2022 年 39 巻 4 号 p. 589-594
Deep brain stimulation (DBS) and levodopa–carbidopa intestinal gel (LCIG) therapy for Parkinson disease (PD) have been covered by insurance in Japan since 2000 and 2016, respectively, and are both very useful for improving motor symptoms in advanced Parkinson disease. However, they have various problems in the perioperative, induction, and post–operative phases because they use surgery and devices. The indication for treatment is the occurrence of fluctuating motor symptoms, i.e., wear–off and dyskinesia, which cannot be adequately improved by drugs. In the perioperative and maintenance phases, there are complications due to the use of opportunity therapy, and the frequency of these complications should be considered. There is still insufficient evidence for post–operative treatment, and further findings are needed. In conclusion, the treatment of DBS and LCIG in PD should be considered strategic in itself.
