South African guideline on deep brain stimulation for Parkinson's disease

S Afr Med J. 2017 Nov 6;107(10):1027-1032.

Abstract

Background: Parkinson's disease (PD) is a common neurodegenerative disease, associated with severe impairment of quality of life. Although the motor aspects of the illness are typically successfully treated with medications acting on the dopaminergic system, a number of patients encounter progressive difficulties associated with their medical treatment.

Recommendations: Carefully selected patients will benefit from deep brain stimulation (DBS) treatment for their PD. Selection requires dopamine challenge testing and neuropsychological testing for the presence of cognitive impairment. Careful follow-up and programming of the DBS system are mandatory, and a major reason for DBS failure is inadequate programming and management of medication.

Conclusion: DBS is a useful component of standard therapy for PD and may reduce symptoms, improve quality of life, promote patient independence and reduce healthcare costs by reducing requirements for medicine.