Q:
Should a neurosurgeon perforrming DBS have any special training?
A: Yes. He or she should have done postgraduate fellowship or training
in stereotactic functional neurosurgery. Also, you should always check that
any surgeon in any specialty is board certified.
Q:
How important is microelectrode recording?
A: Microelectrode recording is critically important in achieving the
optimal placement of the DBS. There should be a Ph.D. Neurophysiologist working
together with the surgeon to target and map the placement. If this service
is not provided... keep shopping.
Q:
Who should make the decision if I am a candidate for DBS, my neurologist or
the neurosurgeon?
A: Generally, the initial suggestion of DBS will come from your neurologist.
The next step will be to have a consultation with a neurosurgeon, followed
by an evaluation consisting of “on” and “off” timed tasks,
videotaping and neuropsychological evaluation. This data should be presented
at a team meeting consisting of the neurosurgeon, neurologist, neurophysiologist
and movement disorder nurse. Together, this team will review all the options
available to you, and determine the best course of treatment.
A: Again, this needs to be a team approach. Your medication tapering should be guided by the neurologist, and programming adjustments of the DBS by a designated team member, this may be a nurse or neurophysiologist, or in some teams, a neurologist. All of the information about your care should be presented at the team meetings so that all of you care providers are on the same page.
