Staged lesions through implanted deep brain stimulating electrodes: A new surgical procedure for treating tremor or dyskinesias
Identifieur interne : 000447 ( France/Analysis ); précédent : 000446; suivant : 000448Staged lesions through implanted deep brain stimulating electrodes: A new surgical procedure for treating tremor or dyskinesias
Auteurs : Sylvie Raoul [France] ; Mirella Faighel [France] ; Isabelle Rivier [France] ; Marc Vérin [France] ; Youenn Lajat [France] ; Philippe Damier [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2003-08.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Personne âgée.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (adverse effects), Associated technique, Brain (pathology), Case study, Dyskinesia, Dyskinesia, Drug-Induced (etiology), Dyskinesia, Drug-Induced (surgery), Dyskinesia, Drug-Induced (therapy), Elderly, Electric Stimulation Therapy (instrumentation), Electrical stimulus, Electrodes, Electrodes, Implanted, Globus Pallidus (surgery), Humans, Magnetic Resonance Imaging, Male, Neurosurgical Procedures (methods), Pallidum, Parkinson Disease (drug therapy), Parkinson Disease (pathology), Parkinson's disease, Prognosis, Radiation injury, Radiofrequency, Thalamotomy, Treatment, Tremor, Tremor (surgery), Tremor (therapy), deep brain stimulation, essential tremor, pallidotomy, thalamotomy.
- MESH :
- chemical , adverse effects : Antiparkinson Agents.
- drug therapy : Parkinson Disease.
- etiology : Dyskinesia, Drug-Induced.
- instrumentation : Electric Stimulation Therapy.
- methods : Neurosurgical Procedures.
- pathology : Brain, Parkinson Disease.
- surgery : Dyskinesia, Drug-Induced, Globus Pallidus, Tremor.
- therapy : Dyskinesia, Drug-Induced, Tremor.
- Aged, Electrodes, Implanted, Humans, Magnetic Resonance Imaging, Male.
Abstract
Thalamotomy and pallidotomy have been shown to have some efficacy for treating some movement disorders such as disabling tremor or parkinsonian levodopa‐induced dyskinesias (LID). Compared to continuous deep brain stimulation (DBS), this surgical procedure has the disadvantage of irreversibility and a lack of adaptability. Making a lesion involves a risk of inducing permanent side effects, especially if the lesion is large, or of observing a resurgence of the symptoms if the lesion is too small. We performed unilateral pallidotomy in one patient suffering from LID and unilateral thalamotomy in two patients suffering from tremor through the lead classically used for DBS. The technique of lead implantation was similar to that used for DBS treatment but, instead of connecting the lead to a pulse generator, it was left in place and used to make a radiofrequency lesion. This technique allowed the lesion to be kept as small as possible, thereby minimizing the risk of permanent side effects and made possible to extend the lesion if the symptoms reappeared. One lesioning session was enough to relieve tremor in the two patients treated by thalamotomy; three lesioning sessions over a 7‐month period were required to relieve drug‐induced dyskinesias in the patient treated by pallidotomy. In all 3 patients, disabling symptoms were still relieved without any permanent side effects 6 months after the last lesion was performed. © 2003 Movement Disorder Society
Url:
DOI: 10.1002/mds.10457
Affiliations:
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2003-08">2003-08</date><biblScope unit="vol">18</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="933">933</biblScope><biblScope unit="page" to="938">938</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">D95F066B2D632FE8102D85E5E18945104B769B35</idno><idno type="DOI">10.1002/mds.10457</idno><idno type="ArticleID">MDS10457</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Associated technique</term><term>Brain (pathology)</term><term>Case study</term><term>Dyskinesia</term><term>Dyskinesia, Drug-Induced (etiology)</term><term>Dyskinesia, Drug-Induced (surgery)</term><term>Dyskinesia, Drug-Induced (therapy)</term><term>Elderly</term><term>Electric Stimulation Therapy (instrumentation)</term><term>Electrical stimulus</term><term>Electrodes</term><term>Electrodes, Implanted</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Neurosurgical Procedures (methods)</term><term>Pallidum</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (pathology)</term><term>Parkinson's disease</term><term>Prognosis</term><term>Radiation injury</term><term>Radiofrequency</term><term>Thalamotomy</term><term>Treatment</term><term>Tremor</term><term>Tremor (surgery)</term><term>Tremor (therapy)</term><term>deep brain stimulation</term><term>essential tremor</term><term>pallidotomy</term><term>thalamotomy</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Neurosurgical Procedures</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Globus Pallidus</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Electrodes, Implanted</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dyskinésie</term><term>Electrode</term><term>Etude cas</term><term>Mâle</term><term>Pallidum</term><term>Personne âgée</term><term>Pronostic</term><term>Radiofréquence</term><term>Radiolésion</term><term>Stimulus électrique</term><term>Technique associée</term><term>Thalamotomie</term><term>Traitement</term><term>Tremblement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Personne âgée</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Thalamotomy and pallidotomy have been shown to have some efficacy for treating some movement disorders such as disabling tremor or parkinsonian levodopa‐induced dyskinesias (LID). Compared to continuous deep brain stimulation (DBS), this surgical procedure has the disadvantage of irreversibility and a lack of adaptability. Making a lesion involves a risk of inducing permanent side effects, especially if the lesion is large, or of observing a resurgence of the symptoms if the lesion is too small. We performed unilateral pallidotomy in one patient suffering from LID and unilateral thalamotomy in two patients suffering from tremor through the lead classically used for DBS. The technique of lead implantation was similar to that used for DBS treatment but, instead of connecting the lead to a pulse generator, it was left in place and used to make a radiofrequency lesion. This technique allowed the lesion to be kept as small as possible, thereby minimizing the risk of permanent side effects and made possible to extend the lesion if the symptoms reappeared. One lesioning session was enough to relieve tremor in the two patients treated by thalamotomy; three lesioning sessions over a 7‐month period were required to relieve drug‐induced dyskinesias in the patient treated by pallidotomy. In all 3 patients, disabling symptoms were still relieved without any permanent side effects 6 months after the last lesion was performed. © 2003 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country></list><tree><country name="France"><noRegion><name sortKey="Raoul, Sylvie" sort="Raoul, Sylvie" uniqKey="Raoul S" first="Sylvie" last="Raoul">Sylvie Raoul</name></noRegion><name sortKey="Damier, Philippe" sort="Damier, Philippe" uniqKey="Damier P" first="Philippe" last="Damier">Philippe Damier</name><name sortKey="Faighel, Mirella" sort="Faighel, Mirella" uniqKey="Faighel M" first="Mirella" last="Faighel">Mirella Faighel</name><name sortKey="Lajat, Youenn" sort="Lajat, Youenn" uniqKey="Lajat Y" first="Youenn" last="Lajat">Youenn Lajat</name><name sortKey="Rivier, Isabelle" sort="Rivier, Isabelle" uniqKey="Rivier I" first="Isabelle" last="Rivier">Isabelle Rivier</name><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Vérin">Marc Vérin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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