Chapter 10 - Implementing deep brain stimulation into practice

Summary

This chapter considers how a neurologist specializing in movement disorders should assemble a team and organize a standard protocol for accomplishing the necessary procedures. The deep brain stimulation (DBS) evaluation protocol is more complex for Parkinson's disease (PD) compared to essential tremor (ET) and dystonia, so most of the discussion in the chapter is focused on PD. The chapter discusses the general roles of the team members and details of the patient selection process. A psychologist provides psychological monitoring and mental healthcare to patients. Most often, a patient is referred from a neurologist who has cared for the patient for several years, when that neurologist thinks the patient might be helped by DBS. The medical evaluation is ordinarily performed by the primary care physician treating the patient. The clinicians involved need additional training, so that they can develop an understanding of the details of the selection process and programming techniques.