- intractable tremor
- motor fluctuations
- good "on" response to levodopa
Before Referral
- patient provided with DBS literature
- patient and/or carer able to cope with treatment
- do not refer if:
- multiple falls (not attributable to gait freezing)
- prominent speech problems
- significant cognitive impairment
- previous major psychiatric problems
- case discussed with PD team at RVI:
- PD surgery nurse specialist
- referral made to PD surgery team for MDT assessment
Admission
- formal assessment
- funding application
- set surgery date
Post-discharge
- dose adjustments by local PD team
- DBS adjustments initially by neurosurgical team
- local team as first port of call for established DBS patients
- refer back to DBS centre for battery changes