Türk Nöroşirürji Dergisi 2001 , Vol 11 , Num 3
SURGERY IN PARKINSON'S DISEASE- REVIEW OF THE LITERATURE
M. Cenk AKBOSTANCI1, Sıla USAR1, Ali SAVAŞ2
1Ankara Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Ankara
2Ankara Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, Ankara
The significance of surgery is getting greater in the management of Parkinson' s disease (PD). Widespread use of operations forces neurosurgeons and neurologists to increase their acquaintance in the field. The roles of thalamotomy, thalamic stimulation, pallidotomy, pallidal stimulation, bilateral subthalamic stimulation, subthalamotomy, transplantation, gamma knife, and micro electrode recording are evaluated by studying the papers published between 1991 and April 200l. Talamotomy is safe and effective in patients with severe, asymmetrical, pharmacoresistant tremor. Patients younger than 70 years of age with asymmetrical parkinsonism and drug dyskinesias are ideal candidates for pallidotomy Pallidal stimulation is reported to be efficacious in patients with advanced parkinsonism, motor fluctuations and dyskinesias. Bilateral subthalamic stimulation is effective in the treatment of advanced parkinsonism, fluctuations, and dyskinesias. Microelectrode recording can be effectively utilised for target localisation during stereotactic surgery. Gamma thalamotomy and pallidotomy, sub thalamotomy and transplantations are methods that are still under investigation. Among procedures listed only pallidotomy was tested by controlled trials and was found to be effective. Anahtar Kelimeler : Parkinson's disease, surgery