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Case 34 - Postoperativemanagement of Parkinson's medications

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Milind Deogaonkar
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Deep brain stimulation (DBS) for Parkinson's disease (PD) has now become a routine therapeutic option. The success of surgery depends on proper patient selection, proper placement of electrodes, and postoperative programming. This chapter presents a case study of a 62-year-old female with a 15-year history of PD who was scheduled to have bilateral subthalamic nucleus (STN) DBS implantation. In this case the chapter highlights the importance of restarting PD medications soon after surgery, interactions between the STN DBS and levodopa, effect of postoperative neurologic changes and medication, and interactions of other medication and Parkinsonism. The best antinausea medication for PD patients in the postoperative period is ondansetron, lorazepam in small doses works very well for confusion. STN DBS has been demonstrated to be effective in alleviating the symptoms of medically refractory PD across multiple reports in the literature. These results were confirmed by prospective series with double-blinded assessments.

Keywords

neurologic deficitnormal perfusion pressure breakthroughpostoperative periodcomputed tomography scanarteriovenous malformationanesthesia
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 108 - 109
Publisher: Cambridge University Press
Print publication year: 2011

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