Deep brain stimulation in movement disorders: a Prague-center experience
Authors:
Dušan Urgošík 1,2; Robert Jech 2; Evžen Růžička 2; Filip Růžička 1; Roman Liščák 1; Vilibald Vladyka 1
Authors‘ workplace:
Oddělení stereotaktické a radiační neurochirurgie Nemocnice Na Homolce, Praha
1; Univerzita Karlova v Praze, 1. lékařská fakulta, Neurologická klinika a Centrum klinických neurověd VFN
2
Published in:
Čas. Lék. čes. 2011; 150: 223-228
Category:
Review Article
Overview
Deep brain stimulation (DBS) in the basal ganglia plays an irreplaceable role in the treatment of Parkinson’s disease (PD), essential tremor (ET), and some types of dystonia. Electrodes are typically inserted into the subthalamic nucleus (STN), the internal globus pallidus (GPi) and the ventral intermediate nucleus of the thalamus (VIM). Stimulation of the STN is the main objective in PD, GPi in the treatment of dystonia and PD, and VIM stimulation is effective against tremor. In patients indicated for DBS treatment, stimulation eliminates or reduces rigidity (PD), hypokinesia (PD), tremor (ET, PD) and dyskinesias (dystonia, PD). At the Center for Movement Disorders in Prague, DBS has been performed in 127 patients: in 86 patients for PD, 19 patients for dystonia (11 primary generalized dystonia, 5 primary cervical dystonia, 1 segmental craniocervical dystonia), and in 22 patients for tremor (20 ET, 2 other types of tremor). Intraoperatively we have succeeded in eliminating rigidity in 95% of cases of PD, and tremor in 93% of cases of ET. The positive effect of stimulation on dystonia appeared in 95% with a latency of weeks. Transitory intraoperative morbidity occurred in 8%, intracranial hemorrhage in 1%, infectious complications in 6%, and problems with hardware in 7%.
Key words:
deep brain stimulation, stereotaxy, Parkinson’s disease, tremor, dystonia.
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