Print

Print


Unilateral pallidotomy for Parkinson's disease:
results after more than 1 year.

OBJECTIVE: To examine follow up results of unilateral ventral medial
pallidotomy in 22 patients with advanced Parkinson's disease more than 1
year after the operation in comparison with their results (previously
reported) at 3 months.

METHODS: 20 patients who had undergone unilateral pallidotomy were assessed
with the core assessment programme for intracerebral transplantation
(CAPIT) protocol preoperatively, at 3 months postoperatively, and again
after a median postoperative follow up of 14 months. 2 further patients had
only one evaluation 3 months postoperatively.

RESULTS: The reduction of contralateral dyskinesias (median 67%) at 3
months was slightly attenuated after 1 year to 55% (both p<0.001 compared
with baseline).

A less pronounced effect on ipsilateral and axial dyskinesias decreased
from 39% to 33% (p<0.005 and p<0.01), and from 50% to 12.5% (p<0.001 and
p<0.01), respectively.

However, there was no significant change between the 3 month and the follow
up assessment.

The modest improvement of the contralateral unified Parkinson's disease
rating scale (UPDRS) motor score in the "off" state remained improved
compared with preoperative levels, but less significantly (26%, p<0.001,
and 18%, p<0.01).

The activities of daily living (ADL) subscore of the UPDRS in the off state
remained improved with median changes of 23% and 22% at follow up (both
p<0.005).

There was no significant improvement of "on" state or ipsilateral off state
motor scores.

Median modified Hoehn and Yahr scores in off and on state were unchanged,
as was the time spent off.

Speech in off had significantly deteriorated by 1 year after the operation.

CONCLUSIONS: The beneficial effects of unilateral pallidotomy persist for
at least 12 months and, dyskinesias are most responsive to this procedure.


J Neurol Neurosurg Psychiatry 1999 Oct;67(4):511-517
Schrag A, Samuel M, Caputo E, Scaravilli T, Troyer M,
Marsden CD, Thomas DG, Lees AJ, Brooks DJ, Quinn NP
Institute of Neurology, Queen Square, London, UK.
PMID: 10486400

<http://www.ncbi.nlm.nih.gov/PubMed/>

janet paterson
52 now / 41 dx / 37 onset
613 256 8340 po box 171 almonte ontario canada K0A 1A0
a new voice: <http://www.geocities.com/SoHo/Village/6263/>
<[log in to unmask]>