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(Continued from previous message) 1/L/11 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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) 1/L/13 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 1/L/15 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 1/L/16 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 1/L/18 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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 1/L/20 DIALOG(R)File 154:MEDLINE(R) (c) format only 1995 Knight-Ridder Info. All rts. reserv. 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