Individualised custom-tailored treatmentParkinson's treatment basically consists of the two modules drug treatment and activating therapies. Together with you and your family members, our physicians and therapists determine the goals of treatment that will be decisive for you and which are the focus of your phase of disease. This is the foundation for our experts to determine the corresponding drug and therapy treatment combination.
Conservative treatment methods
Parkinson’s: dopamine replacement
The most important medications for treating Parkinson’s disease are dopamine agents (DOPA drugs, COMT inhibitors, MAO B inhibitors and dopamine antagonists). A balanced dosage determined by an experienced and specialised neurologist can achieve a noticeable reduction of symptoms. However, over the course of taking dopamine for many years, fluctuations in its effectiveness may occur, exhibited by exaggerated movements or inability to move, for instance. In some cases, deep brain stimulation (“brain pacemaker”) or the use of a drug pump may be a good idea.
Parkinson’s: apomorphine pump therapy
Apomorphine pump therapy helps to reduce the symptoms of advanced Parkinson’s. It is suitable for patients who suffer from fluctuations in the effectiveness of levodopa drugs products or involuntary movements in “on” phases.
The apomorphine pump works in a way that is similar to that of the insulin pump that diabetics use: it continuously supplies the body with the dopamine replacement agent apomorphine. This is done via a very small needle that is inserted into the skin one time per day. The continuous administration of apomorphine ensures a more constant level in the bloodstream than oral medication.
An inpatient stay is required for the dosing and initial adjustment phase. At home you will need special care: filling and switching on the pump each morning can be done by family members or care services.
We already start with drug therapy - called “activating” therapies - in early stages in order to improve your symptoms.
- Physiotherapy to develop your mobility, body stability and ability to react
- Occupational therapy to support you in everyday life and maintain your independence
- Voice / speech therapy to retain your speech as long as possible
- Swallowing therapy
- Psychological methods
We also offer a wide range of innovative therapies such as LSVT-BIG, Yoga, fall prevention programmes, E-Health, dance therapy and Munich anti-freezing training (MAFT).
Close cooperation between the specialists at orthopaedic medical centres and the pain experts at Schoen Clinic also enables an expanded and holistic perspective on damage to the locomotor system or pain possibly related to Parkinson’s.
E-Health – therapy with games consoles
Games consoles and computer games used to be thought of only as leisure time activities. But they can also be used as therapeutic aids. The virtual and networked world can help regulate impairments such as reduced step size, slow walking pace, risk of falling and freezing through the use of audio and visual signals. Attention, concentration and motivation are especially addressed in digital games. Through a combination of instruction and feedback, Parkinson’s patients can correct their movement patterns.
Nintendo Wii, for example, can be used effectively with patients who have a mild form of Parkinson’s because it is not primarily associated with the disease. The learning effect is reinforced by patients having fun playing the game. Seeing a score after having completed a few games is also an incentive for even better performance and improvements at the next training session.
When every movement becomes more difficult, the steps keep getting smaller, and your motor skills simply give out, it’s hard to get excited about dancing. The solution is a prescription for dancing. Dancing is not only fun, it also is proven to help make patients more mobile over the long term since tango, waltzes and foxtrot improve balance, speed and step length.
Munich anti-freezing training (MAFT) for freezing of gait
“Freezing” is a type of gait disorder that every Parkinson’s patient encounters sooner or later. A fluid gait suddenly stalls all at once. The gait can no longer be controlled temporarily with pure willpower. It feels like your feet are stuck to the ground.
To prevent such freezing episodes and to overcome the state, we at Schoen Clinic München Schwabing have developed a specialised training method called MAFT:
First we perform a test to find out when freezing occurs in your gait. These situations are then targeted in subsequent training - first at the clinic and then out on the street. The instruments used include a laser pointer and a metronome. With the laser pointer, you can emit a point of light in front of you to set your steps to. The metronome is an audio aid – you can march along to a tempo of your choosing.
It’s important to keep on training regularly at home. That keeps you mobile, gives you greater independence in your situation, and reduces the stress that is responsible for the freezing.
By the way, an additional aid for managing freezing of gait is the anti-freezing cane, a cane with a small tab on the handle. When freezing occurs you put the cane out in front of you and press the tab by slightly bending your finger. Then a small barrier is unlocked from the lower end of the cane that you can focus on to initiate your next step.
Surgical treatment methods
Deep brain stimulation – Parkinson’s
Deep brain stimulation (“brain pacemaker”) is another treatment option for patients who experience considerable fluctuations in effectiveness with the use of levodopa drugs during the day.
This neurosurgical procedure can be used to treat the basic symptoms of Parkinson’s. With the latest imaging techniques we localise the sites for stimulation in your brain down to the millimetre. First, we implant tiny electrodes, and then a matchbox-sized controller element, the “brain pacemaker”. It is implanted under your skin in the chest or abdomen region and connected to the electrodes via extremely thin cables that also runs under the skin. The cables lead to precisely defined core neuron areas in both halves of the brain. Through pulses of current sent by the controller, the symptoms, such as slow movement, muscle stiffness and tremors, can then be improved.
After you are discharged, we offer personal, long-term and immediate follow-up care. At our outpatient department, we work on making fine adjustments to your pacemaker and optimising your drug therapy.