication three times a day, they might eventually require it more than eight times daily as the effect diminishes. This constant on-and-off cycle significantly impacts their quality of life.
DBS, on the other hand, provides a constant effect for 24 hours. It avoids dyskinesias (the halting of involuntary movements) and prevents tremor fluctuations seen with medications. Unlike medications, DBS does not lose its effect unpredictably. This makes it easier for patients to plan daily activities like work or shopping without the risk of sudden symptom recurrence, thereby improving their quality of life.
The writer is Associate Director – Neuro Surgery & Neuro Spine, BLK-Max Super Speciality Hospital, New Delhi