Are there any contraindications for Rhizotomy?

Doctor's Answers 1

Rhizotomy is where we use a needle to go through the cheek to reach the nerve near the base of the brain. It's quite a long needle. There is no specific contraindication per se, things like patients being on anticoagulant medication being the key one.

I think the main thing in terms of choosing rhizotomy versus something else is the symptom duration and how long the patient expects to be controlled like I said rhizotomy does not last so long and there is a higher failure rate. So maybe it is useful as an acute treatment but maybe not a good treatment long term unless the patients are ok with it being repeated every so often.

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Who is a good candidate for DBS (deep brain stimulation)?

Essentially the criteria we look out for are Parkinson's patients we feel will greatly benefit from this. We are looking for patients who maybe have mobile fluctuations, meaning they have this “on-off” phenomenon. We want to make sure we do not treat patients with dementia because they do not respond as well to DBS and we want to exclude patients who have severe depression. Again, patients with depression should not have surgery until their depression is stable. So we eliminate those patients who aren't suitable.

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Answered By

Dr Nicolas Kon

Neurosurgeon

What is the cut off age requirement for deep brain stimulation?

Traditionally, we kind of set an age limit of 70 years old, meaning that beyond that we would say that maybe they should not get DBS because it might not be able to help. Over time we became more flexible with age limits, and have done DBS for patients in their mid to late 70s to help them. The amount of help DBS can give often diminishes as the patient ages.

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Answered By

Dr Nicolas Kon

Neurosurgeon

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