Parkinson's disease surgery is only appropriate for Parkinson's disease patients who were initially responsive to Levodopa but have either developed side effects or are poorly controlled at the present time.

Before considering surgical therapy, it is very important to note that the diagnosis of the Parkinson's disease should be confirmed unequivocally. There are various diseases that can present with "Parkinsonian" symptoms. This includes Multiple System Atrophy (MSA), Cortico Basal Ganglionic Degeneration (CBGD), Progressive Supra-Nuclear Palsy (PSP), etc. The best way to confirm the diagnosis of Parkinson's disease is to be examined by a clinician who is skilled in movement disorders. Another way of confirming this is the assessment of response tool to Levodopa treatment. Patients who respond dramatically to Levodopa treatment, even though for a short time, are more likely to be suffering from Parkinson's disease then any other disease.

1. The patient who does experience some symptomatic relief but develops significant dyskinesia (involuntary movements). Further patient should have been tried adequately with various permutations and combinations to reduce the dyskinesia including use of dopamine agonist.
2. The patient who has marked motor fluctuations such that the significant portion of the day is spent in functionally impaired state. This includes dyskinesia and off period symptoms.
3. Patients suffering from severe pain related to off medication period which cannot be improved upon by drug adjustments. Severe painful off phase dystonia is also a indication for surgery.
4. The patient who have unpredictable symptomatic relief that prevent establishment of a consistent medical regime.
5. Patients having significant complications with Levodopa treatment in form of intolerability because of gastric upset, hallucination or depression are also the potential candidates for Parkinson's disease surgery.
6. Some patients of early Parkinson's disease having tremor as the most disabling symptom, not responding to medical treatment, can benefit from surgery.

To find out if you are a candidate for Parkinson's disease surgery follow this interactive worksheet.