Stimulation of the subthalamic nucleus for the treatment of Parkinson's disease: postoperative management, programming, and rehabilitation.
High-frequency stimulation of the subthalamic nucleus is a neurosurgical procedure for the alleviation of motor symptoms of Parkinson's disease and debilitating medication-induced dyskinesias. Stimulation is achieved with electrodes implanted stereotactically in the subthalamic nucleus by a neurosurgeon specializing in stereotactic surgery and a team composed of an anesthesiologist, a neurophysiologist, certified nurses and nurse practitioners and, at some centers, a neurologist. The teamwork continues in the recovery room and the intensive care unit, where the patient may experience transient adverse behavioral effects. Two weeks after surgery, the neurostimulator is activated and programmed. The medications also are adjusted to complement stimulation to maximize the therapeutic effects and minimize the stimulation-induced side effects. For those patients who are deconditioned or have major speech, gait, or balance problems, rehabilitation therapy is employed.
Stewart
R Malcolm
RM
Human Performance Lab, Presbyterian Hospital of Dallas, Jackson Building, 8200 Walnut Hill Lane, Dallas, TX 75231, USA.
Desaloms
J Michael
JM
Sanghera
Manjit K
MK
D000776:Anesthesiology; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D004867:Equipment Design; D005190:Family / Q000523:psychology; D006801:Humans; D009048:Motor Skills; D009482:Neurophysiology; D009493:Neurosurgery; D009722:Nurse Practitioners / Q000458:organization & administration; D010300:Parkinson Disease / Q000534:rehabilitation / Q000601:surgery; D010348:Patient Care Team / Q000458:organization & administration; D018579:Patient Selection; D010810:Physical and Rehabilitation Medicine; D011182:Postoperative Care / Q000379:methods* / Q000451:nursing; D020531:Subthalamic Nucleus / Q000601:surgery*; D013781:Texas; D016896:Treatment Outcome
D000978:Antiparkinson Agents