ParkinsonCanadaV1, Main, Exploration, bibRecord, 003579

Microelectrode-guided thalamotomy for Parkinson's Disease. Commentary

Identifieur interne : 003579 ( Main/Exploration ); précédent : 003578; suivant : 003580

Microelectrode-guided thalamotomy for Parkinson's Disease. Commentary

Auteurs : M. N. Linhares [Canada] ; R. R. Tasker [Canada] ; R. A. E. Bakay ; K. J. Burchiel ; P. J. Kelly

Source :

Neurosurgery [ 0148-396X ] ; 2000.

RBID : Pascal:00-0121743

Descripteurs français

Pascal (Inist)
- Parkinson maladie, Tremblement, Thalamotomie, Guidage, Microélectrode, Radiofréquence, Traitement, Technique, Assistance technique, Adulte.
Wicri :
- topic : Adulte.

English descriptors

KwdEn :
- Adult, Aged, Brain Mapping (instrumentation), Dominance, Cerebral (physiology), Electrosurgery (instrumentation), Female, Follow-Up Studies, Guidance, Humans, Male, Microelectrode, Microelectrodes, Middle Aged, Neurologic Examination, Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson disease, Postoperative Complications (physiopathology), Radiofrequency, Retrospective Studies, Stereotaxic Techniques (instrumentation), Technical assistance, Technique, Thalamotomy, Treatment, Treatment Outcome, Tremor, Ventral Thalamic Nuclei (physiopathology), Ventral Thalamic Nuclei (surgery).
MESH :
- instrumentation : Brain Mapping, Electrosurgery, Stereotaxic Techniques.
- physiology : Dominance, Cerebral.
- physiopathology : Parkinson Disease, Postoperative Complications, Ventral Thalamic Nuclei.
- surgery : Parkinson Disease, Ventral Thalamic Nuclei.
- Adult, Aged, Female, Follow-Up Studies, Humans, Male, Microelectrodes, Middle Aged, Neurologic Examination, Retrospective Studies, Treatment Outcome.

Abstract

OBJECTIVE: To describe the outcomes in our first 40 microelectrode-guided thalamotomies for parkinsonian tremor. METHODS: Twenty-four left-sided and 16 right-sided thalamotomies were performed between October 1984 and January 1996; the mean follow-up period was 35.8 months (range, 1-152 mo). The results were evaluated retrospectively and semiquantitatively by a disinterested observer (MNL) and correlated with the quality of the microelectrode recording and the number and size of radiofrequency lesions made. The first 20 and second 20 procedures were evaluated separately. RESULTS: At the last follow-up, the Unified Parkinson's Disease Rating Scale showed no or virtually no tremor in the upper limb in 75% of patients or in the lower limb in 73% of patients. No significant persistent complications were found. These results were achieved at the expense of having to repeat the procedure on 11 sides (in 5 because of technical problems and in 6 for no obvious reason). Total or nearly total abolition of tremor occurred after the first procedure in 40% of the first 20 operations and in 65% of the second 20. Eight of the first 20 procedures and 2 of the second 20 failed for technical reasons. Lesions were made larger in the second 20 procedures than in the first 20. With the use of an electrode with a 1.1 x 3-mm bare tip for 60 seconds, it seems that lesions had to be created at 60°C or more to produce a successful result. CONCLUSION: Thalamotomy with microelectrode recording is an effective procedure with which to treat tremor in patients with Parkinson's disease and may involve fewer complications than conventional techniques. The procedure appears to involve a learning curve.

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en">OBJECTIVE: To describe the outcomes in our first 40 microelectrode-guided thalamotomies for parkinsonian tremor. METHODS: Twenty-four left-sided and 16 right-sided thalamotomies were performed between October 1984 and January 1996; the mean follow-up period was 35.8 months (range, 1-152 mo). The results were evaluated retrospectively and semiquantitatively by a disinterested observer (MNL) and correlated with the quality of the microelectrode recording and the number and size of radiofrequency lesions made. The first 20 and second 20 procedures were evaluated separately. RESULTS: At the last follow-up, the Unified Parkinson's Disease Rating Scale showed no or virtually no tremor in the upper limb in 75% of patients or in the lower limb in 73% of patients. No significant persistent complications were found. These results were achieved at the expense of having to repeat the procedure on 11 sides (in 5 because of technical problems and in 6 for no obvious reason). Total or nearly total abolition of tremor occurred after the first procedure in 40% of the first 20 operations and in 65% of the second 20. Eight of the first 20 procedures and 2 of the second 20 failed for technical reasons. Lesions were made larger in the second 20 procedures than in the first 20. With the use of an electrode with a 1.1 x 3-mm bare tip for 60 seconds, it seems that lesions had to be created at 60°C or more to produce a successful result. CONCLUSION: Thalamotomy with microelectrode recording is an effective procedure with which to treat tremor in patients with Parkinson's disease and may involve fewer complications than conventional techniques. The procedure appears to involve a learning curve.</div>
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La maladie de Parkinson au Canada (serveur d'exploration)

Microelectrode-guided thalamotomy for Parkinson's Disease. Commentary

Microelectrode-guided thalamotomy for Parkinson's Disease. Commentary

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

	La maladie de Parkinson au Canada (serveur d'exploration)
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.