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Andre Machado, MD, PhD: Referrals for Deep Brain Stimulation

The Chairman of the Neurological Institute at Cleveland Clinic discussed getting patient referrals for deep brain stimulation and how often patients miss the window during which the treatment could offer them benefit.

“One of the sad things we deal with in our center is to evaluate a patient that was probably a good candidate for DBS a long time ago, but by the time the patient is referred, they’re no longer a viable candidate. We missed the window of opportunity.”

Deep brain stimulation (DBS) has become a valuable tool for clinicians in the movement disorder space, particularly for those with patients with Parkinson disease or essential tremor. Despite this, sometimes the window in which patients can receive the most benefit from the intervention are missed.

To find out why this may be, NeurologyLive sat down with Andre Machado, MD, PhD, Institute Chair, Neurological Institute, Cleveland Clinic. He offered some reasoning as to why clinicians may be hesitant to refer these patients or believe in the treatment. Ultimately, while he and colleagues in the center understand that their neurological care will be supplemental, he hopes that with a referral, they can become co-managers of these patients prior to and after DBS in order to boost their quality of life.

Additionally, he spoke to the educational tools and programs that Cleveland Clinic has put together for general neurologists and practitioners to develop a symbiotic relationship with their center in order to get patients DBS when it is still beneficial. Part of that includes their distance health program, which also offers telemedicine visits to patients who are interested in learning more about DBS.

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