The following is a paper on the use of the Gamma Knife at the Hospital of the
Good Samaritan in Los Angeles
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EARLY RESULTS OF THALAMOTOMY FOR THE
RELIEF OF TREMOR IN PARKINSON'S DISEASE (12/94)
Over the course of the past four years, there have been 39 thalamotomies
completed for patients with the symptom of tremor. This procedure was
performed with the Leksell Gamma Knife at the Good Samaritan Hospital in Los
Angeles. This technique was used instead of standard, open, stereotactic
surgery because the Gamma Knife is considered accurate and safe and offers
some benefits over the open surgery for older patients who may not be
candidates for open brain surgery.
The 39 patients who underwent thalamotomies over the past three years have
had results similar to what has been achieved with open stereotactic
techniques. Specifically, 29 of the 39 patients who were treated have had a
decrease in their tremor. Four thalamotomy patients had only fair or poor
resolution of their tremor. Seven recently treated patients had not yet seen
any benefit from the surgery (tremor reduction is expected to begin approx. 6
- 10 weeks after treatment). Approximately 87% of the patients treated with
the Gamma Knife thalamotomy experienced the expected reduction in their
tremor.
All patients had postoperative MRI scans to verify the positioning and size
of the radiosurgical lesion. All lesions were placed with sub-millimeter
accuracy and confirmed by MRI scans.
The Neurosciences Institute at the Good Samaritan Hospital feels that the
Gamma Knife is a reasonable alternative for some individuals to open,
standard thalamotomy techniques, with the additional benefit of being less
invasive. The Neurosciences Institute has now begun a series of "open"
radiofrequency thalamotomies which offer the advantage of immediate relief
from tremor.
The new radiofrequency thalamotomy and pallidotomy series will be monitored
carefully by Dr. Abraham Lieberman, who is the Neurological Consultant to the
Surgical Intervention Program for Parkinson's Disease at the Neurosciences
Institute. Dr. Lieberman will be serving as a consultant here in Los Angeles
at least one day per month.
For further information or to discuss the criteria for surgical candidates,
contact Carole Hilton, Parkinson's Coordinator at 800-841-8765.
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Greg Johnson
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