|
| September 12, 2006 |
| |
|
|
| |
| The physicians and staff of The Neuroscience Group are providing this physician and provider communication to help you stay abreast of issues and updates in the dynamic field of neurosciences, with the goal of helping you provide better overall healthcare services to your patients. |
|
Deep Brain Stimulation for Parkinson’s Disease
|
Over 1 million people in the United Sates with Parkinson’s disease (PD) are faced with adaptations that differ from other chronic diseases. The incidence of Parkinson’s disease, as well as other neurological diseases is estimated to increase significantly as older persons become a substantially larger portion of the population.
|
|
Advances in surgical techniques as well as increased understanding of the basal ganglia circuitry, neuroimaging and intraoperative microelectrode recording have brought to the forefront surgical interventions for PD refractory to medical management. The New England Journal of Medicine 2006:355:896-908 provided a report from Gunether Deuschl, et al on a randomized trail of deep brain stimulation (DBS) for Parkinson’s Disease. In a randomized-pairs trial of 156 patients with severe PD and severe motor symptoms, primary end points were changed from baseline to six months in evaluating quality of life. Neurostimulation was compared with medical management. The study group included patients under 75 years of age with severe motor complications of PD. Neurostimulation of the subthalmic nucleus was more effective than medical management alone.
|
|
|
DBS has become the most commonly performed surgery for PD in North America. DBS of the STN is becoming a more frequently used treatment option for PD patients to improve motor function, reduce motor fluctuations, dyskinesia and medication usage. Appropriate patient selection is foundational to the success of the intervention. Preoperative response to levodopa, younger age and shorter disease duration are considered possibly predictive of greater improvement with DBS. Once implanted, DBS patients require a series of visits to establish the most efficacious levels for stimulation.
|
|
|
Realistic, caring, education-based strategies must be incorporated into the diagnosis and follow-up care required as the disease progresses regardless of the pace of progression. Post DBS implantation requires consistent follow-up and monitoring. Dr. Lisa Kokontis has established a sub-specialty practice caring for patients with Parkinson’s disease and other movement disorders. She will help with determining patient suitability for DBS. Neurosurgeon, Dr. Randall Johnson, has been trained in neurostimulation electrode implant procedures.
|
|
| Stroke and Pregnancy |
| Recent studies have demonstrated that the incidence of stroke during pregnancy and the puerperium is higher than previously thought. Moreover, women who have had complications during pregnancy are a higher risk for stroke in later life. Risk factors for stroke during pregnancy and the puerperium included race (African Americans), age > 35 years, cardiovascular and hematologic disorders, complications of pregnancy (like post partum hemorrhage, preeclampsia, gestational diabetes), migraines, blood transfusions and lupus. Practical steps to prevent stroke in women whose pregnancies place them at higher risk for stroke include regular monitoring of blood pressure and blood glucose levels, weight management, moderate exercise and good prenatal and post natal care. |
| |
| Community Outreach |
| To celebrate national PA week, some of the local Physician Assistants are involved in promoting health literacy by reading stories at the local libraries. The community is invited to a story hour, on 10/4 at 6:00 PM at the Kimberly Little Chute Library and on 10/23 at the Menasha Library at 6:00 PM, coordinated by Jill Hietpas PA-C and Maria Stumo, PA-C. |
| |
| We have a no spam policy. If you would like to be removed from our mailing list, please reply to this letter with the word “remove” in the subject line. | |
|
 |
|
Services Available:
Fox Cities
Green Bay
New London
Shawano
Waupaca
| |
 |
|
|
|
|
|
 |
| | |
