Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is the recommended action regarding Parkinson's medications before undergoing deep brain stimulation?

1. Administer double the usual dosage

2. Continue medications as usual

3. Discontinue medications the night before surgery

4. Stop medications one week prior

The correct answer is: Discontinue medications the night before surgery

Before undergoing deep brain stimulation (DBS) for Parkinson's disease, it is generally recommended to discontinue Parkinson's medications the night before surgery. This approach is important because continuing these medications may complicate the surgical procedure and affect the accurate placement of the DBS electrodes. By having the patient off medication, the surgical team can better assess the patient's motor symptoms and determine optimal electrode placement based on the patient's baseline condition without medication interference. This practice also helps in ensuring that the patient can be evaluated for the potential benefits of the procedure more clearly, as the stimulation levels can be adjusted based on the patient's unmedicated state. Other options, such as administering double the usual dosage or continuing medications as usual, would not provide the necessary clarity for surgical assessment and could increase the risks associated with surgery. Stopping medications one week prior is also typically too long, as it may lead to significant worsening of symptoms and impact the patient's overall health and the outcomes of the surgery. Thus, the approach of discontinuing medications the night before surgery strikes the right balance in preparing the patient for deep brain stimulation while allowing for optimal surgical conditions.