All patients considering DBS are evaluated by a Johns Hopkins neurologist specializing in movement disorders. This evaluation is necessary to find out if the patient has Parkinson’s disease (PD), rather than a less common, but similar, movement disorder. It also establishes if a PD patient receives any benefit from taking PD medications.
A cognitive evaluation assesses a patient's ability to participate accurately and actively in the surgical implantation of the stimulator, and in the post-operative process of programming the stimulator. One of our Hopkins’ neurosurgeons will also participate in the evaluation to discuss the risks and benefits of surgery as well as the expected outcomes of surgery.
Parkinson’s disease patients
There are two types of Parkinson's disease patients who may benefit most from DBS:
- patients with uncontrollable tremor for whom medications have not been effective
- patients with symptoms that are well treated with medications but who experience severe motor fluctuations, including wearing off and dyskinesias, despite attempts to control the fluctuations by altering the medications.
Essential tremor patients
DBS can also treat essential tremor, the most common movement disorder. In most cases, essential tremor is mild enough to be effectively treated with medication. But in some cases, the tremor is so severe, it can be disabling, limiting everyday tasks like dressing, shaving, eating or drinking. When essential tremor is this severe, then DBS becomes an option. Since tremor is the only symptom in essential tremor – unlike Parkinson's disease – DBS can help a patient function normally and improve their quality of life.
Dystonia – a relatively uncommon, but disabling movement disorder – is characterized by abnormal postures and twisting movements. A number of studies have demonstrated that DBS is now an option when medication fails.
Learn more about what to expect if you are a candidate for DBS.
To make an appointment call 410-502-0133.