Motor performance after posteroventral pallidotomy and VIM-thalamotomy in Parkinson's disease: a 1-year follow-up study

Motor performance after posteroventral pallidotomy and VIM-thalamotomy in Parkinson's disease: a 1-year follow-up study

Alternative title Desempenho motor após palidotomia póstero-ventral e talamotomia ventro-lateral na doença de Parkinson: acompanhamento de um ano
Author Aguiar, PatrÍcia M. C. Autor UNIFESP Google Scholar
Ferraz, Henrique B. Autor UNIFESP Google Scholar
Ferraz, Fernando P. Autor UNIFESP Google Scholar
Saba, Roberta Arb Autor UNIFESP Google Scholar
Hisatugo, Marcelo Ken-iti Autor UNIFESP Google Scholar
Andrade, Luiz Augusto Franco de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hospital do Servidor Público Estadual Francisco Morato Oliveira
Abstract Twenty-three patients with Parkinson's disease underwent stereotactic surgery. To study the long-term motor performance, the patients were evaluated at the pre-operative period and at the 1st, 3rd, 6th, and 12th post-operative months, with the following scales: Unified Parkinson's Disease Rating Scale (UPDRS) motor score and Larsen's Scale for Dyskinesias. The patients under levodopa therapy were assessed both in on and off periods. Fourteen unilateral ventrolateral thalamotomies (VLT), 4 unilateral posteroventral pallidotomies (PVP), 2 bilateral PVP, and 3 VLT with contralateral PVP were performed. The motor improvement was significant and long-lasting in the off period, except for 2 patients. The on period quality improved, mainly due to the control of dyskinesias. The improvement of dyskinesias was long-lasting for the majority of the patients. There was no significant decrease in the levodopa dose. Three patients showed permanent complications, but none was severe.

Vinte e três pacientes portadores de doença de Parkinson foram submetidos a cirurgia estereotáxica para tratamento da doença. Com o objetivo de estudar o desempenho motor a longo prazo, os pacientes foram avaliados clinicamente no período pré-operatório, no 1°, 3°, 6°, e 12° mês pós-operatório, com as seguintes escalas: Escala Unificada para Doença de Parkinson (Unified Parkinson's Disease Rating Scale-UPDRS), item III, escore motor e com a Escala de Larsen para Discinesias. Os pacientes que utilizavam levodopa foram avaliados nos estados off e on. Foram realizadas 14 talamotomias ventro-laterais (TVL) unilaterais, 4 palidotomias póstero-ventrais (PPV) unilaterais, 2 PPV bilaterais; 3 TVL associadas à PPV contralateral. O benefício motor foi observado de forma significante no estado off, e manteve-se a longo prazo na maioria dos pacientes, exceto em 2. Houve melhora da qualidade do período on, devido ao controle das discinesias. A melhora das discinesias se manteve a longo prazo na maioria dos pacientes. As cirurgias não promoveram um decréscimo significante na dose de levodopa.Três pacientes tiveram complicações permanentes, mas nenhuma delas foi considerada grave e nem houve prejuízo funcional importante em decorrência das mesmas.
Keywords Parkinson's disease
thalamotomy
pallidotomy
doença de Parkinson
talamotomia
palidotomia
Language English
Date 2000-09-01
Published in Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 58, n. 3B, p. 830-835, 2000.
ISSN 0004-282X (Sherpa/Romeo)
Publisher Academia Brasileira de Neurologia - ABNEURO
Extent 830-835
Origin http://dx.doi.org/10.1590/S0004-282X2000000500007
Access rights Open access Open Access
Type Article
SciELO ID S0004-282X2000000500007 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1018

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