Unilateral combined stereotactic radiofrequency pallidotomy and thalamotomy for Idiopathic Parkinson’s disease.

Document Type : Original Articles

Authors

1 Department of Neurosurgery, Suez Canal University.

2 Department of Neurosurgery, Suez Canal University

3 Rheumatology and Physical medicine Department, Suez Canal University, Faculty of Medicine, Ismailia, Egypt.

Abstract

Background: Lesioning surgeries in PD include target obliteration of a certain area in brain tissue in to disrupt maladaptive neuronal arrangements. Target selections were modulated various times until in 1960s when thalamotomy was used for tremors and pallidotomy was used for Bradykinesia and rigidity.
Purpose: To report efficacy of unilateral combined stereotactic pallidotomy and thalamotomy for Idiopathic Parkinson’s disease.
Patients and Methods: 62 patients with PD underwent pallidotomy and thalamotomy. Pre-op assessment using the UPDRS and Hoen and Yahr scale for PD. Post-op assessment using the UPDRS and Hoen and Yahr scale for PD, complications in 1,6,12 and 24 months.
Results: The mean age was 57.47±9.90. The average UPDRS off motor assessment results showed reduction after 1 month from 60.16 to 30.88 and at 24-month follow-up was 41.6. The average Yahr and Hoen scale 3.63 to 1.19 after 1-month and 24 months was 1.87. The average UPDRS constancy of tremors improved after 1-month from 3.53 to 0.75. Improvement in constancy of tremors reached 75% of cases after 24-month with average 1.62. the average UPDRS rigidity score improved at 1-month follow-up from 3.31 to 1.21. Total improvement of rigidity reached 63% after 24-month. 2 patients had post-operative thalamic hematoma presented with hemiplegia, which was conservatively managed, and improved after 1-month with little deficit. 51.6% had gait imbalance at 6-month follow-up. 22.5% showed dysarthria immediately while 12.9% totally resolved after 1-month follow-up.
Conclusion: Our data suggest that Unilateral combined stereotactic pallidotomy and thalamotomy for Idiopathic PD is effective procedure.

Keywords

Pan Arab Journal of Neurosurgery
Volume 18, Issue 2
December 2023
Pages 139-145

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