Stereotaxic treatment of patients with Parkinson's disease
Identifieur interne : 002D23 ( Main/Exploration ); précédent : 002D22; suivant : 002D24Stereotaxic treatment of patients with Parkinson's disease
Auteurs : J. Hullay [Hongrie]Source :
- Acta Neurochirurgica [ 0001-6268 ] ; 1969-03-01.
Abstract
Summary: The author describes the observations obtained during 40 stereotactic operations performed on 35 Parkinsonian patients. A new stereotactic method has been elaborated, which, as far as possible, adapts itself to variations in the ventricular size and in the neural structures, and accordingly makes it possible not only to aim precisely but also to localize, document, and interpret the operative procedure in vivo. Carrying out lesion-analysis by means of this new system, the author observed the concentration of lesions affecting tremor and tonicity in the thalamus on the border of the V. o. p. and V. im., and V. o. a. respectively, and in the subthalamus on the border of Z. i. and Ra. prl. and H2 respectively. In the target point corresponding to the subthalamic concentration of lesions a permanent arrest of the tremor was observed when inserting the EMG-controlled electrode, and a single small lesion (about 40 mm3) proved to be very effective in respect of both tremor and tonicity. The role of the effect of the electrode introduction and of the responses obtained by electrical stimulation in the functional control of the position of the electrode is emphasized. On evaluating the operative results in regard to the location of the lesions, it was found that the combined lesion of the VL nucleus and the subthalamus showed better results than the pallidal lesion, but that the best results were obtained after a subthalamus, Z. i., Ra. prl. lesion. Undesired psychic side symptoms were observed most often with the VL nucleus plus subthalamic lesion combination. A positive change of the psychic picture and the fewest side effects occurred after subthalamic lesions. The author considers the improvement of psychomotility an important factor in somatomotor improvement as well as in its preservation.
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DOI: 10.1007/BF01402240
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