FREQUENTLY ASKED QUESTIONS: Movement Disorders Surgery

• Is the surgery for me?
  
  
• For what conditions are neurosurgical procedures effective?
  
  
• If I choose to undergo one of these procedures, do I need a lengthy hospital stay?
  
  
• Is this treatment covered by my insurance?
  
  
• What is the role of the referring neurologist?

Is the surgery for me?

Neurological conditions treated using deep brain stimulation:

• Parkinson’s disease with severe tremor that does not improve with medication
  
  
• Parkinson’s disease with “wearing off” spells and dyskinesias
  
  
• Essential tremor that is disabling
  
  
• Dystonia that is generalized and disabling

Other conditions that can be treated using deep brain stimulation are:

• Torticollis, or cervical dystonia
  
  
• Severe tremor due to multiple sclerosis

The decision to undergo surgery for Parkinson’s disease or other movement disorders is reached only after much deliberation. Patients with mild symptoms should not have this surgery. But if medical treatment has proved inadequate to control disabling symptoms, a patient may be a good candidate. A thorough, careful appraisal of each patient’s condition is made by the center’s experienced staff of neurologists and neurosurgeons, and a recommendation is given. Some patients with medically untreatable symptoms choose to live with their condition; others choose the neurosurgical intervention.

For what conditions are neurosurgical procedures effective?

Neurosurgical procedures may offer relief to patients suffering from any of a broad range of movement disorders. The list of treatable disorders includes Parkinson’s disease, essential tremor, and tremor due to multiple sclerosis, stroke, and head trauma. Neurosurgery may also offer dramatic benefits for patients with generalized dystonia — a disabling condition of severe, forceful muscle spasms, twisted postures, and impaired motor control — for which medications are largely ineffective.

If I choose to undergo one of these procedures, do I need to plan for a lengthy hospital stay?

No. Those who choose to undergo deep brain stimulation are admitted to Columbia Presbyterian Medical Center the evening before surgery. The surgery is done in two stages approximately one week apart. The first stage typically lasts between four to six hours. It is performed under local anesthesia and patients remain awake. They are usually discharged home in two days. The second stage is done under general anesthesia and patients usually stay in the hospital for one night. The following week, they return to the office for removal of staples and the first programming session. Several months is anticipated for fine-tuning of the device. This can often be accomplished in three to six visits on an outpatient basis.

Is this treatment covered by my insurance?

All of the necessary testing, clinical evaluations, the surgery itself, and follow-up care are covered by most insurers, Medicare, and Medicaid. Because the techniques are not routinely available, most insurers will approve out-of-network referrals to Columbia Presbyterian Medical Center. If you are uncertain about your insurance coverage, please call The Center for Movement Disorder Surgery at (212) 305-0549 for assistance.

What is the role of the referring neurologist?

Many patients are referred by community-based or network neurologists At Columbia-Presbyterian, the goal is to return each patient to the referring physician after the surgical intervention has been performed. The center’s team provides all necessary care and adjustments for patients implanted with deep brain stimulators, and its clinicians are always available to help out with questions or problems that arise.