When to Consider Brain Surgery for Parkinson’s Disease

You may think brain surgery for Parkinson’s disease is a last resort. But waiting too long to start thinking about this treatment option can mean living with disruptive symptoms longer than you need to.

Here’s how to know when you should raise the subject with your doctor and what that first conversation might look like.

What Are the Signs It’s Time to Talk About Surgery for Parkinson’s?

You should ask your doctor about surgery if your medication: 

• Isn’t working as well as it once did 
• Wears off before your next dose 
• Brings side effects that bother you

That being said, Shabbar F. Danish, M.D., chair of Neurosurgery and director of Stereotactic and Functional Neurosurgery at Jersey Shore University Medical Center, says he’d rather you not wait for these issues to occur. 

“I tell everybody that when they get a confirmation of diagnosis, they should come talk to a surgeon,” he says.

And don’t worry: Talking to a surgeon doesn’t commit you to anything. It’s a chance to get educated and learn about your options.

Fear of surgery often keeps people from having the conversation at all, he notes, and they can spend years relying on secondhand information about what surgery involves.

Why Can Timing Matter?

Dr. Danish tells patients not to wait until their condition reaches its severe stages.

“People are getting surgery earlier and earlier in their disease process because all the data suggests that, for the right patient, they will always do better with surgery,” he says. “Continuing with just medication will not give them the outcome they’re looking for.”

Research supports that strategy. In one study, people who had deep brain stimulation after their medication started causing problems reported better quality of life two years later than those who stuck with medication alone.

“For the right patient, these are like miracle operations,” Dr. Danish says. “It doesn’t cure the disease but really mitigates the symptoms.” And the benefits can last for 10 years or more, according to research. 

What to Expect During a Conversation About Surgery

This first appointment is usually with a movement disorders neurologist or a neurosurgeon who treats Parkinson’s disease.

What you and your doctor discuss depends on what you already know and what you want out of the visit, Dr. Danish says. That can cover how the disease progresses, what keeps you functional, your symptoms, how well you respond to medication and the risks of each option.

Not everyone with Parkinson’s qualifies for surgery. Good candidates are generally in the moderate stages of the disease, have mainly motor symptoms, and still respond to their medication but are running into trouble with it, whether that’s the dosing schedule or the side effects.

If you’re a good fit and want to move ahead, testing comes next to confirm that you’d benefit, Dr. Danish says.

The Bottom Line

Knowing your options lets you decide on your own timeline instead of reacting to symptoms that are increasingly hard to control. If you have a Parkinson’s diagnosis, there’s no reason to wait to start the conversation about surgery.

Next Steps & Resources:

• Meet our source(s): Shabbar F. Danish, M.D.
• Learn more about our neurosurgery services.