Stereotactic pallidotomy in the treatment of Parkinson disease -: An expert opinion

被引:27
|
作者
Bronstein, JM
DeSalles, A
DeLong, MR
机构
[1] Univ Calif Los Angeles, Sch Med, Dept Neurol, Reed Neurol Res Ctr, Los Angeles, CA 90024 USA
[2] Univ Calif Los Angeles, Sch Med, Dept Neurosurg, Los Angeles, CA 90024 USA
[3] Univ Calif Los Angeles, Sch Med, Inst Brain Res, Los Angeles, CA 90024 USA
[4] Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA
关键词
D O I
10.1001/archneur.56.9.1064
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The objective of this workshop was to provide recommendations on several issues involving pallidotomy for patients with medically intractable Parkinson disease to physicians, patients, and other health care providers. An international consortium of experts in neurology, neurosurgery, and neurophysiology who had extensive experience with pallidotomy were invited to the workshop. Participants were sent background materials from the scientific literature for review-based participant recommendations. A proposed agenda was circulated to all participants before the workshop, and the final agenda was based on their recommendations. Topics were introduced at the workshop by members of the organizing committee, followed by extensive group discussion. A draft of a consensus statement, based on the previous day's discussion, was circulated and further modifications were made. The final statement was agreed on by all members. The conclusions of the participants were: (1) Pallidotomy should be performed only at centers that have a team of physicians with substantial expertise and experience in the field. (2) Patients with disabling idiopathic Parkinson disease, without dementia, and who have exhausted medical therapy should be considered for pallidotomy. (3) All patients should be examined by means of standardized rating scales both preoperatively and postoperatively to ensure quality of care at each center. (4) Symptoms that respond best to pallidotomy include medication-induced dyskinesias, rigidity, and tremor, while balance, gait disorders, and hypophonia are generally less responsive to surgery. Benefits of pallidotomy appear to be long lasting. (5) Each institution's complication rate should be discussed before surgery.
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页码:1064 / 1069
页数:6
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