NEUROSURGICAL TREATMENT OF PARKINSON'S DISEASE
Features of the thalamotomyThis type of surgical intervention does not oblige the surgeon to put the patient under general anesthesia. The brain has no pain receptors, so working with it does not bring discomfort to the patient. To destroy the nuclei of the thalamus, the surgeon uses local anesthesia: thanks to this, the patient is in a conscious state, can contact the surgeon and other medical personnel.
EfficiencyThe thalamotomy acts on the foci that cause pathological symptoms. As a rule, after destruction, the symptoms disappear already on the operating table. With dyskinesia, the symptoms disappear smoothly, within a few months. Due to its accuracy, focus on pathological impulses, safety and minimally invasiveness, thalamotomy is considered an extremely effective way to treat parkinsonism and other nervous diseases.
Features of the pallidotomyBefore starting the procedure, the patient's head is fixed on a stereotaxic frame to exclude any head movements during surgery. After fixing the patient's head, a computed tomography (CT) scan is performed to accurately locate the area of the brain that will undergo surgery. In addition, the CT scan allows the neurosurgeon to map out the path to the target. It is important to note that during the operation the patient is conscious: this is necessary for the doctor to be able to monitor the correct location of the electrode and make timely adjustments to the treatment process. Local anesthesia is used, due to which pain during pallidotomy is completely absent.
EfficiencyPallidotomy is highly effective in the treatment of severe motor disorders and the consequences of drug-induced dyskinesia accompanied by violent movements. All patients after the above destructive surgical interventions showed a positive effect in reducing involuntary movements, rigidity, bradykinesia and tremor. In half of the cases, it was possible to reduce the dose of Levodopa by 50%. In medical practice, they prefer to resort to radiofrequency surgery, because it has a high efficiency and low invasiveness.
Contraindications for stereotactic neurosurgeryThere are cases when carrying out thalamotomy and pallidotomy promises more danger than benefit. Common contraindications for surgical treatment include: