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Efficacy of Unilateral Pallidotomy for Parkinson's Diesease
Journal of Korean Neurosurgical Society ; : 976-980, 2001.
Article Dans Coréen | WPRIM | ID: wpr-208546
ABSTRACT

OBJECTIVES:

For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure.

METHODS:

We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H and Y) staging, and neuropsychological examinations.

RESULTS:

Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H and Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion.

CONCLUSION:

We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.
Sujets)

Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Maladie de Parkinson / Lévodopa / Hypocinésie / Syndromes parkinsoniens / Dyskinésies / Traitement médicamenteux / Dysarthrie / Pallidotomie / Hypotonie musculaire Limites du sujet: Humains langue: Coréen Texte intégral: Journal of Korean Neurosurgical Society Année: 2001 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Maladie de Parkinson / Lévodopa / Hypocinésie / Syndromes parkinsoniens / Dyskinésies / Traitement médicamenteux / Dysarthrie / Pallidotomie / Hypotonie musculaire Limites du sujet: Humains langue: Coréen Texte intégral: Journal of Korean Neurosurgical Society Année: 2001 Type: Article