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----- Oorspronkelijk bericht ----- Van: "Irene Rosenthal" <[log in to unmask]> Aan: <[log in to unmask]> Verzonden: zondag 30 juli 2000 3:34 Onderwerp: Re: confused as usual Hi Irene, >> different forms of the new surgery DBS- one is thalmic and one is subthalmic. << DBS stands for Deep Brain Stimulation (and NOT Surgery). The following forms of DBS are performed: #1 - pallidal stimulation, one- or two-sided #2 - thalamic stimulation, one- or two-sided #3 - SUBthalamic stimulation, one- or two-sided In all three a specific area in the brain is stimulated: At #1: the globus pallidus At #2: the thalamus At #3: the subthalamic nucleus (STN) If you have to choose for a DBS now, you should choose ONLY the #3 (STN). Why is that? #1 helps mainly against stiffness and slowness and dyskinesias #2 helps mainly against tremor #3 helps against (almost) all major PD symptoms And in the symptoms mentioned #3 gives better results than #1 and #2. In general the STN is advised to patients who have advanced PD. So their symptoms are most likely affecting BOTH sides. So TWO-sided STN is indicated. Also then the medication can be reduced more than with a ONE-sided STN. Plus the meds reduction helps against dyskinesias, hallucinations and walkingproblems. Only in some specific cases (like in a patient with ONLY a strong ONE-sided tremor) a one-sided STN might be indicated. Hans.