The surgical work up is determined on a case by case basis.
Generally, initial assessment is undertaken by Dr Paul Silberstein, Movement disorder and DBS Neurologist after referral from the usual treating Neurologist or GP.
If you wish to proceed to further assessment after this initial meeting, an MRI Brain and formal medication challenge are arranged. The MRI Brain is performed to assist in evaluating whether there is any structural abnormality that might preclude surgery. The medication challenge gives important predictive information as to the likely individual benefit of DBS. The medication challenge may be undertaken during a brief inpatient stay or as an outpatient at Dr Silberstein’s rooms.
All patients undergo a formal Neuropsychiatric and cognitive assessment with Dr Linton Meagher. This is generally performed as an outpatient at Dr Meagher’s rooms and is an important part of determining potential risks of surgery on an individual basis.
Dependent on your background medical history, you may be requested to attend for further medical evaluation with another physician (a Cardiologist for example).
Subsequent to the above investigations, you will meet again with Dr Silberstein to confirm whether your symptom profile is likely to be responsive to surgical intervention and the potential benefits and risks of surgery in your case. If the Neurologic and Neuropsychiatric assessments are favourable and you wish to proceed to surgery, a referral for consultation to Dr Raymond Cook will be made.
If the risk/benefit ratio of surgery is considered favourable and you wish to proceed, a date for DBS is planned.