帕金森病的脑深部电刺激：澳大利亚转诊指南。

Deep brain stimulation for Parkinson's disease: Australian referral guidelines.

作者信息

Silberstein Paul, Bittar Richard G, Boyle Richard, Cook Raymond, Coyne Terry, O'Sullivan Dudley, Pell Malcolm, Peppard Richard, Rodrigues Julian, Silburn Peter, Stell Rick, Watson Peter

机构信息

North Shore Private Hospital, Sydney, New South Wales, Australia.

出版信息

J Clin Neurosci. 2009 Aug;16(8):1001-8. doi: 10.1016/j.jocn.2008.11.026.

DOI:10.1016/j.jocn.2008.11.026

PMID:19596113

Abstract

The advent of deep brain stimulation (DBS) has been an important advance in the treatment of Parkinson's disease (PD). DBS may be employed in the management of medication-refractory tremor or treatment-related motor complications, and may benefit between 4.5% and 20% of patients at some stage of their disease course. In Australia, patients with PD are reviewed by specialised DBS teams who assess the likely benefits and risks associated with DBS for each individual. The aim of these guidelines is to assist neurologists and general physicians identify patients who may benefit from referral to a DBS team. Common indications for referral are motor fluctuations and/or dyskinesias that are not adequately controlled with optimised medical therapy, medication-refractory tremor, and intolerance to medical therapy. Early referral for consideration of DBS is recommended as soon as optimised medical therapy fails to offer satisfactory motor control.

摘要

深部脑刺激（DBS）的出现是帕金森病（PD）治疗中的一项重要进展。DBS可用于治疗药物难治性震颤或与治疗相关的运动并发症，在疾病进程的某些阶段，可能使4.5%至20%的患者受益。在澳大利亚，帕金森病患者由专业的DBS团队进行评估，这些团队会评估每位患者接受DBS可能带来的益处和风险。本指南的目的是帮助神经科医生和普通内科医生识别可能从转诊至DBS团队中获益的患者。常见的转诊指征包括经优化药物治疗后仍未得到充分控制的运动波动和/或异动症、药物难治性震颤以及对药物治疗不耐受。一旦优化药物治疗无法提供令人满意的运动控制，建议尽早转诊以考虑DBS治疗。