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

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.