ABSTRACT
Objective: To assess the effectiveness and accuracy of deep brain stimulation in Parkinsonian Disease (PD). Methods: This study was a descriptive prospective study, and patients were treated at Neurospinal and Cancer Care Institute Karachi, from February 1, 2016, to June 30, 2020. We had 21 cases of parkinsonian disease. Inclusion criteria was Idiopathic Parkinson's disease, marked motor fluctuations against the response to dopaminergic therapy, UPDRS-III scores, which is 30 or higher, with a duration of disease of five years or longer, developing dyskinesia while the exclusion criteria was patient with known comorbid or active psychiatric disease. Results: Mean age of patient was 64 years. The standard deviation was 1.11697. The male patients' mean, median and mode had a standard deviation of 0.3. For the duration of disease, the mean was 1.4, the median 1 (5-6 years) and mode one. The standard deviation was 0.51177. The primary symptoms' mean was 2.2857, the median was 2.0, and the mode was two (tremor). The mean on medication (age) was 2 (45-49), and the median and mode were the same. Conclusion: Deep brain stimulation (DBS) is an effective treatment option for a carefully selected patient. DBS improves tremors, dyskinesias, rigidity, motor fluctuations and bradykinesia. DBS is unlikely to benefit Autonomic dysfunction, cognitive disorders, hypophonia, and postural instability. Although it is an expensive treatment compared to lesioning or gamma knife, it is reversible.
ABSTRACT
Objective: Glomus jugulare tumor are benign vascular tumors and surgical resection is almost impossible. We have treated these tumors by Gamma knife radiosurgery and share our experience. Methods: This study was conducted at the Neurospinal and Cancer Care Institute, Karachi from January 2010 to May 2020. Thirty-four patients with glomus jugulare tumors treated with gamma knife radiosurgery were included in the study. The comprehensive clinical and demographic characteristics of all patients were collected through a manually designed questionnaire. Computed tomography, digital subtraction angiography and magnetic resonance imaging were used to make the diagnosis. Data was incorporated and analyzed by SPSS version 26. Results: A total of 34 patients were included in the study of which 16(47%) were males and 18(53%) were females with first follow up after 6-month up to two year clinical and radiological follow-up. The mean age of the patients was 42.5±13.5 with a minimum age of 20 years and maximum age of 65 years. The KPS scale was 2.09±0.45 and the volume of the tumor was 33.8±22.5 cm3. The improvement was shown in 27 patients of which 14 were males and 13 were females showing insignificance post radiation change. Of all 34 patients, the outcome was recorded as 3(9%) for excellent, 22(64%) for good, 6(17%) for fair and 3(9%) were poor results. Conclusions: Gamma Knife radiosurgery is a safe and effective primary therapy and salvage therapy for residual and recurrent cases of glomus jugulare and tympanicum tumors.
