Advanced Treatments for Parkinson's Disease

These treatments address symptoms that traditional medications may not.

BOTULINUM TOXIN INJECTIONS

Indications

  • Drooling
  • Dystonia
  • Spasticity
  • Tremors

Drug names 

  • Botox
  • Xeomin
  • Myobloc
  • Dysport

Treatment

  • Solution is easily injected in the office.
  • Effects last for approximately three months.

Side effects 

  • From overdose
    • Difficulty swallowing
    • Difficulty breathing

MRI-GUIDED FOCUSED ULTRASOUND

Indication

  • There’s a medication-resistant tremor in one hand, usually the dominant one.
  • Treatment does not address any symptom other than a tremor.

Treatment 

  • An ultrasound beam is aimed at a specific area in the brain that generates the tremor, burning a small hole about the size of a grain of rice.
  • There is no incision or hardware implanted in the body.

Side effects 

  • Impaired balance
  • Slurred speech
  • Side effects are usually temporary but may be permanent

DEEP BRAIN STIMULATION (DBS)

Indication 

  • May be an effective treatment for many Parkinson’s disease (PD) symptoms when medications lose their effect or cause intolerable side effects
  • Very effective for tremor and dyskinesia but not for speech or balance issues

Treatment

  • A small hole is drilled into the skull and a wire electrode is implanted into various parts of the brain, depending on the symptoms.
  • The brain electrode is connected to a generator the size of a small hockey puck.
  • The generator is implanted under the collarbone.
  • The generator sends electrical impulses to the brain electrode, resulting in improvement of the PD symptoms.
  • DBS settings can be fine-tuned to treat particular symptoms and minimize side effects.
  • The settings can be changed to address evolving symptoms.

Risks

  • Because DBS is a surgical procedure, it carries the risk of bleeding and infection since hardware is implanted inside the body.
  • Out-patient surgery is required every 3-5 years to change the generator battery located in the chest wall.