Bilateral posteroventral pallidotomy in advanced Parkinson's disease in three patients.
Identifieur interne : 004D87 ( Ncbi/Checkpoint ); précédent : 004D86; suivant : 004D88Bilateral posteroventral pallidotomy in advanced Parkinson's disease in three patients.
Auteurs : P R Schuurman [Pays-Bas] ; R M De Bie ; J D Speelman ; D A BoschSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1997.
English descriptors
- KwdEn :
- Activities of Daily Living, Age of Onset, Antiparkinson Agents (therapeutic use), Drug Resistance, Dyskinesia, Drug-Induced (surgery), Dystonia (surgery), Female, Follow-Up Studies, Globus Pallidus (surgery), Humans, Hypokinesia (surgery), Levodopa (therapeutic use), Male, Middle Aged, Muscle Rigidity (surgery), Parkinson Disease (drug therapy), Parkinson Disease (surgery), Pilot Projects, Prospective Studies, Severity of Illness Index, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug therapy : Parkinson Disease.
- surgery : Dyskinesia, Drug-Induced, Dystonia, Globus Pallidus, Hypokinesia, Muscle Rigidity, Parkinson Disease.
- Activities of Daily Living, Age of Onset, Drug Resistance, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pilot Projects, Prospective Studies, Severity of Illness Index, Treatment Outcome.
Abstract
In this report, we describe the effect of staged bilateral posteroventral pallidotomy in three patients with advanced Parkinson's disease who were all of the young-onset type. Two patients had developed response fluctuations after the use of levodopa, with severe hypokinesia, painful dystonia, and rigidity in the "off" phase and violent dyskinesias in the "on" phase. One patient, in a continuous hypokinetic rigid state, was totally unresponsive to dopaminergic medication. All were at Hoehn and Yahr stage 5 in the "off" phase before surgery. After surgery, the hypokinetic state was reversed and dyskinesias were abolished in all patients. Hoehn and Yahr stages were 3 in the "off" phase postoperatively. Overall functional improvement was marked and lasting after follow-up for 7, 12, and 13 months, respectively. Complications were visual field deficit and transient central facial paresis, both in the same patient. Bilateral posteroventral pallidotomy can ameliorate response fluctuations, hypokinesia, rigidity, and painful dystonia in advanced Parkinson's disease.
DOI: 10.1002/mds.870120521
PubMed: 9380060
Affiliations:
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pubmed:9380060Le document en format XML
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<wicri:regionArea>Graduate School of Neurosciences, Department of Neurology, University of Amsterdam</wicri:regionArea>
<wicri:noRegion>University of Amsterdam</wicri:noRegion>
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<author><name sortKey="De Bie, R M" sort="De Bie, R M" uniqKey="De Bie R" first="R M" last="De Bie">R M De Bie</name>
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<author><name sortKey="Speelman, J D" sort="Speelman, J D" uniqKey="Speelman J" first="J D" last="Speelman">J D Speelman</name>
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<author><name sortKey="Bosch, D A" sort="Bosch, D A" uniqKey="Bosch D" first="D A" last="Bosch">D A Bosch</name>
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<author><name sortKey="Speelman, J D" sort="Speelman, J D" uniqKey="Speelman J" first="J D" last="Speelman">J D Speelman</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Drug Resistance</term>
<term>Dyskinesia, Drug-Induced (surgery)</term>
<term>Dystonia (surgery)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Globus Pallidus (surgery)</term>
<term>Humans</term>
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<term>Levodopa (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Muscle Rigidity (surgery)</term>
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<term>Pilot Projects</term>
<term>Prospective Studies</term>
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<term>Treatment Outcome</term>
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<term>Dystonia</term>
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<term>Muscle Rigidity</term>
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<term>Humans</term>
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<front><div type="abstract" xml:lang="en">In this report, we describe the effect of staged bilateral posteroventral pallidotomy in three patients with advanced Parkinson's disease who were all of the young-onset type. Two patients had developed response fluctuations after the use of levodopa, with severe hypokinesia, painful dystonia, and rigidity in the "off" phase and violent dyskinesias in the "on" phase. One patient, in a continuous hypokinetic rigid state, was totally unresponsive to dopaminergic medication. All were at Hoehn and Yahr stage 5 in the "off" phase before surgery. After surgery, the hypokinetic state was reversed and dyskinesias were abolished in all patients. Hoehn and Yahr stages were 3 in the "off" phase postoperatively. Overall functional improvement was marked and lasting after follow-up for 7, 12, and 13 months, respectively. Complications were visual field deficit and transient central facial paresis, both in the same patient. Bilateral posteroventral pallidotomy can ameliorate response fluctuations, hypokinesia, rigidity, and painful dystonia in advanced Parkinson's disease.</div>
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<name sortKey="De Bie, R M" sort="De Bie, R M" uniqKey="De Bie R" first="R M" last="De Bie">R M De Bie</name>
<name sortKey="Speelman, J D" sort="Speelman, J D" uniqKey="Speelman J" first="J D" last="Speelman">J D Speelman</name>
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<country name="Pays-Bas"><noRegion><name sortKey="Schuurman, P R" sort="Schuurman, P R" uniqKey="Schuurman P" first="P R" last="Schuurman">P R Schuurman</name>
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