Bilateral pallidotomy in Parkinson's disease: a retrospective study.
Identifieur interne : 000796 ( Ncbi/Merge ); précédent : 000795; suivant : 000797Bilateral pallidotomy in Parkinson's disease: a retrospective study.
Auteurs : Rob M A. De Bie [Pays-Bas] ; P Richard Schuurman ; Rianne A J. Esselink ; D Andries Bosch ; Johannes D. SpeelmanSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2002.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Stereotaxic Techniques.
- physiopathology : Globus Pallidus, Parkinson Disease.
- surgery : Globus Pallidus, Parkinson Disease.
- Data Collection, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome.
Abstract
We evaluated the effects of bilateral pallidotomy in patients with advanced Parkinson's disease. Thirteen patients with Parkinson's disease had a staged bilateral pallidotomy if they had severe response fluctuations, dyskinesias, painful dystonia, or bradykinesia despite optimum pharmacological treatment. Assessment scales were the Unified Parkinson's Disease Rating scale (UPDRS), the Schwab and England scale, and a questionnaire on the effects of disability in activities of daily living and adverse effects. Postoperative magnetic resonance imaging was evaluated for lesion location and extension. The median off-phase UPDRS motor score was reduced from 43.5 to 29 after the first pallidotomy, and it was further reduced to 23.5 after the second pallidotomy (n = 8). The UPDRS activities of daily living off-phase score improved from 28.5 to 20.5 after the first pallidotomy and to 19 after the second pallidotomy (n = 6). The Schwab and England scale off-phase score showed an improvement after both procedures, first from 40 to 60, and thereafter to 90 (n = 8). On-phase dyskinesias were reduced substantially. Eight patients had adverse effects, of whom five had problems with speech. One patient became hemiplegic due to a delayed infarction. Ten patients experienced further benefit from the second procedure. Bilateral pallidotomy reduces dyskinesias. A second contralateral pallidotomy may reduce parkinsonism, although to a lesser degree compared with the first pallidotomy and with an increased risk for adverse effects.
DOI: 10.1002/mds.10090
PubMed: 12112203
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De Bie</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Schuurman, P Richard" sort="Schuurman, P Richard" uniqKey="Schuurman P" first="P Richard" last="Schuurman">P Richard Schuurman</name></author><author><name sortKey="Esselink, Rianne A J" sort="Esselink, Rianne A J" uniqKey="Esselink R" first="Rianne A J" last="Esselink">Rianne A J. Esselink</name></author><author><name sortKey="Bosch, D Andries" sort="Bosch, D Andries" uniqKey="Bosch D" first="D Andries" last="Bosch">D Andries Bosch</name></author><author><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D" last="Speelman">Johannes D. 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De Bie</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Schuurman, P Richard" sort="Schuurman, P Richard" uniqKey="Schuurman P" first="P Richard" last="Schuurman">P Richard Schuurman</name></author><author><name sortKey="Esselink, Rianne A J" sort="Esselink, Rianne A J" uniqKey="Esselink R" first="Rianne A J" last="Esselink">Rianne A J. Esselink</name></author><author><name sortKey="Bosch, D Andries" sort="Bosch, D Andries" uniqKey="Bosch D" first="D Andries" last="Bosch">D Andries Bosch</name></author><author><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D" last="Speelman">Johannes D. Speelman</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Data Collection</term><term>Female</term><term>Follow-Up Studies</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Retrospective Studies</term><term>Stereotaxic Techniques (adverse effects)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Stereotaxic Techniques</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</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>Data Collection</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We evaluated the effects of bilateral pallidotomy in patients with advanced Parkinson's disease. Thirteen patients with Parkinson's disease had a staged bilateral pallidotomy if they had severe response fluctuations, dyskinesias, painful dystonia, or bradykinesia despite optimum pharmacological treatment. Assessment scales were the Unified Parkinson's Disease Rating scale (UPDRS), the Schwab and England scale, and a questionnaire on the effects of disability in activities of daily living and adverse effects. Postoperative magnetic resonance imaging was evaluated for lesion location and extension. The median off-phase UPDRS motor score was reduced from 43.5 to 29 after the first pallidotomy, and it was further reduced to 23.5 after the second pallidotomy (n = 8). The UPDRS activities of daily living off-phase score improved from 28.5 to 20.5 after the first pallidotomy and to 19 after the second pallidotomy (n = 6). The Schwab and England scale off-phase score showed an improvement after both procedures, first from 40 to 60, and thereafter to 90 (n = 8). On-phase dyskinesias were reduced substantially. Eight patients had adverse effects, of whom five had problems with speech. One patient became hemiplegic due to a delayed infarction. Ten patients experienced further benefit from the second procedure. Bilateral pallidotomy reduces dyskinesias. A second contralateral pallidotomy may reduce parkinsonism, although to a lesser degree compared with the first pallidotomy and with an increased risk for adverse effects.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">12112203</PMID><DateCreated><Year>2002</Year><Month>07</Month><Day>11</Day></DateCreated><DateCompleted><Year>2002</Year><Month>09</Month><Day>16</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>17</Volume><Issue>3</Issue><PubDate><Year>2002</Year><Month>May</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Bilateral pallidotomy in Parkinson's disease: a retrospective study.</ArticleTitle><Pagination><MedlinePgn>533-8</MedlinePgn></Pagination><Abstract><AbstractText>We evaluated the effects of bilateral pallidotomy in patients with advanced Parkinson's disease. Thirteen patients with Parkinson's disease had a staged bilateral pallidotomy if they had severe response fluctuations, dyskinesias, painful dystonia, or bradykinesia despite optimum pharmacological treatment. Assessment scales were the Unified Parkinson's Disease Rating scale (UPDRS), the Schwab and England scale, and a questionnaire on the effects of disability in activities of daily living and adverse effects. Postoperative magnetic resonance imaging was evaluated for lesion location and extension. The median off-phase UPDRS motor score was reduced from 43.5 to 29 after the first pallidotomy, and it was further reduced to 23.5 after the second pallidotomy (n = 8). The UPDRS activities of daily living off-phase score improved from 28.5 to 20.5 after the first pallidotomy and to 19 after the second pallidotomy (n = 6). The Schwab and England scale off-phase score showed an improvement after both procedures, first from 40 to 60, and thereafter to 90 (n = 8). On-phase dyskinesias were reduced substantially. Eight patients had adverse effects, of whom five had problems with speech. One patient became hemiplegic due to a delayed infarction. Ten patients experienced further benefit from the second procedure. Bilateral pallidotomy reduces dyskinesias. 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Esselink</name><name sortKey="Schuurman, P Richard" sort="Schuurman, P Richard" uniqKey="Schuurman P" first="P Richard" last="Schuurman">P Richard Schuurman</name><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D" last="Speelman">Johannes D. Speelman</name></noCountry><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="De Bie, Rob M A" sort="De Bie, Rob M A" uniqKey="De Bie R" first="Rob M A" last="De Bie">Rob M A. De Bie</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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