Parkinson’s disease is the second most common neurodegenerative condition globally, and its impact is expected to rise significantly in the coming decades. In Malaysia, cases are projected to increase five-fold by 2040 from an estimated 20,000 in 2018, according to health experts cited in recent reports. This growing burden underscores the urgent need for greater awareness, early diagnosis, and timely intervention to improve outcomes for patients worldwide.
Far more than just a tremor, Parkinson’s disease is a progressive neurological disorder that affects movement, independence, and daily functioning. As Dr Phua Chun Seng, consultant neurologist and physician at Subang Jaya Medical Centre (SJMC), explains, “Parkinson’s is not just about tremors. It is a condition that can affect how a person moves, thinks, and functions in daily life.” While tremors are a recognizable sign, they are not present in all patients, and the condition is primarily defined by motor symptoms such as muscle stiffness and slowness of movement, often beginning on one side of the body.
As the disease progresses, symptoms can interfere with everyday activities like walking or dressing, and later stages may bring balance issues or falls. Non-motor symptoms, including fatigue, anxiety, low mood, and difficulty concentrating, are also common and can significantly affect quality of life. Early medical assessment is critical, as it allows for more accurate diagnosis and timely management, helping patients maintain function and well-being for longer.
“Raising awareness is significant because many people still do not fully understand Parkinson’s,” Dr Phua adds. “Some patients delay seeking medical treatment due to stigma or misconceptions. Early diagnosis allows us to manage the condition more effectively and support patients throughout their journey.” This emphasis on timely care reflects a broader shift in how Parkinson’s is approached — moving from a view of inevitable decline to one that prioritizes control, independence, and improved quality of life through advances in treatment.
A significant milestone in Malaysia’s neurological care occurred in late March 2026, when SJMC successfully performed its first deep brain stimulation (DBS) surgery. This procedure represents a step forward in expanding access to specialised neurological treatments in the country. DBS is an advanced therapy considered for patients who experience significant motor fluctuations despite medication but still respond well to levodopa, the primary drug used to manage Parkinson’s symptoms.
Patient selection for DBS involves careful evaluation of factors such as overall health, cognitive function, and age. While younger patients — generally under 70 years ancient — often experience more consistent outcomes, suitability ultimately depends on individual health status and response to medication. Unlike older surgical techniques that destroyed brain tissue, DBS delivers controlled electrical stimulation to specific brain regions involved in movement, such as the subthalamic nucleus (STN) or globus pallidus interna (GPi), without causing permanent damage.
“DBS is not a cure,” explains Dr Kalai Arasu Muthusamy, consultant neurosurgeon at SJMC. “It does not stop the disease from progressing, but it can significantly reduce symptoms such as tremors, rigidity, and slowness of movement.” The procedure is minimally invasive, typically involving a small incision of about 2cm, with electrodes placed in targeted areas of the brain measuring just a few millimeters. Its settings can be adjusted or reversed over time, allowing treatment to be tailored as symptoms change — a key advantage over earlier, irreversible approaches.
For suitable patients, DBS can be transformative. Dr Phua recalls a patient in his late 50s who had lived with Parkinson’s for over a decade. Before the procedure, daily tasks like dressing and eating were extremely difficult, and tremors made writing or handling objects nearly impossible. After DBS, the patient regained independence in many areas: he could eat and dress on his own, return to gardening, and experience better sleep. “It made a meaningful difference to his confidence and quality of life,” Dr Phua shares. He also noted that studies have shown DBS can improve quality of life by up to 70% in suitable candidates.
Addressing common fears about brain surgery, Dr Kalai emphasizes the safety and precision of modern neurosurgical techniques. “When performed by an experienced team, DBS is considered a safe and standard procedure with a low risk of complications. The mortality rate for elective brain surgeries in top hospitals is less than 1%,” he says. Unlike older methods, DBS is non-destructive and reversible — stimulation can be fine-tuned, and the device can be turned off or removed if necessary.
Advances in imaging and monitoring have further refined the procedure. Enhanced magnetic resonance imaging (MRI) and computed tomography (CT) scans, combined with intraoperative techniques like microelectrode recording, allow surgeons to target brain structures with high accuracy. This precision supports personalized care, which is essential given that Parkinson’s progresses differently in each individual. “Being able to fine-tune treatment allows us to better manage symptoms while supporting long-term quality of life,” Dr Kalai adds.
Successful management of Parkinson’s disease relies on a multidisciplinary approach. Neurologists, neurosurgeons, and other healthcare professionals collaborate closely to ensure patients receive comprehensive care at every stage. Those being considered for advanced treatments like DBS undergo thorough evaluation, including assessment of diagnosis, medication response, cognitive health, and personal expectations. Open discussions with the care team are vital, as they help patients understand the benefits, risks, and expected outcomes, enabling informed decisions about their treatment.
Even after intervention, long-term follow-up remains essential to monitor effectiveness and make adjustments as the condition evolves. This ongoing partnership between patients and their care teams reflects the evolving standard of care — one that values adaptability, precision, and sustained support throughout the journey of living with Parkinson’s.
As awareness grows and access to advanced therapies like DBS expands, particularly in regions like Malaysia where neurological services are developing, more patients may benefit from interventions that enhance independence and well-being. While Parkinson’s remains a lifelong condition, modern approaches are reshaping what it means to live with the disease — offering not just symptom control, but renewed hope for improved daily function and quality of life.