Treatment of bilateral Parkinson's tremor with bilateral small thalamotomy

Key Findings & Data:Material and methods:In this study, 9 patients (6 males, 3 females) diagnosed as having Idiopathic Parkinson's Disease (IPD) who despite appropriate medical therapy, had parkinsonian tremor, which significantly restricted their quality of life, were included.

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Conclusion & Impact:Mean Unified Parkinson's Disease Scale (UPDRS) tremor scores (subscores 20,21) decreased from 6,8±0,9 to 1,1±1 (p

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Purpose: Thalamotomy is an effective treatment method for medically intractable Parkinson's tremor. However, it is known that bilateral thalamotomy operation can cause some complications and mainly dysarthria. This information is derived from bilateral "large" thalamotomy operations performed in the earlier years. The goal of our study was to investigate the outome of bilateral small thalamotomy in the treatment of Parkinson's disease. Material and methods:In this study, 9 patients (6 males, 3 females) diagnosed as having Idiopathic Parkinson's Disease (IPD) who despite appropriate medical therapy, had parkinsonian tremor, which significantly restricted their quality of life, were included. Bilateral ventralis intermedius (VIM) nuclei of thalamus were ablated stereotactically with small lesions contrary to the technique reported in literature to avoid possible complications. Results: Postoperatively, five patients were free of bilateral tremor, in three patients the operation was very successful on one side and moderately successful on the other side. One patient improved on one side, however tremor did not improve on the other side. Mean Unified Parkinson's Disease Scale (UPDRS) tremor scores (subscores 20,21) decreased from 6,8±0,9 to 1,1±1 (p

Özet

Amaç: Medikal tedaviye dirençli Parkinson hastalığındaki tremorun tedavisinde talamotomi etkin bir tedavi yöntemidir. Ancak bilateral talamotomi operasyonunun başta dizartri olmak üzere bazı komplikasyonlara yol açtığı bilinmektedir. Bu bilgi eskiden yapılan bilateral büyük talamotomi ameliyatlarından gelmektedir. Bu çalışmada ise bilateral küçük talamotomi uygulanması sonrası görülen komplikasyonlar ve elde edilen sonuçlar araştırırıldı. Hastalar ve Yötem: Uygun dozlardaki medikal tedaviye rağmen günlük yaşam aktivitelerini kısıtlayıcı Parkinson tremoru olan 9 hastaya (6 erkek, 3 kadın) mevcut literatürde belirtilenin aksine, olası komplikasyonlardan kaçınmak için stereotaksi yöntemiyle ventralis intermedius (VİM) nükleusa bilateral küçük talamotomi yapıldı. Bulgular: Cerrahi sonrası hastaların beşinde tremor iki yanlı tamamen ortadan kalktı. Üç hastada bir beden yarısında belirgin, karşı beden yarısında kısmi yararlanma görüldü. Bir hastada bir beden yarısında belirgin düzelme görülürken karşı beden yarısındaki yakınmalarında değişiklik olmadı. Ortalama Birleşik Parkinson Hastalığı Değerlendirme Ölçeği tremor skoru (madde 20,21) 6,8±0,9'dan 1,1±1'e (p

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Cite This Article

YAVUZ, C., BARLAS, O., HANAĞASI, H. A., ŞAHİN, H. A., EMRE, M. (2022). Treatment of bilateral Parkinson's tremor with bilateral small thalamotomy. Türk Nöroşirürji Dergsi, Cilt: 12 - Sayı: 3, 242–246. https://ajindex.com/articles/637371

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