From: janet paterson <[log in to unmask]>
Date: Mon, 27 Oct 1997 04:14:37 -0800
Subject: Unilateral pallidotomy for Parkinson's disease:
comparison of outcome in younger versus elderly patients.
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Unilateral pallidotomy for Parkinson's disease:
comparison of outcome in younger versus elderly patients.
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We studied the effects of medial pallidotomy in the first 20 consecutive
patients with Parkinson's disease (PD) undergoing this
MRI/electrophysiologically guided procedure at our institution.
The mean age of patients was 65.5 years (median 66.5) and none suffered any
serious complications.
Pallidotomy significantly improved motor function in both "on" and "off"
states as measured by Unified Parkinson's Disease Rating Scale (UPDRS)
motor scores and timed tests (Purdue pegboard and counter tapping) in the
arm contralateral to surgery 3 months postoperatively.
Patients also improved in terms of activities of daily living, reflected by
improved UPDRS activity of daily living and complications of therapy
scoring and reduced levodopa-induced dyskinesias; six of 11 patients who
could not walk in an "off" state prior to surgery could do so postoperatively.
The total UPDRS score improved by 22% from preoperative values. The
aforementioned improvements occurred similarly in patients greater than (n
= 11) or less than 65 years (n = 9) at surgery.
Neuropsychological measures indicated that although the majority of
cognitive function remains unchanged in right-handed PD patients following
dominant (left) hemisphere pallidotomy, mild specific declines in word
generation are present.
The findings of this study suggest that unilateral pallidotomy is safe and
associated with improved motor functioning in elderly as well as younger PD
patients experiencing significant disability despite optimal medical therapy.
Neurology 1997 Oct;49(4):1072-1077
Uitti RJ, Wharen RE Jr, Turk MF, Lucas JA, Finton MJ, Graff-Radford NR,
Boylan KB, Goerss SJ, Kall BA, Adler CH, Caviness JN, Atkinson EJ
Department of Neurology, Mayo Clinic, Jacksonville, Florida 32224, USA.
PMID: 9339692, MUID: 97479611
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janet paterson - 50/9 - sinemet/selegiline/prozac - [log in to unmask]
