Efectividad y seguridad de la palidotoma posteroventral en el tratamiento de la enfermedad de Parkinson avanzada
Identifieur interne : 000160 ( Main/Corpus ); précédent : 000159; suivant : 000161Efectividad y seguridad de la palidotoma posteroventral en el tratamiento de la enfermedad de Parkinson avanzada
Auteurs : Jos Luis Molinuevo ; Francesc Valldeoriola ; Fritz A. Nobbe ; Eduardo Tolosa ; Jordi Rumi ; Enric FerrerSource :
- Medicina Clinica [ 0025-7753 ] ; 1999.
Abstract
Fundamento: Analizar la efectividad y seguridad de la palidotoma unilateral guiada por microrregistroen el tratamiento de la enfermedad de Parkinson (EP) avanzada despus de 3 mesesy al ao de la intervencin.Pacientes y mtodos: Se intervinieron 23 pacientes con EP avanzada (edad media, 58,9 aos;duracin media de la enfermedad, 14,4 aos). La evaluacin clnica, a los 3 meses (n = 23) yal ao (n = 16) de la intervencin, se efectu por la maana 12 h despus de la ltima dosisde medicacin (off) y tras la administracin de un 100-150% de la dosis habitual (on). Encada una de las evaluaciones se administraron escalas para valoracin de las actividades de lavida diaria, evaluacin motora y discinesias, as como pruebas cronometradas de la actividadmotora.Resultados: Las discinesias contralaterales al hemisferio intervenido se redujeron un 92% a los3 meses y un 89% al ao. Los sntomas motores de la enfermedad mejoraron un 36,5% a los 3meses y un 26,7% al ao de la intervencin. En el anlisis anual apareci una mejora en eltemblor contralateral del 48%, en la rigidez del 36,2% y en la bradicinesia del 37,4% Todoslos cambios observados fueron estadsticamente significativos (p < 0,01). Los efectos adversosfueron leves o transitorios. La dosis de medicacin antiparkinsoniana no se modific durante eltiempo de seguimiento.Conclusiones: La palidotoma unilateral guiada por microrregistro es un mtodo seguro y eficazpara mejorar los sntomas de la EP contralaterales, siendo especialmente eficaz en el tratamientode las discinesias inducidas por L-dopa.
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DOI: 10.1016/S0025-7753(00)71245-0
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Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Nobbe, Fritz A" sort="Nobbe, Fritz A" uniqKey="Nobbe F" first="Fritz A." last="Nobbe">Fritz A. Nobbe</name><affiliation><mods:affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name><affiliation><mods:affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Rumi, Jordi" sort="Rumi, Jordi" uniqKey="Rumi J" first="Jordi" last="Rumi">Jordi Rumi</name><affiliation><mods:affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</mods:affiliation></affiliation></author><author><name sortKey="Ferrer, Enric" sort="Ferrer, Enric" uniqKey="Ferrer E" first="Enric" last="Ferrer">Enric Ferrer</name><affiliation><mods:affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. 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Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Valldeoriola, Francesc" sort="Valldeoriola, Francesc" uniqKey="Valldeoriola F" first="Francesc" last="Valldeoriola">Francesc Valldeoriola</name><affiliation><mods:affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Nobbe, Fritz A" sort="Nobbe, Fritz A" uniqKey="Nobbe F" first="Fritz A." last="Nobbe">Fritz A. Nobbe</name><affiliation><mods:affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name><affiliation><mods:affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</mods:affiliation></affiliation></author><author><name sortKey="Rumi, Jordi" sort="Rumi, Jordi" uniqKey="Rumi J" first="Jordi" last="Rumi">Jordi Rumi</name><affiliation><mods:affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</mods:affiliation></affiliation></author><author><name sortKey="Ferrer, Enric" sort="Ferrer, Enric" uniqKey="Ferrer E" first="Enric" last="Ferrer">Enric Ferrer</name><affiliation><mods:affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Medicina Clinica</title><title level="j" type="abbrev">MEDCLI</title><idno type="ISSN">0025-7753</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">114</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="205">205</biblScope><biblScope unit="page" to="208">208</biblScope></imprint><idno type="ISSN">0025-7753</idno></series><idno type="istex">DA96FCAA64FDBC3D60D67707A9E2D4D2DBBE1604</idno><idno type="DOI">10.1016/S0025-7753(00)71245-0</idno><idno type="PII">S0025-7753(00)71245-0</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0025-7753</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="es">es</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="es">Fundamento: Analizar la efectividad y seguridad de la palidotoma unilateral guiada por microrregistroen el tratamiento de la enfermedad de Parkinson (EP) avanzada despus de 3 mesesy al ao de la intervencin.Pacientes y mtodos: Se intervinieron 23 pacientes con EP avanzada (edad media, 58,9 aos;duracin media de la enfermedad, 14,4 aos). La evaluacin clnica, a los 3 meses (n = 23) yal ao (n = 16) de la intervencin, se efectu por la maana 12 h despus de la ltima dosisde medicacin (off) y tras la administracin de un 100-150% de la dosis habitual (on). Encada una de las evaluaciones se administraron escalas para valoracin de las actividades de lavida diaria, evaluacin motora y discinesias, as como pruebas cronometradas de la actividadmotora.Resultados: Las discinesias contralaterales al hemisferio intervenido se redujeron un 92% a los3 meses y un 89% al ao. Los sntomas motores de la enfermedad mejoraron un 36,5% a los 3meses y un 26,7% al ao de la intervencin. En el anlisis anual apareci una mejora en eltemblor contralateral del 48%, en la rigidez del 36,2% y en la bradicinesia del 37,4% Todoslos cambios observados fueron estadsticamente significativos (p < 0,01). Los efectos adversosfueron leves o transitorios. La dosis de medicacin antiparkinsoniana no se modific durante eltiempo de seguimiento.Conclusiones: La palidotoma unilateral guiada por microrregistro es un mtodo seguro y eficazpara mejorar los sntomas de la EP contralaterales, siendo especialmente eficaz en el tratamientode las discinesias inducidas por L-dopa.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Jos Luis Molinuevo</name><affiliations><json:string>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</json:string></affiliations></json:item><json:item><name>Francesc Valldeoriola</name><affiliations><json:string>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</json:string></affiliations></json:item><json:item><name>Fritz A. Nobbe</name><affiliations><json:string>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</json:string></affiliations></json:item><json:item><name>Eduardo Tolosa</name><affiliations><json:string>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</json:string></affiliations></json:item><json:item><name>Jordi Rumi</name><affiliations><json:string>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</json:string></affiliations></json:item><json:item><name>Enric Ferrer</name><affiliations><json:string>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. 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Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation></author><author><persName><forename type="first">Francesc</forename><surname>Valldeoriola</surname></persName><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation></author><author><persName><forename type="first">Fritz A.</forename><surname>Nobbe</surname></persName><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation></author><author><persName><forename type="first">Eduardo</forename><surname>Tolosa</surname></persName><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation></author><author><persName><forename type="first">Jordi</forename><surname>Rumi</surname></persName><affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</affiliation></author><author><persName><forename type="first">Enric</forename><surname>Ferrer</surname></persName><affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</affiliation></author></analytic><monogr><title level="j">Medicina Clinica</title><title level="j" type="abbrev">MEDCLI</title><idno type="pISSN">0025-7753</idno><idno type="PII">S0025-7753(00)X7126-6</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999"></date><biblScope unit="volume">114</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="205">205</biblScope><biblScope unit="page" to="208">208</biblScope></imprint></monogr><idno type="istex">DA96FCAA64FDBC3D60D67707A9E2D4D2DBBE1604</idno><idno type="DOI">10.1016/S0025-7753(00)71245-0</idno><idno type="PII">S0025-7753(00)71245-0</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2000</date></creation><langUsage><language ident="es">es</language></langUsage><abstract xml:lang="es"><p>Fundamento: Analizar la efectividad y seguridad de la palidotoma unilateral guiada por microrregistroen el tratamiento de la enfermedad de Parkinson (EP) avanzada despus de 3 mesesy al ao de la intervencin.Pacientes y mtodos: Se intervinieron 23 pacientes con EP avanzada (edad media, 58,9 aos;duracin media de la enfermedad, 14,4 aos). La evaluacin clnica, a los 3 meses (n = 23) yal ao (n = 16) de la intervencin, se efectu por la maana 12 h despus de la ltima dosisde medicacin (off) y tras la administracin de un 100-150% de la dosis habitual (on). Encada una de las evaluaciones se administraron escalas para valoracin de las actividades de lavida diaria, evaluacin motora y discinesias, as como pruebas cronometradas de la actividadmotora.Resultados: Las discinesias contralaterales al hemisferio intervenido se redujeron un 92% a los3 meses y un 89% al ao. Los sntomas motores de la enfermedad mejoraron un 36,5% a los 3meses y un 26,7% al ao de la intervencin. En el anlisis anual apareci una mejora en eltemblor contralateral del 48%, en la rigidez del 36,2% y en la bradicinesia del 37,4% Todoslos cambios observados fueron estadsticamente significativos (p < 0,01). Los efectos adversosfueron leves o transitorios. La dosis de medicacin antiparkinsoniana no se modific durante eltiempo de seguimiento.Conclusiones: La palidotoma unilateral guiada por microrregistro es un mtodo seguro y eficazpara mejorar los sntomas de la EP contralaterales, siendo especialmente eficaz en el tratamientode las discinesias inducidas por L-dopa.</p></abstract><abstract xml:lang="en"><p>Objectives: To analyze the results, efficacy and safety of unilateral microelectrode guided pallidotomyfor the treatment of advanced Parkinson's disease, three months and one year after surgery.Patients and methods: 23 patients with advanced Parkinson's disease (mean age 58,9 years andmean disease duration 14,4 years) were submitted to pallidotomy. Neurological evaluation, threemonths (n = 23) and one year (n = 16) after surgery, was performed during the morning inovernight off condition and after receiving 100-150% of their usual l-dopa dose. Parkinsoniansymptoms were evaluated in each follow up visit through motor scales, activities of dailyliving scales, a dyskinesia rating scale and motor timed tests.Results: Contralateral dyskinesias improved 92% three months after surgery and 89% at oneyear. Parkinsonian motor scores were reduced by 36.5% after three months and by 26.7% oneyear after surgery. In the one year follow up visit, contralateral tremor improved 48%, rigidity36.2% and bradykinesia 37.4%. All these changes were statistically significant (p < 0.01). Adverseeffects were minor or transient. Antiparkinsonian medication dosage did not significantlychange during the study period.Conclusion: Microelectrode guided unilateral pallidotomy is an effective and safe procedure toimprove contralateral motor symptoms in Parkinson's disease, being specially useful for the treatmentof l-dopa induced dyskinesias.</p></abstract><textClass xml:lang="es"><keywords scheme="keyword"><list><head>Palabras clave</head><item><term>Enfermedad de Parkinson</term></item><item><term>Palidotoma</term></item><item><term>Discinesias</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1999-05-11">Registration</change><change when="1999">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.1.0//EN//XML" URI="art510.dtd" name="istex:docType"></istex:docType><istex:document><article version="5.1" xml:lang="es" docsubtype="fla"><item-info><jid>MEDCLI</jid><aid>71245</aid><ce:pii>S0025-7753(00)71245-0</ce:pii><ce:doi>10.1016/S0025-7753(00)71245-0</ce:doi><ce:copyright type="full-transfer" year="2000">Elsevier España, S.L.</ce:copyright></item-info><head><ce:title>Efectividad y seguridad de la palidotomía posteroventral en el tratamiento de la enfermedad de Parkinson avanzada</ce:title><ce:alt-title xml:lang="en">Efficacy and safety of posteroventral pallidotomy for the treatment of advanced parkinson's disease</ce:alt-title><ce:author-group><ce:author><ce:given-name>José</ce:given-name><ce:surname>Luis Molinuevo</ce:surname></ce:author><ce:author><ce:given-name>Francesc</ce:given-name><ce:surname>Valldeoriola</ce:surname><ce:cross-ref refid="cor0005"><ce:sup>*</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Fritz A.</ce:given-name><ce:surname>Nobbe</ce:surname></ce:author><ce:author><ce:given-name>Eduardo</ce:given-name><ce:surname>Tolosa</ce:surname></ce:author><ce:affiliation><ce:textfn><ce:italic>Servicios de Neurología Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer. Universitat de Barcelona.</ce:italic></ce:textfn></ce:affiliation><ce:correspondence id="cor0005"><ce:label>*</ce:label><ce:text>Correspondencia: Servicio de Neurología. Hospital Clínic. Villarroel, 170. 08036 Barcelona.</ce:text></ce:correspondence></ce:author-group><ce:author-group><ce:author><ce:given-name>Jordi</ce:given-name><ce:surname>Rumià</ce:surname><ce:cross-ref refid="aff00005"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Enric</ce:given-name><ce:surname>Ferrer</ce:surname><ce:cross-ref refid="aff00005"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="aff00005"><ce:label>a</ce:label><ce:textfn><ce:italic>Neurocirugía. Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer. Universitat de Barcelona</ce:italic></ce:textfn></ce:affiliation></ce:author-group><ce:date-received day="22" month="2" year="1999"></ce:date-received><ce:date-accepted day="11" month="5" year="1999"></ce:date-accepted><ce:abstract xml:lang="es"><ce:abstract-sec><ce:section-title>Fundamento</ce:section-title><ce:simple-para id="spar0005">: Analizar la efectividad y seguridad de la palidotomía unilateral guiada por microrregistroen el tratamiento de la enfermedad de Parkinson (EP) avanzada después de 3 mesesy al año de la intervención.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Pacientes y métodos</ce:section-title><ce:simple-para id="spar0010">: Se intervinieron 23 pacientes con EP avanzada (edad media, 58,9 años;duración media de la enfermedad, 14,4 años). La evaluación clínica, a los 3 meses (n = 23) yal año (n = 16) de la intervención, se efectuó por la mañana 12 h después de la última dosisde medicación (off) y tras la administración de un 100-150% de la dosis habitual (on). Encada una de las evaluaciones se administraron escalas para valoración de las actividades de lavida diaria, evaluación motora y discinesias, así como pruebas cronometradas de la actividadmotora.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Resultados</ce:section-title><ce:simple-para id="spar0015">: Las discinesias contralaterales al hemisferio intervenido se redujeron un 92% a los3 meses y un 89% al año. Los síntomas motores de la enfermedad mejoraron un 36,5% a los 3meses y un 26,7% al año de la intervención. En el análisis anual apareció una mejoría en eltemblor contralateral del 48%, en la rigidez del 36,2% y en la bradicinesia del 37,4% Todoslos cambios observados fueron estadísticamente significativos (p < 0,01). Los efectos adversosfueron leves o transitorios. La dosis de medicación antiparkinsoniana no se modificó durante eltiempo de seguimiento.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Conclusiones</ce:section-title><ce:simple-para id="spar0020">: La palidotomía unilateral guiada por microrregistro es un método seguro y eficazpara mejorar los síntomas de la EP contralaterales, siendo especialmente eficaz en el tratamientode las discinesias inducidas por L-dopa.</ce:simple-para></ce:abstract-sec></ce:abstract><ce:abstract xml:lang="en"><ce:abstract-sec><ce:section-title>Objectives</ce:section-title><ce:simple-para id="spar0025">: To analyze the results, efficacy and safety of unilateral microelectrode guided pallidotomyfor the treatment of advanced Parkinson's disease, three months and one year after surgery.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Patients and methods</ce:section-title><ce:simple-para id="spar0030">: 23 patients with advanced Parkinson's disease (mean age 58,9 years andmean disease duration 14,4 years) were submitted to pallidotomy. Neurological evaluation, threemonths (n = 23) and one year (n = 16) after surgery, was performed during the morning inovernight «off» condition and after receiving 100-150% of their usual l-dopa dose. Parkinsoniansymptoms were evaluated in each follow up visit through motor scales, activities of dailyliving scales, a dyskinesia rating scale and motor timed tests.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Results</ce:section-title><ce:simple-para id="spar0035">: Contralateral dyskinesias improved 92% three months after surgery and 89% at oneyear. Parkinsonian motor scores were reduced by 36.5% after three months and by 26.7% oneyear after surgery. In the one year follow up visit, contralateral tremor improved 48%, rigidity36.2% and bradykinesia 37.4%. All these changes were statistically significant (p < 0.01). Adverseeffects were minor or transient. Antiparkinsonian medication dosage did not significantlychange during the study period.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Conclusion</ce:section-title><ce:simple-para id="spar0040">: Microelectrode guided unilateral pallidotomy is an effective and safe procedure toimprove contralateral motor symptoms in Parkinson's disease, being specially useful for the treatmentof l-dopa induced dyskinesias.</ce:simple-para></ce:abstract-sec></ce:abstract><ce:keywords class="keyword" xml:lang="es"><ce:section-title>Palabras clave</ce:section-title><ce:keyword><ce:text>Enfermedad de Parkinson</ce:text></ce:keyword><ce:keyword><ce:text>Palidotomía</ce:text></ce:keyword><ce:keyword><ce:text>Discinesias</ce:text></ce:keyword></ce:keywords></head><tail><ce:bibliography id="bibl0005"><ce:section-title>Referencias Bibliográficas</ce:section-title><ce:bibliography-sec id="bibs0005"><ce:bib-reference 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Molinuevo</namePart><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesc</namePart><namePart type="family">Valldeoriola</namePart><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fritz A.</namePart><namePart type="family">Nobbe</namePart><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eduardo</namePart><namePart type="family">Tolosa</namePart><affiliation>Servicios de Neurologa Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jordi</namePart><namePart type="family">Rumi</namePart><affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Enric</namePart><namePart type="family">Ferrer</namePart><affiliation>Neurociruga. Hospital Clnic. Institut d'Investigacions Biomdiques August Pi i Sunyer. Universitat de Barcelona</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1999</dateIssued><dateValid encoding="w3cdtf">1999-05-11</dateValid><copyrightDate encoding="w3cdtf">2000</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">spa</languageTerm><languageTerm type="code" authority="rfc3066">es</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="es">Fundamento: Analizar la efectividad y seguridad de la palidotoma unilateral guiada por microrregistroen el tratamiento de la enfermedad de Parkinson (EP) avanzada despus de 3 mesesy al ao de la intervencin.Pacientes y mtodos: Se intervinieron 23 pacientes con EP avanzada (edad media, 58,9 aos;duracin media de la enfermedad, 14,4 aos). La evaluacin clnica, a los 3 meses (n = 23) yal ao (n = 16) de la intervencin, se efectu por la maana 12 h despus de la ltima dosisde medicacin (off) y tras la administracin de un 100-150% de la dosis habitual (on). Encada una de las evaluaciones se administraron escalas para valoracin de las actividades de lavida diaria, evaluacin motora y discinesias, as como pruebas cronometradas de la actividadmotora.Resultados: Las discinesias contralaterales al hemisferio intervenido se redujeron un 92% a los3 meses y un 89% al ao. Los sntomas motores de la enfermedad mejoraron un 36,5% a los 3meses y un 26,7% al ao de la intervencin. En el anlisis anual apareci una mejora en eltemblor contralateral del 48%, en la rigidez del 36,2% y en la bradicinesia del 37,4% Todoslos cambios observados fueron estadsticamente significativos (p < 0,01). Los efectos adversosfueron leves o transitorios. La dosis de medicacin antiparkinsoniana no se modific durante eltiempo de seguimiento.Conclusiones: La palidotoma unilateral guiada por microrregistro es un mtodo seguro y eficazpara mejorar los sntomas de la EP contralaterales, siendo especialmente eficaz en el tratamientode las discinesias inducidas por L-dopa.</abstract><abstract lang="en">Objectives: To analyze the results, efficacy and safety of unilateral microelectrode guided pallidotomyfor the treatment of advanced Parkinson's disease, three months and one year after surgery.Patients and methods: 23 patients with advanced Parkinson's disease (mean age 58,9 years andmean disease duration 14,4 years) were submitted to pallidotomy. Neurological evaluation, threemonths (n = 23) and one year (n = 16) after surgery, was performed during the morning inovernight off condition and after receiving 100-150% of their usual l-dopa dose. Parkinsoniansymptoms were evaluated in each follow up visit through motor scales, activities of dailyliving scales, a dyskinesia rating scale and motor timed tests.Results: Contralateral dyskinesias improved 92% three months after surgery and 89% at oneyear. Parkinsonian motor scores were reduced by 36.5% after three months and by 26.7% oneyear after surgery. In the one year follow up visit, contralateral tremor improved 48%, rigidity36.2% and bradykinesia 37.4%. All these changes were statistically significant (p < 0.01). Adverseeffects were minor or transient. Antiparkinsonian medication dosage did not significantlychange during the study period.Conclusion: Microelectrode guided unilateral pallidotomy is an effective and safe procedure toimprove contralateral motor symptoms in Parkinson's disease, being specially useful for the treatmentof l-dopa induced dyskinesias.</abstract><subject lang="es"><genre>Palabras clave</genre><topic>Enfermedad de Parkinson</topic><topic>Palidotoma</topic><topic>Discinesias</topic></subject><relatedItem type="host"><titleInfo><title>Medicina Clinica</title></titleInfo><titleInfo type="abbreviated"><title>MEDCLI</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">2000</dateIssued></originInfo><identifier type="ISSN">0025-7753</identifier><identifier type="PII">S0025-7753(00)X7126-6</identifier><part><date>2000</date><detail type="volume"><number>114</number><caption>vol.</caption></detail><detail type="issue"><number>6</number><caption>no.</caption></detail><extent unit="issue pages"><start>201</start><end>240</end></extent><extent unit="pages"><start>205</start><end>208</end></extent></part></relatedItem><identifier type="istex">DA96FCAA64FDBC3D60D67707A9E2D4D2DBBE1604</identifier><identifier type="DOI">10.1016/S0025-7753(00)71245-0</identifier><identifier type="PII">S0025-7753(00)71245-0</identifier><accessCondition type="use and reproduction" contentType="">© 2000Elsevier Espaa, S.L.</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Elsevier Espaa, S.L., ©2000</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/DA96FCAA64FDBC3D60D67707A9E2D4D2DBBE1604/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">MEDICINE, GENERAL & INTERNAL</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments></istex></record>Pour manipuler ce document sous Unix (Dilib)
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