New developments in surgical therapy for Parkinson's disease

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 157 KB
• Volume: 9
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.870090709

✦ Synopsis

F r a n c e . Surgical methods are still of interest when levodopa therapy fails. High frequency stimulation has similar effects and is safer than destruction in several basal ganglia, such as Ventral Intermediate Thalamus (Vim), Subthalamic Nucleus (STN) and Globus Pallidus Internus (GPi) has triggered a new trend in surgical treatment of movement disorders. Stereotactic implantation of chronic stimulating electrodes has been performed in Vim for tremor (113 patients, 172 thalami) and in STN for severe bradykinesia (6 patients. 11 nuclei). The target is located according to ventriculography, MRI. extracellular recording and stimulation at 130 Hz. There was no mortality, one large hematoma occured during the penetration of the cortex and the electrode was not inserted, morbidity was limited to transient hemiparesia in 3 patients, side effects were always reversible at the cessation of stimulation or by lowering the intensity, bilateral stimulation (54% of patients) did not induce neuro-psychological deficits. Vim stimulation (VimS) totally suppresses tremor in 80% of parkinsonian rest tremor. in 50 % of postural tremor and in