When medication is ineffective, surgery may be an option to control symptoms and improve

quality of life. However, not everyone is a good candidate for surgery. For example, if a patient
never responds or no longer responds to levodopa and carbidopa, surgery is unlikely to help.

Deep Brain Stimulation (DBS) is a surgical procedure that involves implanting a small device
called a stimulator into the brain. The stimulator delivers electrical impulses to specific areas of
the brain that are affected by Parkinson's disease, helping to reduce symptoms such as
tremors, stiffness, and slowness of movement. DBS is considered a reversible treatment
because the device can be turned off or removed if necessary.

Neuroablative lesion surgeries involve destroying a small area of brain tissue that is causing
symptoms in Parkinson's disease patients. This can be done using radiation therapy,
radiofrequency, or other techniques. While this treatment can be effective at reducing
symptoms, it is considered irreversible because the destroyed tissue cannot be replaced or
regenerated.

Neural transplantation is a surgical procedure that involves implanting fetal brain tissue into
the brain of a Parkinson's disease patient. The hope is that the transplanted cells will produce
dopamine, a chemical that is deficient in Parkinson's disease patients, and help to alleviate
symptoms. However, this treatment is still in the experimental stage and has not yet been widely
adopted due to safety concerns and inconsistent results.

Stereotactic procedures are a group of surgical techniques used to precisely target and
manipulate specific areas of the brain. These procedures can be used for a variety of purposes,
including diagnosing brain tumors, treating epilepsy, and relieving pain. In the context of
Parkinson's disease, stereotactic procedures can be used to place electrodes or other devices
into the brain for diagnostic or therapeutic purposes.

Overall, surgical procedures for Parkinson's disease are typically reserved for advanced cases
that do not respond well to medication or for individuals with severe side effects from
medication. The choice of procedure will depend on the specific symptoms and the individual's
overall health and medical history