Patients may present with classical symptoms suggesting aphasia following thalamotomy (repetition, comprehension, fluency and naming abnormalities). They may also present with 'freezing of speech', and this symptom should not be considered as a speech disorder or a symptom of Parkinson's disease progression, without careful testing to rule out language deficits, particularly dysfluency. There are important issues related to all language complications of thalamotomy, including (1) the time course of problems following surgery, (2) the impact of preexistingspeech problems, (3) the importance of the size and location of lesions, (4) the potential circuits important in the pathogenesis of a thalamic language disturbance and (5) whether laterality makes a difference (left- versus right-sided thalamic lesions). As more centers switch from thalamotomy to deep brain stimulation, the issues regarding aphasia will need to be addressed.
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A late complication of γ knife radiosurgery.
Rev Neurol Dis
September 2011
Department of Neurology, George Washington University, Washington, DC, USA.
An 85-year-old man was hospitalized after developing sudden weakness on his right side and mild expressive aphasia. He had undergone γ knife stereotactic radiosurgery to the left thalamus 7.5 years earlier for a disabling essential tremor; the surgery had led to remarkable improvement in his ability to write and use utensils.
View Article and Find Full Text PDFThe authors report the neuroimaging features, treatment planning, and outcome in a case of radiosurgical thalamotomy targeting the centromedian nucleus (CMN) for stroke-induced thalamic pain. A 79-year-old man, with embolic occlusion of the left middle cerebral artery and large hemispheric infarction involving the thalamus, suffered a right hemiplegia and expressive aphasia. One year poststroke, severe right-sided facial, scalp, arm, and trunk pain developed and was exacerbated by any tactile contact.
View Article and Find Full Text PDFAphasia and thalamotomy: important issues.
Stereotact Funct Neurosurg
January 2005
Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida, Gainesville, FL 32610, USA.
Patients may present with classical symptoms suggesting aphasia following thalamotomy (repetition, comprehension, fluency and naming abnormalities). They may also present with 'freezing of speech', and this symptom should not be considered as a speech disorder or a symptom of Parkinson's disease progression, without careful testing to rule out language deficits, particularly dysfluency. There are important issues related to all language complications of thalamotomy, including (1) the time course of problems following surgery, (2) the impact of preexistingspeech problems, (3) the importance of the size and location of lesions, (4) the potential circuits important in the pathogenesis of a thalamic language disturbance and (5) whether laterality makes a difference (left- versus right-sided thalamic lesions).
View Article and Find Full Text PDFComplications of gamma knife surgery for Parkinson disease.
Arch Neurol
December 2001
Emory University, Wesley Wood Health Center Building, Third Floor Neurology, 1841 Clifton Rd NE, Atlanta, GA 30329, USA.
Background: Many medical centers throughout the world offer radiosurgery with the gamma knife (GK) for pallidotomy and thalamotomy as a safe and effective alternative to radiofrequency ablative surgery and deep brain stimulation for Parkinson disease (PD). The reported incidence of significant complications varies considerably, and the long-term complication rate remains unknown.
Design: We describe 8 patients seen during an 8-month period referred for complications of GK surgery for PD.
Stereotactic mesencephalotomy versus multiple thalamotomies in the treatment of chronic cancer pain syndromes.
Appl Neurophysiol
June 1988
Division of Neurosurgery, Bellaria Hospital, Bologna, Italy.
Two neurosurgical centers, Bologna (Italy) and Freiburg (FRG), have compared results obtained with stereotactic mesencephalotomy (SM; Bologna) and multiple thalamotomies (MT; Freiburg) in the surgical treatment of chronic cancer pain syndromes. In total, 161 patients were operated, 109 in Bologna and 52 in Freiburg. In SM the lesions were single and centered on the spinothalamic tract at the mesencephalic level, while in MT the lesions were multiple in the thalamic nuclei (ventrocaudal parvocellular nucleus, nucleus limitans, lamella medialis, centromedian nuclei).
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