How do Parkinson’s patients judge whether they are suitable for installing a pacemaker? Which patients cannot be loaded?

  Be sure to find a professional doctor in the neurology department for a detailed and systematic evaluation. First, it must be clear that it is primary Parkinson’s disease, not Parkinson’s syndrome caused by other diseases; second, the patient has undergone reasonable medical treatment and it is clear that the best time to install a brain pacemaker has arrived. After evaluation, the following situations cannot be equipped with a pacemaker:    ① In the early stage of some diseases, such as Parkinson’s syndrome, or certain types of dystonia, some symptoms similar to Parkinson’s disease will also appear, and use After the treatment of Parkinson’s disease, the drug is effective for a short time, but it is not actually Parkinson’s disease. Only when the disease progresses to the middle stage can the diagnosis be confirmed. Therefore, it is not recommended to install a brain pacemaker when the patient has not been able to make a definite diagnosis during this period.  ②For patients who have been diagnosed with Parkinson’s disease, a brain pacemaker can be installed. However, due to physical conditions or other serious complications, the pacemaker cannot be installed in time.   ③ Parkinson’s disease patients have been delayed until the late stage, and even have complications, such as long-term tremor and rigidity of the hands and feet, causing muscle contractures and joint deformation. At this time, the effect of installing a pacemaker is not very good.  Why can’t the pacemaker be installed too early or too late?  Do patients with Parkinson’s disease have to install a brain pacemaker to control the disease? Apart from installing a brain pacemaker, is there any other way to relieve the condition?  If the diagnosis is definitely Parkinson’s disease and it has progressed to the middle stage, the “honeymoon period” has just ended, “switching phenomenon” and “dyskinetic disorder” gradually appear, the effect of installing a brain pacemaker is the most ideal. But this does not mean that all patients have to pretend, after all, economic factors and physical endurance must also be considered. If the patient cannot install the pacemaker in time due to various reasons, the core treatment method is still medicine, assisted rehabilitation, psychological counseling and life care. These comprehensive treatments can maintain the patient’s higher life for as long as possible. quality.  Since Parkinson’s patients will install a pacemaker sooner or later, they must wait until the medicine is no longer used to install the pacemaker? Can it be installed in advance?  The current domestic and foreign research results and various guidelines unanimously suggest that the best time for Parkinson’s patients to install a pacemaker is when the “honeymoon period” has just passed, the “switching phenomenon”, and the side effects of dyskinesia drugs have just come out.  Can I install it in advance? According to our clinical experience, patients with a pacemaker installed earlier can improve the quality of life as early as possible and avoid complications. But the premise is that a rigorous evaluation must be carried out for patients who have been diagnosed with Parkinson’s disease.   So what we advocate is to give the right treatment at the right time, and don’t wait until the medicine is completely gone before considering installing a pacemaker. Choose the best time to achieve the synergy of drugs and surgery is the best.

Questions and answers on the surgical treatment of Parkinson’s disease brain pacemaker

Every Parkinson’s disease patient has a different timing for installing a pacemaker, but in general, the “honeymoon period” of drug treatment for Parkinson’s disease patients is over, and there are “end-of-agent” “switching phenomenon”, abnormal movements and other drugs The side effects appear, you can start to consider the best time to install a pacemaker. What are “honeymoon period” and “switching phenomenon”? What are the side effects of drugs? Parkinson’s disease patients will choose to take medicine at the beginning to control motor symptoms such as limb tremor and rigidity. During the period of taking medicine, the effect is very good, and the motor function can be restored to almost the same as that of normal people, and even people around can not see that this person has Parkinson’s disease. This is called the “honeymoon period” of the drug and generally lasts 3-5 years. With the progress of the disease, the efficacy will slowly decline, or only increase the dose to achieve the original efficacy, indicating that the “honeymoon period” is about to end. At the same time, there will also be a “switching phenomenon”, that is, when the patient takes the medicine, the duration of the drug effect is shortened, and the ineffective time is relatively prolonged, that is, the so-called “on” time is shortened and the “off” time is extended. For example, once taking medicine once, it can last for three hours, but now taking medicine once can only last one hour. The most commonly used drug for the treatment of Parkinson’s disease is levodopa. Its common side effects include “dyskinesia”, which means that after taking the medicine, the patient’s hands and feet move involuntarily, and the hands and feet dance, and the range can be very large. Why are some patients unable to control the medicine or have a large side effect, they can switch to another medicine and continue to take it, and some patients need to install a pacemaker at this time? How do you know if the medicine really doesn’t work or you need to adjust the amount or change the medicine? The core component of levodopa drugs is levodopa, which can make up for the lack of dopamine in the brain. Regardless of which manufacturer and dosage form of dopa-based drugs, the final dose is converted to the content of levodopa. Its recommended dose is 800 mg per day. If it exceeds 800 mg, side effects may occur. If the patient has previously taken other types of medicines without levodopa, when the medicine is not effective or the side effects are relatively large, the doctor will recommend the patient to switch to medicines containing levodopa. How long will Parkinson’s patients take these medicines after taking the medicine? Is this true for everyone? Overall, Parkinson’s patients will experience these problems on average 3-5 years after taking the medicine. In Parkinson’s patients, the function of the brain’s substantia nigra cells to secrete dopamine will gradually decline, but each patient’s condition progresses differently and the sensitivity to drugs is different, so the time for problems such as “switching phenomenon” is also different. Install brain pacing The best time for the device is different. How do Parkinson’s patients judge whether they are suitable for installing a pacemaker? Which patients cannot be loaded? Be sure to find a professional doctor in the neurology department for a detailed and systematic evaluation. First, it must be clear that it is primary Parkinson’s disease, not Parkinson’s syndrome caused by other diseases; second, the patient has undergone reasonable medical treatment and it is clear that the best time to install a brain pacemaker has arrived. After evaluation, the following situations cannot be equipped with a pacemaker: ① In the early stage of some diseases, such as Parkinson’s syndrome, or certain types of dystonia, some symptoms similar to Parkinson’s disease will also appear, and use After the treatment of Parkinson’s disease, the drug is effective for a short time, but it is not actually Parkinson’s disease. Only when the disease progresses to the middle stage can the diagnosis be confirmed. Therefore, it is not recommended to install a brain pacemaker when the patient has not been able to make a definite diagnosis during this period. ②For patients who have been diagnosed with Parkinson’s disease, a brain pacemaker can be installed. However, due to physical conditions or other serious complications, the pacemaker cannot be installed in time. ③ Parkinson’s disease patients have been delayed until the late stage, and even have complications, such as long-term tremor and rigidity of the hands and feet, causing muscle contractures and joint deformation. At this time, the effect of installing a pacemaker is not very good. Why can’t the pacemaker be installed too early or too late? Do patients with Parkinson’s disease have to install a brain pacemaker to control the disease? Apart from installing a brain pacemaker, is there any other way to relieve the condition? If the diagnosis is definitely Parkinson ’s disease, and it has progressed to the middle stage, the “honeymoon period” has just ended, and the “switching phenomenon” and “dyskinesia” are gradually appearing.