Is stereotactic surgical treatment still necessary for Parkinson's disease in the contemporary trend of medical therapy with dopamine receptor agonist?
Clinical experience with the use of pergolide is presented in 55 patients with Parkinson's disease. Fifty to 900 micrograms/day (mean 242.73, SD 217.51) of pergolide and 0.64-17.05 micrograms/kg/day (mean 4.58, SD 4.25) pergolide was given together with L-carbidopa to 29 males and 26 females for a period of up to 2 years 7 months. Low-dose pergolide together with L-carbidopa is effective in the treatment of parkinsonism without side effects, even in advanced stages of the disease. No patients required surgical treatment such as pallidotomy or deep brain stimulation recommended by other investigators. We emphasize that parkinsonism can be sufficiently treated with pergolide and L-dopa and that surgical treatment should be minimized unless there is no alternative.
Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical College, Japan.
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K
Amano
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K
Takakura
D000368:Aged; D000369:Aged, 80 and over; D001971:Bromocriptine / Q000627:therapeutic use; D002230:Carbidopa / Q000627:therapeutic use*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000601:surgery*; D010479:Pergolide / Q000627:therapeutic use*; D013238:Stereotaxic Techniques; D016896:Treatment Outcome
D018491:Dopamine Agonists; D010479:Pergolide; D001971:Bromocriptine; D007980:Levodopa; D002230:Carbidopa