FROM: The Boston Herald, Wed 24 January '96, Pg 16.
Updated surgery may relieve Parkinson's
By MICHAEL LASALANDRA
Neurosurgeons in Boston are now performillg a revived and
advanced version of a brain operation that offers hope to
long-term Parkinson's patients.
Called a pallidotomy, the surgery was developed in the 1950s but
largely abandoned in the '60s, partially because of a high rate of
complications, but mostly because of the discovery of L-dopa the
first drug proven effective against Parkinson's.
Those who are now having the operation are patients for whom
L-dopa stopped working.
Dr. David Dubuisson of Beth Israel Hospital performed an
updated version of the operation last month on Agnes Rocci, a 75
year-old Parkinson's patient from Everett.
"She's better than what she was," said Doris Messier, Rocci's
sister-in-law. "It has quieted her shaking an awful lot."
The operation is also being done by Dr. Rees Cosgrove at
Massachusetts General Hospital.
The goal is to destroy a pea-sized area in the brain that is
responsible for producing Parkinson's symptoms, including
uncontrollable shaking and difficulty in moving.
To find the area, doctors use a new technique of mapping the part
of the brain that contains the overactive nerve cells that produce
the symptoms.
The technique involves recording the activity of individual nerve
cells through a tiny electrical probe called a microelectrode,
inserted via the skull.
Pinpointing the area in this fashion allows surgeons to identify
and destroy just the area in question, and to distinguish it from
neighboring areas that serve other critical functions.
The method is considered more accurate than the older electrical
stimulation approach that only gives a rough approximation of the
brain area that must be removed In that method, an electrical
current is delivered in different brain areas through a stimulation
probe, which seeks to find and avoid areas that are not
responsible for the disease symptoms.
With the electrical stimulation approach, the surgeon tries to
localize the site in the brain much as you might try to find your
way to the center of a darkened room by first feeling your way
along the walls," said neurologist Dr. Clifford Saper.
Dubuisson said the more precise mapping technique cuts the risk
of injury, although data is not available because the procedure is
so new. He said the old way carries a 10 percent risk of partial
blindness and a 5 percent risk of paralysis.
The updated pallidotomy is now being performed at a half-dozen
hospitals across the United States, but doctors say it is only
effective for some patients -- primarily those where one side of the
body is affected more than the other.
END OF STORY---------
Thought some of you might find this "intro" useful.
Jim
"So what if I can't do 2000 things anymore -
just think of all the extra time I have
to do the 1798 things I still can do!"
jea
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