(Continued from previous message)
 
 1/L/11
DIALOG(R)File 154:MEDLINE(R)
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08818819   94133819
  Reversal of Parkinson's akinesia by pallidotomy [letter]
  Iacono RP; Lonser RR
  Lancet (ENGLAND)   Feb 12 1994,  343 (8894) p418-9,  ISSN 0023-7507
Journal Code: L0S
  Languages: ENGLISH
  Document type: LETTER
  JOURNAL ANNOUNCEMENT: 9405
  Subfile:   AIM; INDEX MEDICUS
  Tags: Human
  Descriptors:  *Globus  Pallidus--Surgery--SU; *Parkinson
Disease--Surgery
--SU; Adult; Aged; Middle Age; Stereotaxic Techniques
 
 1/L/12
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08789104   94104104
  [Surgical treatment of Parkinson's disease]
  Komai N
  Department of Neurological Surgery, Wakayama Medical College.
  Nippon Rinsho (JAPAN)   Nov 1993,  51 (11) p2940-6,  ISSN 0047-1852
Journal Code: KIM
  Languages: JAPANESE   Summary Languages: ENGLISH
  Document  type:  JOURNAL  ARTICLE;  REVIEW;  REVIEW,  TUTORIAL
English
Abstract
  JOURNAL ANNOUNCEMENT: 9404
  Subfile:   INDEX MEDICUS
  Surgical  treatment  for  Parkinson's  disease  began  by blocking of
the
pyramidal  system  in  early  part  of  this era. In 1942, Meyers
performed
Ansotomy  for  the  treatment  of  Parkinsonism without leaving
hemiplegia,
leading  subsequent  operating  target  to  blocking of pallidofugal
fiber.
Then, the development of stereotaxy in 1947 caused an operative progress
to
Pallidotomy  and  further  to  Thalamotomy. Although the spread of
levodopa
therapy  gradually brought about decline of surgical treatment,
Thalamotomy
became  to  be  reexamined  in view of not a little problems about and
side
effects  of levodopa therapy. With the development of CT, MRI and the
like,
Thalamotomy  via  MRI-stereotaxy was developed, making operations safer
and
surer.  Besides,  transplantation of dopamine neurons into the striatum
was
tried  as  an essential treatment and is in clinical application via
animal
experiments.  Fetal  ventral  mesencephalic  tissue  and  adrenal
medullary
tissue are available therefore, but demerits are such that the former
poses
some  ethical  problem and the latter is poor and short-lived response.
The
transplantation  of  stellate  ganglion  into  the  striatum, which we
have
recently  developed  is  safe and more effective than the adrenal
medullary
tissue.  The  respective  one  thirds  of  the  cases  did without
levodopa
following transplantation, needed half as much as the preoperative
levodopa
dose  and  needed  the  same  as the latter. Although Horner's syndrome
was
noted  in all cases following transplantation, no Parkinson syndrome
became
aggravated in any one of the cases.  (15 Refs.)
  Tags: Human
  Descriptors:  *Parkinson  Disease--Surgery--SU;  *Stereotaxic
Techniques;
Adrenal  Medulla--Transplantation--TR;  Brain Tissue Transplantation;
Fetal
Tissue Transplantation; Levodopa--Administration and Dosage--AD;
Substantia
Nigra--Transplantation--TR; Thalamus--Surgery--SU
  CAS Registry No.: 0   (Levodopa)
 
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08573757   93283757
  Transplantation and surgical treatment of parkinsonian syndromes.
  Widner H; Rehncrona S
  Department of Neurology, University Hospital, Lund, Sweden.
  Curr Opin Neurol Neurosurg (UNITED STATES)   Jun 1993,  6 (3) p344-9,
ISSN 0951-7383   Journal Code: BDI
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
  JOURNAL ANNOUNCEMENT: 9309
  Subfile:   INDEX MEDICUS
  Neurosurgical  attempts  to  correct  parkinsonism  use  strategies
aimed
either  at  alleviating the underlying dopamine deficiency or at
correcting
abnormal  compensatory effects in neural circuits within the basal
ganglia.
During  the  review period, clinical trials of four different
neurosurgical
approaches    were    reported.    These   approaches   are
intracerebral
transplantation of fetal dopamine neurons, intracerebral transplantation
of
adrenal   medullary   tissue,   tremor-reducing  surgical  lesions  in
the
ventrolateral  thalamus,  and ventroposterior pallidotomy aimed at
reducing
akinesia and rigidity. Experimental studies in rats and monkeys designed
to
explore mechanisms of graft actions were also reported.  (33 Refs.)
  Tags: Animal; Human
  Descriptors:   *Adrenal  Medulla--Transplantation--TR;  *Globus
Pallidus
--Surgery--SU;   *Parkinson   Disease--Surgery--SU;   *Parkinson
Disease,
Symptomatic--Surgery--SU;     *Thalamus--Surgery--SU;    Adrenal
Medulla
--Physiopathology--PP;     Dopamine--Physiology--PH;     Globus
Pallidus
--Physiopathology--PP;  Parkinson  Disease--Physiopathology--PP;
Parkinson
Disease,  Symptomatic--Physiopathology--PP; Receptors,
Dopamine--Physiology
--PH; Thalamus--Physiopathology--PP
  CAS Registry No.: 0   (Receptors, Dopamine); 51-61-6   (Dopamine)
 
 1/L/14
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08430974   93140974
  Neurosurgical horizons in Parkinson's disease.
  Goetz CG; De Long MR; Penn RD; Bakay RA
  Department of Neurological Sciences, Rush-Presbyterian-St. Luke's
Medical
Center, Chicago, IL 60612.
  Neurology (UNITED STATES)   Jan 1993,  43 (1) p1-7,  ISSN 0028-3878
Journal Code: NZ0
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE; REVIEW; REVIEW, ACADEMIC
  JOURNAL ANNOUNCEMENT: 9304
  Subfile:   AIM; INDEX MEDICUS
  Based  on recent neuroanatomic and physiologic discoveries,
neurosurgical
therapies  may  increasingly complement and extend pharmacologic
management
of  Parkinson's  disease. Procedures showing promise include
subthalamotomy
and pallidotomy; thalamic electrical stimulation may also offer
application
for  tremor  control.  Transplantation  of adrenal chromaffin cells has
not
been associated with consistent long-term improvement in most patients,
and
fetal  mesencephalic transplantation remains controversial. Trophic
factors
that  may be pivotal to cellular repair and survival of transplanted
tissue
have  potential  therapeutic  roles when purified and perfused centrally
or
when the cells that produce the factors are transplanted.  (92 Refs.)
  Tags: Animal; Human
  Descriptors:     *Parkinson    Disease--Surgery--SU;    Adrenal
Glands
--Transplantation--TR;  Brain  Tissue  Transplantation;  Combined
Modality
Therapy; Electric Stimulation Therapy; Fetal Tissue Transplantation;
Globus
Pallidus--Surgery--SU;     Mesencephalon--Transplantation--TR;
Thalamus
--Surgery--SU
 
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08357680   93067680
  Ventroposterolateral pallidotomy can abolish all parkinsonian
symptoms.
  Laitinen LV; Bergenheim AT; Hariz MI
  Department of Neurosurgery, Sophiahemmet Hospital, Stockholm, Sweden.
  Stereotact  Funct Neurosurg (SWITZERLAND)   1992,  58 (1-4) p14-21,
ISSN
1011-6125   Journal Code: SFN
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE
  JOURNAL ANNOUNCEMENT: 9302
  Subfile:   INDEX MEDICUS
  Stereotactic ventroposterolateral pallidotomy in 46 parkinsonian
patients
resulted  in  a  complete  or  almost  complete  and long-lasting relief
of
rigidity  and  hypokinesia  in  91% of the patients. Good tremor effect
was
obtained  in  80%  of them. The L-dopa-induced dyskinesias, gait and
speech
improved  in most patients. Complications were observed in 7 cases after
51
pallidotomies,  i.e.  14% (partial homonymous hemianopia in 6 and
transient
dysphasia  and  facial  weakness  in 1). We believe that the good effect
of
surgery    is    based   on   interruption   of   some   striopallidal
 or
subthalamopallidal pathways.
  Tags: Human
  Descriptors:  *Globus  Pallidus--Surgery--SU; *Parkinson
Disease--Surgery
--SU;  Dystonia--Physiopathology--PP;  Electric  Stimulation;  Gait;
Globus
Pallidus--Physiopathology--PP;   Middle   Age;
Pain--Physiopathology--PP;
Parkinson   Disease--Physiopathology--PP;  Retrospective  Studies;
Speech;
Stereotaxic Techniques
 
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08238679   92376679
  Unexpected  movement disorders in neurosurgical practice: report of
three
cases.
  Taira T; Kawamura H; Tanikawa T; Iseki H; Amano K
  Department of Neurosurgery, Tokyo Women's Medical College, Japan.
  Surg Neurol (UNITED STATES)   Aug 1992,  38 (2) p135-40,  ISSN
0090-3019
Journal Code: VBJ
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE
  JOURNAL ANNOUNCEMENT: 9211
  Subfile:   INDEX MEDICUS
  Hyperkinetic   movement  disorders  may  develop  as  a  complication
 of
stereotactic  thalamotomy  or pallidotomy. However, such movement
disorders
are  uncommon  after  nonsterotactic  intracranial  operations. The
authors
report   three   cases   of  involuntary  movement  disorders
unexpectedly
developing  after  intracranial  operations.  The  patients  had
undergone
clipping  of  an  internal  carotid  aneurysm,  removal of an
intracerebral
hematoma,  and  resection of a tentorial meningioma. Two patients
developed
choreic movements and a dystonic posture of the unilateral upper
extremity.
One  patient  showed  a  tremor  that had features of both parkinsonism
and
essential   tremor.   The   symptoms   of  these  patients  were
medically
uncontrollable,  and  they  were  successfully  treated  with
stereotactic
ventrolateral thalamotomy.
  Tags: Case Report; Female; Human; Male
  Descriptors:   *Movement   Disorders--Etiology--ET;   Aged;  Middle
Age;
Movement  Disorders--Pathology--PA;   Movement
Disorders--Radiography--RA;
Postoperative Complications; Stereotaxic Techniques
 
 
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07941042   92079042
  Leksell's  posteroventral  pallidotomy  in  the  treatment of
Parkinson's
disease [see comments]
  Laitinen LV; Bergenheim AT; Hariz MI
  Department of Neurosurgery, Sophiahemmet Hospital, Stockholm, Sweden.
  J Neurosurg (UNITED STATES)   Jan 1992,  76 (1) p53-61,  ISSN
0022-3085
Journal Code: JD3
  Comment in  J Neurosurg 1992 Sep;77(3):487-8
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE
  JOURNAL ANNOUNCEMENT: 9203
  Subfile:   AIM; INDEX MEDICUS
  Between  1985 and 1990, the authors performed stereotactic
posteroventral
pallidotomies  on 38 patients with Parkinson's disease whose main
complaint
was  hypokinesia. Upon re-examination 2 to 71 months after surgery (mean
28
months), complete or almost complete relief of rigidity and hypokinesia
was
observed in 92% of the patients. Of the 32 patients who before surgery
also
suffered  from  tremor,  26 (81%) had complete or almost complete relief
of
tremor. The L-dopa-induced dyskinesias and muscle pain had greatly
improved
or  disappeared  in  most  patients, and gait and speech volume also
showed
remarkable  improvement. Complications were observed in seven patients:
six
had  a  permanent  partial  homonymous  hemianopsia (one also had
transient
dysphasia  and  facial weakness) and one developed transitory
hemiparesis 1
week  after  pallidotomy.  The  results  presented  here  confirm  the
1960
findings  of  Svennilson,  et  al., that parkinsonian tremor, rigidity,
and
hypokinesia  can be effectively abolished by posteroventral pallidotomy,
an
approach developed in 1956 and 1957 by Lars Leksell. The positive effect
of
posteroventral  pallidotomy  is believed to be based on the interruption
of
some   striopallidal  or  subthalamopallidal  pathways,  which  results
 in
disinhibition of medial pallidal activity necessary for movement
control.
  Tags: Female; Human; Male
  Descriptors:  *Globus  Pallidus--Surgery--SU; *Parkinson
Disease--Surgery
--SU;  Adult;  Aged;  Aged,  80  and  over;  Follow-Up Studies; Middle
Age;
Movement;  Parkinson Disease--Physiopathology--PP; Psychomotor
Performance;
Retrospective Studies; Stereotaxic Techniques
 
 1/L/19
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07661491   91180491
  Correlation  between  clinical outcome and size and site of the lesion
in
computed tomography guided thalamotomy and pallidotomy.
  Hariz MI
  Department of Neurosurgery, University Hospital, Ume.ANG.a, Sweden.
  Stereotact  Funct  Neurosurg (SWITZERLAND)   1990,  54-55  p172-85,
ISSN
1011-6125   Journal Code: SFN
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE
  JOURNAL ANNOUNCEMENT: 9107
  Subfile:   INDEX MEDICUS
  Fourteen  thalamotomies  and  five  pallidotomies  were  performed  in
19
patients  with  hereditary  intention  tremor  or  Parkinson's disease.
The
target  coordinates  were  determined by a stereotactic computed
tomography
study  using  the  Laitinen  noninvasive  stereoadapter.  Surgery  was
done
without  ventriculography. The patients were assessed 3-12 months later.
In
a  postoperative  stereotactic  computed tomography study, the positions
of
the  thalamic  and pallidal targets were marked, and the coordinates of
the
center of the lesion were measured in relation to these targets. The
volume
of  the  lesion  was  calculated.  In 3 thalamic lesion patients, no
lesion
could be visualized. The size of the eleven visible thalamic lesions
ranged
from  4  to 75 mm3 (mean 26), and the size of the 5 pallidal lesions
ranged
from  28 to 150 mm3 (mean 67). On the average, the center of the lesion
was
1.4 mm medial to the position of the anatomical target (p less than
0.002).
Neither size nor site of the lesion correlated with the clinical
outcome.
  Tags: Female; Human; Male
  Descriptors:  *Globus  Pallidus--Surgery--SU; *Parkinson
Disease--Surgery
--SU;  *Stereotaxic Techniques; *Thalamic Nuclei--Surgery--SU;
*Tomography,
X-Ray  Computed--Methods--MT;  *Tremor--Surgery--SU; Adult; Aged;
Follow-Up
Studies;  Globus  Pallidus--Radiography--RA;  Middle Age; Parkinson
Disease
--Radiography--RA; Postoperative Complications--Radiography--RA;
Stereotaxi
c    Techniques--Instrumentation--IS;   Thalamic
Nuclei--Radiography--RA;
Tomography, X-Ray Computed--Instrumentation--IS; Tremor--Radiography--RA
 
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05993434   86294434
  Stereotactic pallidotomy in extrapyramidal disorders.
  Burzaco J
  Appl Neurophysiol (SWITZERLAND)   1985,  48 (1-6) p283-7,  ISSN
0302-2773
Journal Code: 6KK
  Languages: ENGLISH
  Document type: JOURNAL ARTICLE
  JOURNAL ANNOUNCEMENT: 8611
  Subfile:   INDEX MEDICUS
  The   results   of   stereotactic   pallidotomy   in   37  patients
with
extrapyramidal  disorders  are  presented.  All  patients  had  the same
RF
lesions  and  target coordinates. The patients are classified into 5
groups
according  to  the  clinical picture. These results are compared with
those
obtained   by  thalamotomy  in  a  similar  group  of  patients.  The
main
indications for pallidotomy are given. The spatial representation of
globus
pallidus  medialis  according  to  Andrews  and  Watkins, Talairach and
the
author are shown and their differences discussed.
  Tags: Human
  Descriptors:   *Basal  Ganglia  Diseases--Surgery--SU;  *Globus
Pallidus
--Surgery--SU; *Stereotaxic Techniques; Follow-Up Studies