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.