Surgery risk for Parkinson Patients

I have a 68 year old sister who was diagnosed with Parkinson”s in the mid 1990s. She continued to be in the mild stage until recently when it has progressed to the high moderate level. In Sept 2012, she underwent an 8 hour spinal lamenectomy in which she developed Guillain-Barre Syndrome a week later. She was in ICU for three months and had 3 strokes during that time. Miraculously, she has mostly recovered from most of the problems aasociated with GBS and the strokes. However, her Parkinson’s started to progress at a much more rapid pace since her recovery. I had read a post on your site from Dr. A. Lieberman regarding the potential risks of surgery for Parkinson’s patients. Our family has been wondering whether or not the back surgery could have been a factor with the GBS and the fast progression of the Parkinson’s. Is there any other information you can provide?

Dr. Sanchez-Ramos said...

Any stressor, either psychological or physiological (as in surgery or intercurrent illness) will temporarily exacerbate the signs and symptoms of PD. In fact whenever a PD patient decompensates (becomes much worse over a short period of time), I will look for bladder infection or pneumonia in that patient.
And whenever a patient is scheduled to have surgery, I let them know that they will have some difficulties with their PD signs and symptoms during the period of convalescence. Guillain-Barre syndrome is an auto-immune disorder in which a person’s antibodies “attack” the myelin of the nerve roots as they exit the spinal cord. The exact trigger is not known, but it often follows a minor infection (lung or GI system) or days to weeks after a surgery. I can see how the combination of two stressors (the surgery and the Guillain-Barre syndrome) would negatively impact the patient with PD.