Surgical treatment of Parkinson's disease
From WikiLectures
Parkinson's disease is caused by degeneration of neurons pars compacta substantiae nigrae - dopamine, production is reduced, which leads to its deficiency in the striatum.
- Clinically: hypokinetic-hypertonic syndrome – tremor, rigidity, bradykinesia
- Ventrolateral thalamotomy was used before the discovery of levodopa it affected mainly tremor, limiting the possibility of only one-sided performance with an unacceptable risk of dysarthria, gait disorders and cognitive deficit in bilateral thalamotomy
- Today surgical therapy reserved: for patients refractory to pharmacotherapy + those who develop significant dyskinesias as an adjunct to levodopa treatment
- Stereotactic pallidotomy radiofrequency / cryodestruction
- Non-destructive deep stimulation ncl. subthalamicus / posteroventral pallid
- Transplantation of fetal dopaminergic bb. - results not yet convincing
