Deep Brain Stimulation Evaluation
You have made the important decision to have Deep Brain Stimulation (DBS) surgery for treatment of Parkinson’s disease. As part of your treatment, we would like to record your function before and after surgery. This evaluation is performed by a physical or occupational therapist who is trained in assessing Parkinson’s patients. The evaluations are done before your surgery, 6 months after your surgery, and then once a year. These evaluations are different than the DBS programming visits. You may need to come to the clinic more frequently for programming adjustments.
Why are these evaluations done?
There are three important reasons for these evaluations:
1. Some patients wonder if their function is any better after surgery. The
evaluations are videotaped. This allows you to compare your function before
and after surgery.
2. Our doctors present information about the University of Wisconsin Deep
Brain Stimulation program around the world. This allows other doctors to
see if the program might help their patients.
3. The evaluations allow UWHC to assess the quality of the DBS program and
improve the treatment so patients’ needs are well met. Patients and staff
can measure how patients respond to the surgery.
When will the evaluations be scheduled?
Your first evaluation may be done at your initial meeting with the neurosurgeon in the clinic. You will also be evaluated in the hospital the day before your surgery or at the UW Middleton Rehab Clinic prior to your admission to the hospital. The second evaluation is done six months after your surgery. You will be evaluated again at one year and then once a year for up to 5 years. This is done at the UW Hospital Rehab Department or at the UW Middleton Rehab Clinic.
What is included in the evaluation?
You will be asked to fill out several questionnaires that will be mailed to you before your clinic appointment. These questionnaires are an important part of the evaluations. Please complete and bring to your evaluation appointments.
Part of the evaluation is videotaping of your function on and off medications before surgery. This will be repeated on and off stimulation after surgery. We will videotape your tremor, your hand movements, and your ability to walk down the hallway.
What happens before my surgery?
If you are having your pre-surgical evaluation the day before surgery, you will need to arrive at UW Hospital and Clinics at 7:00 a.m. to be admitted to the hospital. You will check in at the Admissions Department. Please bring along your medicines in the bottles.
You may be having your pre-surgical evaluation at the UW Middleton Rehab Clinic. You will be given a scheduled time to arrive. Please bring along your medicines in the bottles.
On the day of your pre-operative evaluation, you will be evaluated by a Physical Therapist (PT) or Occupational Therapist (OT). Take your last dose of Parkinson’s medications before 9:00 p.m. the night before your evaluation so that you will still be “off” your medicine when you arrive in the morning. The PT or OT will see you for your first evaluation while you are “off” medications. You will be asked to:
• Complete a timed walking test
• Be videotaped walking down a hall
• Be videotaped doing a series of tests called the Unified Parkinson’s Disease
Rating Scale
This should all take 30-60 minutes.
After the first evaluation is completed, you will be asked to take your Parkinson’s medicines. The PT or OT will return when you think the medicines are working and you feel “on”. They will repeat the tests and videotaping listed above. This will take around 20-40 minutes. This information will be stored in your medical record. It allows your doctors to compare your function before and after surgery.
If you are worried that you will not be able to function when you are off your medications, be assured that the physical or occupational therapist will be there to help you if needed.
What is the evaluation like after my surgery?
After your DBS surgery, you will be evaluated by the Physical or Occupational Therapist. For this evaluation you may keep taking your Parkinson's medications. You may come into the clinic or hospital with your DBS turned on. The PT or OT will perform the same tests that were performed before surgery including videotaping. We can then compare your results to see how the DBS is working for you. After the evaluation is performed with your DBS turned on, we will ask you to turn your DBS off for the second evaluation. The same tests will be repeated. You will be able to turn your DBS on again right after the second evaluation is complete. As before, the physical or occupational therapist will be there to assist you if needed.
Where will the evaluations be done?
The evaluations are done at either:
• UW Middleton Rehab Clinic on University Avenue, Middleton or
• UW Hospital in the physical therapy gym on the second floor of the hospital.
How should I prepare for the evaluation?
Wear comfortable clothes and shoes. Bring along your medicines so you can take them when we tell you that you can. Bring your patient programmer (remote control) so that you are able to turn the stimulator on and off as part of the evaluation.
Will my insurance pay for this?
The appointments are considered evaluations and not intended to be treatment. Most, but not all, insurance companies cover evaluations. It is important that you call your insurance provider to discuss your insurance coverage.
Contact numbers:
Neurosurgery Clinic: 608-263-7502
Neurology Clinic: 608-262-0550
UW Middleton Rehab Clinic: 608-263-8412
UW Hospital Rehab Department: 608-263-8060
If you live outside the area, call 1-800-323-8942
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/23/2012
Copyright © 09/10/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7408
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