[Neurosurgical treatment for dopamine-induced dyskinesias in Parkinson's disease patients].
The effects of current neurosurgical interventions for levodopa-induced dyskiensias (DID) in Parkinson's disease are reviewed. Thalamotomy has been reported to be effective for DID when the lesions include Vo or CM-Pf nucleus, while thalamic deep brain stimulation(DBS) is less effective than thalamotomy. Both pallidotomy and pallidal DBS are probably the most effective neurosurgical treatment for DID, because they significantly improve all of the DID, including off-period dystonia, without reduction of levodopa dosage. Subthalamic DBS has no direct therapeutic effects on DID, but substantially can improve DID as a result of decreased levodopa dosage. The effects of cerebral transplantation on DID remain undefined. More researches are expected to clarify the pathophysiology of DID.
Sugiyama
K
K
Department of Neurosurgery, Hamamatsu University School of Medicine.
Yokoyama
T
T
Namba
H
H
D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016380:Brain Tissue Transplantation; D004409:Dyskinesia, Drug-Induced / Q000601:surgery*; D004599:Electric Stimulation Therapy; D016332:Fetal Tissue Transplantation; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects*; D010300:Parkinson Disease / Q000188:drug therapy*; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000601:surgery; D013788:Thalamus / Q000601:surgery
D000978:Antiparkinson Agents; D007980:Levodopa