Analysing the reasons for rejection of neurosurgery intervention in patients with Parkinson’s disease referred to an extrapyramidal movement disorders clinic

We present findings of a 10-year retrospective study, analysing the reasons for rejection neurosurgical intervention (deep brain stimulation or DBS) in patients with Parkinsons disease, who were referred to an extrapyramidal movement disorders clinic and then neurosurgery centre. It was found that after screening, 78.6% as candidates treatment rejected, while 21.4% centre, where 12% underwent surgery. The main rejecting potential DBS were: early referral, inadequate pharmacotherapy, levodopa-resistant symptoms, atypical/secondary Parkinsonism, cognitive reasons, psychological comorbidity, abnormal MRI, poor response levodopa medication declined Furthermore, number self-referrals decreased, by neurologists increased, rejections unsuitable suitable centre increased during time period 10 years. In addition, surgery there which suggests greater awareness selection criteria among doctors, well knowledge experience both primary healthcare specialized centres.