Staged bilateral thalamus and globus pallidus stereotactic lesioning in patients with Parkinson' s disease: a strategy and efficacy analysis
10.3760/cma.j.issn.1671-8925.2012.06.003
- VernacularTitle:分期双侧丘脑及苍白球毁损治疗帕金森病的手术策略及疗效分析
- Author:
Jiang LIU
1
;
Xiang-Pin WEI
;
Chao-Shi NIU
;
Xian-Ming FU
;
Ye-Han WANG
Author Information
1. 安徽医科大学附属省立医院
- Keywords:
Parkinson's disease;
Ventralis intermedius nucleus;
Globus pallidus-internal segment;
Stereotaxis
- From:
Chinese Journal of Neuromedicine
2012;11(6):549-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of staged bilateral thalamus and globus pallidus stereotactic lesioning in patients with idiopathic Parkinson's disease (PD). Methods Nineteen PD patients,admitted to our hospital from February 1998 to May 2008 and received staged bilateral thalamus and globus pallidus stereotactic lesioning under the stereotactic microelectrode-guidance,were chosen in our study; 16 of them had a primary operation with ventral intermediate (Vim) stereotactic lesioning,and other 3 had globus pallidus-intemal segment (Gpi)stereotactic lesioning; second-staged operation with contralateral Gpi and small focal of Vim nucleus stereotactic lesioning was performed on all patients.The unified Parkinson disease rating scale (UPDRS)was used to estimate the "switch-on" and "switch-off" states of each patient before operation and 1 week after operation.The improvement of symptoms and the happening of complications after the operation were analyzed. Results Improvements were observed in all the 19 patients postoperatively in terms of stiffness and tremor.Stiffness was significantly alleviated after lesioning of Gpi,and tremor was markedly relieved after the Vim nucleus small focal lesioning.Two patients had dysarthria postoperatively,and 1 of them had dysphagia; the symptoms were alleviated 3 months after the operation. Conclusion Staged bilateral thalamus and globus pallidus stereotactic lesioning is a safe and effective surgical treatment for PD patients with bilateral severe symptoms.Controlling the indications and the size of lesioning strictly,and selecting the targets appropriately are of vital importance to the operation.
