Surgical Treatment Options

Treatment for Parkinson’s disease (PD) often includes a combination of medications, exercise and other approaches to manage symptoms. Parkinson’s changes over time, and as it progresses, symptoms may worsen and become harder to manage with standard treatments alone. Some people notice that symptom response to medications becomes less predictable throughout the day, with more “off” time or side effects such as dyskinesia.

When this happens, surgical treatment options or other advanced therapies may be considered to help provide more consistent symptom control.

Surgical Treatment Options

Surgical treatment options primarily help manage movement symptoms, such as tremor, stiffness or “off” time. These options include:

• Deep brain stimulation (DBS): A type of brain surgery that places thin wires (leads) in specific areas of the brain to deliver electrical signals that help manage movement symptoms.
• Focused ultrasound (FUS) & other lesion therapies: Procedures that use targeted energy to create a small, permanent area of tissue damage in the brain (called a lesion) to help reduce movement symptoms.
• Duopa: A form of carbidopa/levodopa delivered continuously through a tube into the small intestine using a portable pump.

Other advanced treatment options may include pump-based medications that do not require surgery.

Next Steps

Talk with your Parkinson’s doctor about your treatment plan if you notice:

• Symptoms are not well controlled throughout the day
• Symptoms return between medication doses
• Side effects are difficult to manage

Your doctor may adjust medications or discuss surgical or other advanced treatment options.

Page reviewed by Dr. Sneha Mantri, MD, MS, FAAN, Chief Medical Officer for the Parkinson’s Foundation and Movement Disorders Specialist at Duke Health.