[Stereotactic surgery in Parkinson disease: patient selection criteria in the light of existing research].
The renewal of interest in the neurosurgical treatment of Parkinson's disease (PD) also in Poland results from of our improved understanding of functional anatomy of basal ganglia, developments in neurophysiological and neuroimaging techniques, as well as from advances in stereotactic surgery techniques. In view of the growing number of PD patients referred to surgical treatment and the wide variety of interventions offered, the development of clear of PD patient's selection to surgery seems necessary. Various surgical options and possible targets provide different functional benefits, but the almost 10 year's experience makes us aware also of the limitations and possible complications involved. Algorithms worked out by researchers from the most experienced centers include the following selection criteria as a minimal standard of the PD patient's evaluation before surgery: a reliable diagnosis of Parkinson's disease, at least 5 years of PD duration since the onset of symptoms, good responsiveness to L-dopa or apomorphine, exclusion of severe depression and dementia, neuroimaging (MRI) performed before the surgery, and optimal (but ineffective) attempts at available pharmacological therapy prior to the surgery.
Sławek
Jarosław
J
Poradni Chorób Układu Pozapiramidowego, Szpitala Specjalistycznego św. Wojciecha-Adalberta w Gdańsku. jslawek@szpital.gda.pl
D000465:Algorithms; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001058:Apomorphine / Q000627:therapeutic use; D001479:Basal Ganglia / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D019635:Neurosurgical Procedures / Q000379:methods; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D016634:Radiosurgery / Q000295:instrumentation
D000978:Antiparkinson Agents; D007980:Levodopa; D001058:Apomorphine