publicado em 30/03/2013 às 10h38:00
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Surgery improves quality of life for people with Parkinson's

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When he was diagnosed with Parkinson's six years ago, the lawyer Juliana Torres, 59, said he thought his life had lost its meaning. "I knew it was a degenerative disease. Over time, the symptoms were getting worse. My body went rigid, barely moved the neck. We also suffers from loneliness, because it loses the social life," he reported. In February this year, however, a high-tech surgery has changed her perspective on life. The implantation of an electrode in the brain, done by a team of functional neurosurgery at Santa Casa de São Paulo, made her regain movement and, with them, the quality of life.

The procedure, funded by the National Health System (SUS), is to encourage, by means of a device, the brain regions responsible for the manifestation of the main symptoms of the disease, such as tremor and stiffness. "The idea of ​​surgically treating this disease has more than 50 years, but before cauterizavam up pieces that were sick," said neurosurgeon Nilton Lara, who coordinates the team. The method with the electrode is considered minimally invasive, in order that the device is installed through a small hole and bleeding risk decreases from 0.05% to 2%.

Soon after going through surgery, Juliana resumed simple activities that for years did not. "Achieving writing was very shocking to me. Previously, I could only enter and still in pain," described. Gradually, the lawyer is conquering other movements. "I came back to live. Felt a well-being as never" reported. An estimated 200,000 Brazilians, like her, suffer from disease, especially people from the age of 50, according to the Ministry of Health is expected that this number will increase over the next 30 to 50 years with an aging population .

This surgery can cost up to $ 150,000 in private is made free at Santa House since January this year and four patients have received the implant. "We expect to serve up to four patients per month," said neurosurgeon. According to the doctor, is the only entity of the public to do the surgery. "The information we have is that the Hospital das Clinicas did some implants with bias studies. Otherwise, only private hospitals [did], and yet, in a few capitals, like Rio de Janeiro, Curitiba, Goiania, Recife and Belo Horizonte, "he said.

This surgery can cost up to $ 150,000 in private is made free at Santa House since January this year

Nilton Lara explained that the profile of patients selected to receive the electrode are no longer present improvements to the medication or side effects developed. "At first, dopamine [substance used in treatment] works very well, but then begins to experience side effects, which are involuntary movements. Sometimes they are more disabling than the actual symptoms of Parkinson's disease. Something without It output. " The loss of functionality of the drug occurs after five to ten years of use.

Juliana was how he felt before doing the procedure. "I was at rock bottom. Surgery for me was a light at the end of the tunnel. I took the medication every two hours and to avoid losing the effect, could not feed myself. Was to wither from hunger," he reported. The neurosurgeon said that studies are being done to evaluate the early use of the electrode, as when the first symptoms appear. But he agrees that, for now, is maintained the profile of patients who have not responded to medication. "If you take the medication and feels good, because to undergo a surgical procedure? Surgery does not alter the progression of the disease, the drug did not," he said.

Despite not mean a cure for Parkinson's disease, the implant allows, until you see symptoms of cognitive and behavioral impairment, the patient has a normal life by controlling motor symptoms. "In the advanced stage, cognitive complications begin to appear. So there's nothing left to do but they can take 20-30 years to appear," he said.

Once installed, the electrode no longer need to be replaced. Only the battery, placed in the same location of the pacemaker cardiac surgery is that needs to be replaced when wear out. "After discharge, which occurs about four days after the procedure, the patient returns to the hospital every week for us to do adjustment of stimulation by means of telemetry," explained the doctor. Once the regulation is more spaced, until no longer needed monthly trips to the hospital. "We shall change the pacing if the patient reports any worse," he said.

   Palavras-chave:   Parkinson    Surgery    SUS    São Paulo    Santa Casa   
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