Abstract:
:The goals of this study were to analyze the effect of pallidotomy on parkinsonian tremor and to ascertain whether an association exists between microrecording findings and tremor outcome. Forty-four patients with Parkinson's disease (PD) who had drug-induced dyskinesia, bradykinesia, rigidity, and tremor underwent posteroventral pallidotomy. Using a 1-micro-tip tungsten electrode, microrecordings were obtained through one to three tracts, starting 10 mm above the pallidal base. Tremor severity was measured on a patient-rated, 100-mm Visual Analog Scale (VAS), both preoperatively and 3 to 9 months (mean 6 months) postoperatively. Preoperatively, tremor was rated as 50 mm or greater in 24 patients (55%) and as less than 25 mm in 13 patients (30%). Postoperatively, tremor was rated as 50 mm or greater in five patients (11%) and less than 25 mm in 29 patients (66%). The difference was significant (p = 0.0001). Four patients (9%) had no postoperative tremor. Tremor improved by at least 50% in eight (80%) of 10 patients in whom tremor-synchronous cells were recorded (Group A) and in 12 (35%) of 34 patients in whom tremor-synchronous cells were not recorded (Group B). This difference was significant (p = 0.03). Tremor improved by at least 50 mm in all (100%) of the seven Group A patients with severe (> or = 50 mm) preoperative tremor and in nine (53%) of 17 Group B patients with severe preoperative tremor. This difference was also significant (p = 0.05). The authors proffer two conclusions: 1) after pallidotomy, tremor improves by at least 50% in two-thirds of patients with PD who have severe (> or = 50 mm on the VAS) preoperative tremor; and 2) better tremor control is obtained when tremor-synchronous cells are included in the lesion.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Taha JM,Favre J,Baumann TK,Burchiel KJdoi
10.3171/foc.1997.2.3.5subject
Has Abstractpub_date
1997-03-15 00:00:00pages
e2issue
3issn
1092-0684pii
020302journal_volume
2pub_type
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pub_type: 杂志文章,评审
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doi:10.3171/2020.6.FOCUS20360
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journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
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journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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doi:10.3171/2015.10.FOCUS15456
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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doi:10.3171/2018.1.FocusVid.17572
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pub_type: 杂志文章
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journal_title:Neurosurgical focus
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
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journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
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