Long term outcome of unilateral pallidotomy: follow up of 15 patients for 3 years
Identifieur interne : 003476 ( Main/Exploration ); précédent : 003475; suivant : 003477Long term outcome of unilateral pallidotomy: follow up of 15 patients for 3 years
Auteurs : P K Pal [Canada] ; A. Samii [Canada] ; A. Kishore [Canada] ; M. Schulzer [Canada] ; E. Mak [Canada] ; S. Yardley [Canada] ; I M Turnbull [Canada] ; D B Calne [Canada]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2000-09-01.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Activities of Daily Living, Adult, Aged, Disease Progression, Dyskinesias (classification), Dyskinesias (pathology), Evolution, Female, Follow-Up Studies, Globus Pallidus (surgery), Human, Humans, Long term, Male, Middle Aged, Pallidum, Parkinson Disease (surgery), Parkinson disease, Stereotaxic surgery, Treatment, Treatment Outcome, Treatment efficiency, Tremor (classification), Tremor (pathology), Unilateral.
- MESH :
- classification : Dyskinesias, Tremor.
- pathology : Dyskinesias, Tremor.
- surgery : Globus Pallidus, Parkinson Disease.
- Activities of Daily Living, Adult, Aged, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Treatment Outcome.
Abstract
OBJECTIVES With the advent of new antiparkinsonian drug therapy and promising results from subthalamic and pallidal stimulation, this study evaluated the long term efficacy of unilateral pallidotomy, a technique which has gained popularity over the past decade for the management of advanced Parkinson's disease. METHODS The 15 patients reported here are part of the original cohort of 24 patients who underwent posteroventral pallidotomy for motor fluctuations and disabling dyskinesias 3 years ago as part of a prospective study. Evaluation scales included the unified Parkinson's disease rating scale, the Goetz dyskinesia scale, and the Purdue pegboard test. RESULTS When compared with the prepallidotomy scores, the reduction in the limb dyskinesias and off state tremor scores persisted on the side contralateral to pallidotomy at the end of 3 years (dyskinesias were reduced by 64% (p<0.01) and tremor by 63% (p<0.05). Other measures tended to deteriorate. The dosage of antiparkinsonian medications did not change significantly from 3 months prepallidotomy to 3 years postpallidotomy. CONCLUSIONS Although unilateral pallidotomy is useful in controlling the contralateral dyskinesias and tremor 3 years after surgery, all other early benefits disappear and activities of daily living continue to worsen.
Url:
- https://api-v5.istex.fr/document/29EE5EFC093277AD9084ED4C384685416D146591/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737095
DOI: 10.1136/jnnp.69.3.337
Affiliations:
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Le document en format XML
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Samii</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Kishore, A" sort="Kishore, A" uniqKey="Kishore A" first="A" last="Kishore">A. Kishore</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Schulzer, M" sort="Schulzer, M" uniqKey="Schulzer M" first="M" last="Schulzer">M. Schulzer</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Mak, E" sort="Mak, E" uniqKey="Mak E" first="E" last="Mak">E. Mak</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Yardley, S" sort="Yardley, S" uniqKey="Yardley S" first="S" last="Yardley">S. Yardley</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Turnbull, I M" sort="Turnbull, I M" uniqKey="Turnbull I" first="I M" last="Turnbull">I M Turnbull</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Calne, D B" sort="Calne, D B" uniqKey="Calne D" first="D B" last="Calne">D B Calne</name><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, M 36 Purdy Pavilion, Vancouver Hospital and Health Sciences Centre, 2221 Wesbrook Mall, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2000-09-01">2000-09-01</date><biblScope unit="volume">69</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="337">337</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">29EE5EFC093277AD9084ED4C384685416D146591</idno><idno type="DOI">10.1136/jnnp.69.3.337</idno><idno type="href">jnnp-69-337.pdf</idno><idno type="PMID">10945808</idno><idno type="local">jnnp;69/3/337</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Adult</term><term>Aged</term><term>Disease Progression</term><term>Dyskinesias (classification)</term><term>Dyskinesias (pathology)</term><term>Evolution</term><term>Female</term><term>Follow-Up Studies</term><term>Globus Pallidus (surgery)</term><term>Human</term><term>Humans</term><term>Long term</term><term>Male</term><term>Middle Aged</term><term>Pallidum</term><term>Parkinson Disease (surgery)</term><term>Parkinson disease</term><term>Stereotaxic surgery</term><term>Treatment</term><term>Treatment Outcome</term><term>Treatment efficiency</term><term>Tremor (classification)</term><term>Tremor (pathology)</term><term>Unilateral</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Dyskinesias</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Dyskinesias</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Adult</term><term>Aged</term><term>Disease Progression</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chirurgie stéréotaxique</term><term>Efficacité traitement</term><term>Evolution</term><term>Homme</term><term>Long terme</term><term>Pallidum</term><term>Parkinson maladie</term><term>Traitement</term><term>Unilatéral</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">OBJECTIVES With the advent of new antiparkinsonian drug therapy and promising results from subthalamic and pallidal stimulation, this study evaluated the long term efficacy of unilateral pallidotomy, a technique which has gained popularity over the past decade for the management of advanced Parkinson's disease. METHODS The 15 patients reported here are part of the original cohort of 24 patients who underwent posteroventral pallidotomy for motor fluctuations and disabling dyskinesias 3 years ago as part of a prospective study. Evaluation scales included the unified Parkinson's disease rating scale, the Goetz dyskinesia scale, and the Purdue pegboard test. RESULTS When compared with the prepallidotomy scores, the reduction in the limb dyskinesias and off state tremor scores persisted on the side contralateral to pallidotomy at the end of 3 years (dyskinesias were reduced by 64% (p<0.01) and tremor by 63% (p<0.05). Other measures tended to deteriorate. The dosage of antiparkinsonian medications did not change significantly from 3 months prepallidotomy to 3 years postpallidotomy. CONCLUSIONS Although unilateral pallidotomy is useful in controlling the contralateral dyskinesias and tremor 3 years after surgery, all other early benefits disappear and activities of daily living continue to worsen.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Pal, P K" sort="Pal, P K" uniqKey="Pal P" first="P K" last="Pal">P K Pal</name></noRegion><name sortKey="Calne, D B" sort="Calne, D B" uniqKey="Calne D" first="D B" last="Calne">D B Calne</name><name sortKey="Kishore, A" sort="Kishore, A" uniqKey="Kishore A" first="A" last="Kishore">A. Kishore</name><name sortKey="Mak, E" sort="Mak, E" uniqKey="Mak E" first="E" last="Mak">E. Mak</name><name sortKey="Samii, A" sort="Samii, A" uniqKey="Samii A" first="A" last="Samii">A. Samii</name><name sortKey="Schulzer, M" sort="Schulzer, M" uniqKey="Schulzer M" first="M" last="Schulzer">M. Schulzer</name><name sortKey="Turnbull, I M" sort="Turnbull, I M" uniqKey="Turnbull I" first="I M" last="Turnbull">I M Turnbull</name><name sortKey="Yardley, S" sort="Yardley, S" uniqKey="Yardley S" first="S" last="Yardley">S. Yardley</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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