Deep brain stimulation for Parkinson's disease: Australian referral guidelines.
The advent of deep brain stimulation (DBS) has been an important advance in the treatment of Parkinson's disease (PD). DBS may be employed in the management of medication-refractory tremor or treatment-related motor complications, and may benefit between 4.5% and 20% of patients at some stage of their disease course. In Australia, patients with PD are reviewed by specialised DBS teams who assess the likely benefits and risks associated with DBS for each individual. The aim of these guidelines is to assist neurologists and general physicians identify patients who may benefit from referral to a DBS team. Common indications for referral are motor fluctuations and/or dyskinesias that are not adequately controlled with optimised medical therapy, medication-refractory tremor, and intolerance to medical therapy. Early referral for consideration of DBS is recommended as soon as optimised medical therapy fails to offer satisfactory motor control.
Silberstein
Paul
P
North Shore Private Hospital, Sydney, New South Wales, Australia. paul@silberstein.com.au
Bittar
Richard G
RG
Boyle
Richard
R
Cook
Raymond
R
Coyne
Terry
T
O'Sullivan
Dudley
D
Pell
Malcolm
M
Peppard
Richard
R
Rodrigues
Julian
J
Silburn
Peter
P
Stell
Rick
R
Watson
Peter
P
D000203:Activities of Daily Living; D000367:Age Factors; D001315:Australia; D000075202:Contraindications; D046690:Deep Brain Stimulation / Q000009:adverse effects; D004567:Electrodes, Implanted; D005917:Globus Pallidus / Q000503:physiopathology; D006801:Humans; D009043:Motor Activity; D010300:Parkinson Disease / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D018579:Patient Selection; D011788:Quality of Life; D020531:Subthalamic Nucleus / Q000503:physiopathology; D013787:Thalamic Nuclei / Q000503:physiopathology; D013997:Time Factors