Stereotactic microelectrode-guided postero-ventral pallidotomy for Parkinson ' s disease  

作　　者：黄永安 

机构地区：[1]Dept Neurosurg,Air Force Gener Hosp, Beijing 100036

出　　处：《外科研究与新技术》2003年第2期104-104,共1页Surgical Research and New Technique

摘　　要：Objective To assess postoperative effects of microelectrode-guided postoventral pallidotomy (PVP) for Parkinson ’ s disease. Methods Intraoperative microelectrode recordings and microstimulation were used to explore the globus pallidus to performance of posteroventral pallidotomy in 48 patients with Parkinson’s disease (47 unilateral and 1 bilateral). Assessment was made at baseline preoperatively and at 6 months intervals postoperatively, with unified Parkinson’ s disease rating scale (UPDRS). Results All patients were significantly improved on the limbs contralateral to the lesion side 6-34 months after operation ( mean 24 months). The improvement was seen in the ’on’ or ’off state:UPDRS scores with patients on levodopa were improved by an average of 28. 7 % , while off medication scores showed reductions (47.6% ) at 24 months. There were no deaths and no visual complications,but there were 4 patients (8. 3%) of a delayed contralateral limbs dystonia after pallidotomy. Conclusion The techniques ofObjective To assess postoperative effects of microelectrode-guided postoventral pallidotomy (PVP) for Parkinson ' s disease. Methods Intraoperative microelectrode recordings and microstimulation were used to explore the globus pallidus to performance of posteroventral pallidotomy in 48 patients with Parkinson's disease (47 unilateral and 1 bilateral). Assessment was made at baseline preoperatively and at 6 months intervals postoperatively, with unified Parkinson' s disease rating scale (UPDRS). Results All patients were significantly improved on the limbs contralateral to the lesion side 6-34 months after operation ( mean 24 months). The improvement was seen in the 'on' or 'off state:UPDRS scores with patients on levodopa were improved by an average of 28. 7 % , while off medication scores showed reductions (47.6% ) at 24 months. There were no deaths and no visual complications,but there were 4 patients (8. 3%) of a delayed contralateral limbs dystonia after pallidotomy. Conclusion The techniques of microelectrode recording and microstimulation indicate the location of the internal capsule and optic tract, which allow easy idenification of these structure and facilitate PVP target in conjunction with radiofrequency microelectrode stimulation. 7 refs.

关 键 词：guided VENTRAL bilateral medication LIMBS DEATHS unified unilateral postoperative baseline 

分 类 号：R651[医药卫生—外科学]