Comment je prends en charge un parkinsonien stimulé

Deep brain stimulation (DBS) is a well-established treatment for advanced Parkinson's disease (PD). Currently, DBS of the subthalamic nucleus (STN) is the surgical gold standard for severe PD. DBS is approved to treat motor complications and dopa-resistant tremor. The management of stimulated PD patients is multidisciplinary, involving neurologists, neurosurgeons, neurophysiologists, neuropsychologists, psychiatrists, neuroradiologists, physiotherapists, general practitioners and caregivers. This approach is fundamental for correct patient selection, perioperative management and postoperative follow-up to ensure quality results. We propose in this paper the main points of initial and long-term postoperative practical management of PD patients with DBS. The initial postoperative management aims to prevent complications related to the surgical procedure and the implanted material and to achieve a therapeutic balance before discharge. The long-term follow-up is based on the detection of complications and management of the disease course. The role of the neurologist in care for DBS PD patients is fundamental to optimize the treatment, detect complications related to DBS or implanted material and to monitor the disease course.