Treatment of Parkinson's disease abroad

Parkinson’s disease is a slowly progressive disease in which brain cells responsible for human motor functions die. The condition is sometimes referred to as “trembling paralysis”. It has a chronic character.

According to WHO, Parkinson’s disease is the most common pathology in people over 60 years old, and men are affected by the disease 2 times more often than women.

Modern medicine does not have methods for the complete cure of this pathology. However, the treatment of Parkinson’s disease abroad in leading clinics guarantees high-quality medical care that can return the patient to a full life.

Parkinson’s disease is characterized by the gradual destruction of brain cells that produce dopamine. The lack of this substance leads to the occurrence of the disease. The exact causes of the onset of the disease have not been established.

The risk group includes the following categories of people:

• if relatives have a disease;
• poisoning with toxic substances, such as heavy metals, alcohol, drugs;
• previous brain injuries;
• neuroinfections, such as meningitis and encephalitis;
• atherosclerosis of cerebral vessels.

The first harbingers of a developing pathology are the loss of smell and a change in handwriting.

Characteristic manifestations:

• slow motion;
• tremor of the limbs and the head both during movement and at rest;
• changes in posture – a person walks with a slight bend;
• quiet slurred speech;
• muscle stiffness (tension that makes it difficult to move);
• gait disorder;
• jumps in blood pressure.

The symptoms of Parkinson’s disease worsen as the disease progresses. There are 5 stages of the disease:

1 stage. A person begins to feel stiffness in one hand, fatigue, depressed mood, suffer from insomnia, and notice changes in handwriting.

2 stage. The patient’s speech worsens, a tremor in both hands appears, and gait worsens.

3 stage. There are problems with balance, festinating gait, and constant twitching of the head.

4 stage. The patient often loses balance and is in a state of depression.

5 stage. A person rapidly develops dementia, swallowing function is impaired, and cannot move independently.

The development of the disease is preceded by a zero stage, in which there are no symptoms. At this stage, the pathology can be diagnosed by the level of dopamine, using special tests – DAT-SPECT and IBZM-SPECT.

The lack of treatment for Parkinson’s disease leads to the development of movement disorders, which threatens the patient with falls and injuries. They can be complicated by comorbidities such as osteoporosis (brittle bones).

The sooner you diagnose and start treatment, the higher the chance of:

• to reduce significantly the manifestation of symptoms;
• for a long time to preserve the possibility of a full-fledged lifestyle;
• to slow down the progression.

Treatment of Parkinson’s disease abroad provides for an accurate diagnosis, which largely determines the tactics and successful outcome of therapy. In foreign hospitals, a set of studies using modern devices is used to make a diagnosis, which includes:

• electromyography;
• electroencephalography;
• computed, magnetic resonance, and positron emission tomography (PET).

In the leading hospitals in Israel, diagnostics are carried out using a specially developed PET method – Dat Scanning PET CT. It allows to accurately visualize the location of foci of the destruction of brain cells.

At an early stage, for the treatment of Parkinson’s disease, doctors prescribe drug therapy. It includes special neurotropic drugs that are designed to improve the conductivity of nerve cells and reduce spasms and tremors.

Botulinum therapy helps to reduce muscle hyperactivity and pain. The doctor makes a subcutaneous injection of Botox into the spasmodic muscles. The procedure is performed under the control of electromyography, a special device for monitoring muscle contraction.

When treating the disease, a special diet and attendance at physiotherapy sessions are also important.

Neurosurgeons in foreign Parkinson’s clinics have made great strides in the treatment of Parkinson’s disease. In the states of Eastern Europe and Central Asia, it is mainly aimed at relieving symptoms.

The most effective methods in the leading neurological centers in the treatment of Parkinson’s disease abroad are minimally invasive interventions on the brain:

1. Deep brain stimulation (DBS).
2. Ultrasonic scalpel (MRiFUS).
3. Stereotactic ablation. This is a radiosurgical technique, in which the doctor steams the affected area of the patient’s brain tissue.

There is another experimental technology that has begun to be used in the best neurosurgical departments. For the treatment of Parkinson’s disease abroad, the implantation of stem cells that produce dopamine is carried out.

Indications for surgical treatment of Parkinson’s disease may include:

• lack or decrease in the positive response to traditional therapies;
• adverse reactions to medications;
• young age, surgery can prolong the social activity of a person;
• decrease in working capacity;
• unwillingness of the patient to depend on others and be a burden to them.

Surgical procedures are not able to completely treat Parkinson’s disease, but they can significantly reduce the patient’s functional disorders and improve his (or her) well-being.

Deep brain stimulation (DBS) is an effective surgical therapy that can normalize brain electrical activity and reduce symptoms.

The procedure is based on the installation of a DBS system, which will constantly affect the subcortical structures of the brain with weak electric currents.

The DBS device consists of three components:

• electrode;
• micro cable;
• neurostimulator.

Deep brain stimulation is performed under local anesthesia.

The operation consists of several stages, during which the doctor:

1. Carefully examines the patient and conducts an MRI of the brain.
2. Implants electrodes in the right part of the brain.
3. Installs a neurostimulator in the collarbone area under the skin.
4. Connects the neurostimulator to the electrode using a microcable, which is sewn under the skin in the head, neck, and above the collarbone.
5. After 2-3 weeks, the doctor programs the neurostimulator, which generates continuous impulses to normalize the electrical activity of the brain.

Typically, a neurostimulator serves a person for 4-5 years. It works on batteries. The replacement of the neurostimulator is carried out on an outpatient basis. There are rechargeable neurostimulators that last longer but they require regular recharging.

In recent years, leading Parkinson’s clinics have been offering patients an advanced treatment method – MRiFUS (ultrasonic scalpel). When using this technology, the impact of ultrasonic waves on the affected areas of the patient’s brain is carried out.

The operation is performed under the control of the latest generation 3Tesla MRI machine. The device allows the doctor to direct the beam to the desired area of the brain with an accuracy of up to a millimeter. It also controls the ablation process in real-time using video surveillance.

During the operation, the patient is conscious, the doctor talks to him, and regularly checks motor functions. This is an important point for a successful outcome.

Among the advantages:

• the procedure is non-invasive, so there are no incisions or scars;
• no need for implantation in the body of devices and periodic replacement of batteries;
• improvement in brain function occurs within 10 minutes after the start of the procedure;
• in most cases, 1 session is enough, if necessary, it can be repeated;
• no adverse reactions of the body.

The only drawback is the higher cost of the procedure compared to deep brain stimulation.

Ultrasound therapy can significantly reduce symptoms in all patients. It is suitable as an alternative to brain surgery, mainly for patients with unilateral tremor.

Parkinson’s treatment abroad is carried out in advanced clinics equipped with modern equipment for performing interventions on the brain. Leading Parkinson’s clinics are equipped with intraoperative MRI, neuronavigation and neurophysiological monitoring systems.

They provide the doctor with a maximum overview of the surgical field, allow to accurately perform the necessary manipulations. The risks of this type of intervention are practically reduced to zero.

Foreign patients for the treatment of Parkinson’s disease abroad most often choose hospitals in Germany, South Korea, Turkey, Austria, Israel, and Greece.

TOP-3 clinics for the treatment of Parkinson’s:

1. Sourasky Medical Center (Israel, Tel Aviv). The neurosurgical center employs doctors of the highest category. One of the leading neurosurgeons is Itzhak Fried, a specialist in the treatment of epilepsy and Parkinson’s disease. He carried out over 3,200 successful brain surgeries.
2. NP clinic (Turkey, Istanbul). He specializes in the treatment of brain diseases. The well-known neurosurgeon Mustafa Bozbuga practices in the hospital. He is one of the most sought-after specialists in Istanbul and has over 30 years of experience.
3. Acibadem Medical Network is one of the best Turkish clinics for the treatment of Parkinson’s. Well-known Turkish specialists work in the hospitals of the network. Leading neurosurgeons are Memet Ozek and Halit Cavujoglu.

All leading Parkinson’s clinics are equipped with modern equipment for the recovery of patients after surgery. A comprehensive rehabilitation plan is developed by a group of specialists individually for each person. This program will not only consolidate the results of the operation but also significantly improve the quality of life.

When choosing a medical center for the treatment of Parkinson’s disease abroad, one should take into account: the availability of special medical diagnostic and rehabilitation equipment, the doctor’s experience, and the certification of drugs. You can read about the reviews and conditions of stay in Parkinson’s clinics on the Experts Medical website. The medical coordinator of the company will answer the questions.

The cost of deep brain stimulation in clinics in Turkey is from $20,000, in Israel – $42,000, and in Germany – $80,000. The price can be affected by the level of comfort in the hospital, the equipment used for diagnostics, and the qualifications of the doctor. The services of an experienced doctor with an advanced degree will be higher than the usual rates.

Patients from Central Asia and Eastern Europe have access to quality Parkinson’s disease treatment in the best hospitals abroad. Doctors-coordinators of Experts Medical will help you quickly organize a trip. To do this, you need to call the phone numbers listed on the website.

The coordinator will consult the patient free of charge and help to choose a hospital and an attending physician, with whom he organizes a preliminary online consultation. If necessary, Experts Medical also provides services for the preparation of medical documents, booking air tickets, hotel rooms, and transfer.