Surgical treatment of Parkinson's disease

From WikiLectures

Parkinson's disease is caused by degeneration of neurons pars compacta substantiae nigrae - dopamine, production is reduced, which leads to its deficiency in the striatum.

  • Clinically: hypokinetic-hypertonic syndrome – tremor, rigidity, bradykinesia
  • Ventrolateral thalamotomy was used before the discovery of levodopa it affected mainly tremor, limiting the possibility of only one-sided performance with an unacceptable risk of dysarthria, gait disorders and cognitive deficit in bilateral thalamotomy
  • Today surgical therapy reserved: for patients refractory to pharmacotherapy + those who develop significant dyskinesias as an adjunct to levodopa treatment
  • Stereotactic pallidotomy radiofrequency / cryodestruction
  • Non-destructive deep stimulation ncl. subthalamicus / posteroventral pallid
  • Transplantation of fetal dopaminergic bb. - results not yet convincing

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