Detalle Publicación

ARTÍCULO
Therapeutic efficacy of unilateral subthalamotomy in Parkinson s disease: results in 89 patients followed for up 36 months
Autores: Alvarez, M; Macias, R; Pavon, N; Lopez, G; Rodríguez Oroz, María Cruz; Rodriguez, R; Alvarez, L; Pedroso, I; Teijeiro, J; Fernandez, R; Casabona, E; Salazar, S; Maragoto, C; Carballo, M; Garcia, I; Guridi Legarra, Jorge; Juncos, DL; DeLong, MR; Obeso Inchausti, José Ángel
Título de la revista: Journal of Neurology, Neurosurgery and Psychiatry
ISSN: 0022-3050
Volumen: 80
Número: 9
Páginas: 979 - 985
Fecha de publicación: 2010
Resumen:
BACKGROUND: Stereotactic thermocoagulative lesions of the subthalamic nucleus (STN) have been shown to induce significant motor improvement in patients with Parkinson's disease (PD). PATIENTS AND METHODS: 89 patients with PD were treated with unilateral subthalamotomy. 68 patients were available for evaluations after 12 months, 36 at 24 months and 25 at 36 months. RESULTS: The Unified Parkinson's Disease Rating Scale (UPDRS) motor scores improved significantly contralaterally to the lesion in the "off" and "on" states throughout the follow-up, except for the "on" state at the last evaluation. Axial features and signs ipsilateral to the lesion progressed steadily throughout the study. Levodopa daily doses were significantly reduced by 45%, 36% and 28% at 12, 24 and 36 months post-surgery. 14 patients (15%) developed postoperative hemichorea-ballism which required pallidotomy in eight. These 14 patients had significantly higher dyskinesia scores (levodopa induced) preoperatively than the entire cohort. CONCLUSION: Unilateral subthalamotomy was associated with significant and sustained motor benefit contralateral to the lesio