surgery for Parkinson's disease
Surgical treatment of Parkinson's disease
Surgery for Parkinson's disease is indicated when the drug treatment does not control the patient’s symptoms throughout the day.
The procedure is conducted with deep brain stimulation. To achieve this, a small part of the brain known as the subthalamic nucleus is applied high-frequency stimulation through a number of electrodes. Through electrical impulses, the overactive part of the brain causing the disease is inhibited.
Parkinson's disease is a disease without a current cure, but the benefits of surgery are clear. It achieves a regression of the disease equivalent to years of evolution. In particular, it improves patients’ movement and reduces stiffness and tremors.
The procedure also reduces the need for medication, which prevents the adverse psychiatric effects of drugs.
Do you want to learn more about the Department of Neurosurgery?
The Clínica Universidad de Navarra is a pioneer and experienced center in the surgical treatment of Parkinson's disease".
The first step consists of performing brain magnetic resonance imaging, and the images are used by a neuronavigation programme. Magnetic resonance helps calculate the coordinates of the area where the stimulator electrodes are to be inserted.
A small incision is made in the scalp and a 1 cm opening is created in the cranium (stereotactic). Thanks to the guidance offered by an electrophysiological neuronal activity recorder, the exact point where the electrical stimulators are to be placed is located.
The surgery is conducted with local anaesthesia, and the patient is aware during the procedure and can therefore help the surgical team understand the effects of the stimulation before the final implantation of the electrode.
The second part of the treatment is conducted a few days later under general anaesthesia and consists of placing (under the skin) the connection cables, pacemakers and/or battery that will supply the electrical stimulation. Generally, the pacemakers are inserted below the clavicle.
Surgery is performed for patients who do not tolerate drug treatment well or for whom it is not effective, as well as for individuals for whom the disease incapacitates them significantly.
Surgical success is related to candidate selection, the proper placement of the electrode in the brain and achieving good stimulation and proper medication.
Deep brain stimulation is a reversible procedure in the event that adverse effects occur or if the result was not what was expected.
After surgery, patients should attend periodic check-ups with their neurologist.
Occasionally, if the symptoms change, the stimulator might need reprogramming.
Learn more about surgery for Parkinson's disease
There is a therapeutic alternative indicated for patients who have symptoms and signs eminently unilateral of Parkinson's of several years of evolution, as well as those who cannot undergo an implantation of a stimulator.
This technique is known as subthalamotomy and it consists of controlled thermolesion in the motor area of the subthalamic nucleus causing the patient’s symptoms.