Relationship between lesion location and the outcome of pallidotomy for Parkinson's disease.
The relationships between lesion location and clinical outcome following posteroventral pallidotomy for Parkinson's disease were studied. Forty-four patients were operated forty-six times and studied with neurological and psychological examinations before and after pallidotomy. Lesion location was confirmed using films with a coagulation electrode which were X-rayed during the operation. Changes of intelligence were observed in the patients with anteromedial lesions. Wearing-off phenomenon in four patients and dopa-induced dyskinesia in three patients were not improved following pallidotomy in twenty patients with severe wearing-off and dyskinesia. Lesions in the patients with no improvement of wearing off were located more lateral and those in the patients with sustained severe dyskinesia were located more dorsal in the internal part of the globus pallidus. It may be concluded that clinical outcome is related to lesion location.
Yokochi
F
F
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Fucyu, Japan.
Okiyama
R
R
Taniguchi
M
M
Takahashi
H
H
Hasegawa
N
N
Hamada
I
I
D000978:Antiparkinson Agents / Q000009:adverse effects; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D007361:Intelligence Tests; D007980:Levodopa / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa