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Parkinson's Disease
Compiled from across the library · built automatically
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
When lumbar disc patients present late with established foot weakness or bladder control loss, surgery can stop further damage but cannot restore what is already lost. The Surgical Window: Why Timing Matters as Much as Skill | Functional Surgery Minute #05 · 0:42
The Surgical Window: Why Timing Matters as Much as Skill | Functional Surgery Minute #05
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In neurosurgery, there's a right moment to operate — not too early, not too late. We call it the surgical window. From lumbar disc prolapse to Parkinson's and DBS, here's why timing can decide whether surgery changes a life or causes harm.
video2:03 · Jul 2026
Exclusion criteria for deep brain stimulation include dementia, untreated depression or psychosis, and atypical Parkinsonism like progressive supranuclear palsy and multiple system atrophy. Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics · 4:29
Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics
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Preparing for functional neurosurgery exam questions can be challenging, especially when the subject includes movement disorders, patient selection, surgical targets, stimulation, and clinical decision-making.
In this new series, we will g
video9:40 · Jul 2026
3 Eras of Parkinson's Surgery: Destroy → Modulate → Respond
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From ablation, to DBS (Grenoble 1987), to adaptive stimulation that reads the brain's beta oscillations in real time. One section from Episode 3 of Functional Neurosurgery Explained — full episode: https://www.rfr.bz/yd06ce5f5 #shorts
video2:08 · Jul 2026
Expert statements from the recordings in this collection.
Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics
Functional neurosurgery is under-taught in basic training and most units don't do much of it.
Expert opinion0:29
Examiner expectations for functional neurosurgery are low and basic knowledge is sufficient.
Expert opinion0:36
Functional neurosurgery splits into three exam topics: movement disorders, pain surgery, and epilepsy.
Bradykinesia is mandatory for the diagnosis of Parkinson's disease.
Tremor responds best to deep brain stimulation in Parkinson's disease.
Gait freezing, speech, and cognition respond poorly to deep brain stimulation.
Cognition can be worsened by deep brain stimulation.
Balance, speech, and postural instability all respond poorly to deep brain stimulation.
The subthalamic nucleus is the first choice target for deep brain stimulation in Parkinson's disease.
Cites a guideline2:25
The globus pallidus internus is the second choice target for deep brain stimulation in Parkinson's disease.
Cites a guideline2:29
When dyskinesia dominates in Parkinson's disease, the globus pallidus internus is the preferred target because it smooths dyskinesia directly.
When tremor dominates in Parkinson's disease, the ventral intermediate nucleus of the thalamus is the preferred target.
The anterior limb of the internal capsule is an obsessive compulsive disorder target, not a Parkinson's disease target.
Inclusion criteria for deep brain stimulation include disease over 5 years, a meaningful levodopa response, disabling fluctuations, or refractory tremor.
Cites a guideline4:12
Exclusion criteria for deep brain stimulation include dementia, untreated depression or psychosis, and atypical Parkinsonism like progressive supranuclear palsy and multiple system atrophy.
Cites a guideline4:29
The levodopa challenge predicts the response to deep brain stimulation, not severity of disease.
Stimulation of the subthalamic nucleus roughly reproduces the patient's best medication on state.
A good levodopa response predicts a good stimulation response to deep brain stimulation.
Atypical Parkinsonism does not respond to deep brain stimulation and is a contraindication.
At the subthalamic nucleus, medial spread of stimulation hits the third cranial nerve and red nucleus, causing diplopia.
At the subthalamic nucleus, lateral spread of stimulation hits the internal capsule, causing contralateral twitching and dysarthria.
At the globus pallidus internus, ventral spread of stimulation hits the optic tract, causing phosphenes (flashes of light).
At the globus pallidus internus, posteromedial spread of stimulation hits the internal capsule, causing muscle contraction.
The side effect during stimulation tells you where the electrode is, and you correct by moving away from the structure you're hitting.
Motor fibers run in the internal capsule just lateral to the subthalamic nucleus.
Twitching during subthalamic nucleus stimulation means the electrode is too lateral and should be moved medially.
Reducing voltage during stimulation just shrinks the therapeutic window and doesn't fix electrode position.
Diplopia during subthalamic nucleus stimulation is the medial side effect from spread toward the third cranial nerve and red nucleus.
The optic tract is ventral to the globus pallidus internus, so ventral spread produces phosphenes.
The dopamine transporter scan separates Parkinson's disease from essential tremor and drug-induced tremor by showing reduced uptake in the posterior putamen.