Methods for localizing the posteroventral globus pallidus intermus are described. The authors' techniques include the use of microelectrodes to record single-unit activity and to microstimulate in human pallidum and its surrounding structures. This technique allows a precise determination of the locations of characteristic cell types in sequential trajectories through the external and internal segments of the pallidum. The location of the optic tract can be determined from microstimulation-evoked visual sensations and recordings of flash-evoked potentials. In addition, microstimulation-evoked motor and sensory responses allow the internal capsule to be identified. The data collected using this technique are an important adjunct to selecting optimum sites to place electrocoagulation lesions for stereotactic posteroventral pallidotomy for refractory Parkinson's disease.
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http://dx.doi.org/10.3171/jns.1996.84.2.0194 | DOI Listing |
Front Neurosci
August 2022
Department of Neurology & Institute of Neurology, Ruijin Hospital, Affiliated With Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Introduction: Globus pallidus internus (GPi) deep brain stimulation (DBS) is widely used in patients with dystonia. However, 10-20% of patients receive insufficient benefits. The objectives of this study are to evaluate the effectiveness of bilateral subthalamic nucleus (STN) DBS along with unilateral posteroventral pallidotomy (PVP) in patients with dystonia who experienced unsatisfactory GPi-DBS and to address the reported rescue procedures after suboptimal DBS or lesion surgery in dystonia patients.
View Article and Find Full Text PDFStereotact Funct Neurosurg
August 2022
Department of Clinical Neuroscience, Umeå University, Umeå, Sweden.
Neurol India
June 2020
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
The authors report a case of successful management of right side hemidystonia with gamma knife radiosurgery. A 24-year-old male with a history of birth asphyxia subsequently developed worsening right-sided torsional hemidystonia which failed to respond to the medical management. MRI of the brain was unremarkable.
View Article and Find Full Text PDFStereotact Funct Neurosurg
May 2019
Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Background: The optimum target in surgery for Parkinson's disease (PD) is still controversial, especially in patients with tremor-dominant PD. We aim to compare results in tremor-dominant patients undergoing pallidotomy vs. those undergoing simultaneous posteroventral pallidotomy (PVP) and ventral intermediate nucleus (VIM) thalamotomy.
View Article and Find Full Text PDFZh Vopr Neirokhir Im N N Burdenko
April 2018
Semenov Institute of Chemical Physics, Moscow, Russia.
Objective: to determine the efficacy of unilateral posteroventral pallidotomy (PVP) in the treatment of drug-induced dyskinesia (DID) in Parkinson's disease (PD).
Material And Methods: We analyzed surgical treatment of 14 patients with PD complicated by DID who underwent unilateral PVP at the Research Center of Neurology in the period between 2012 and 2015. The clinical type of DID was mainly represented by peak-dose choreoathetoid dyskinesia, more pronounced in the distal limbs, and predominantly unilateral.
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