RESUMO
BACKGROUND: Deep brain stimulation is an essential therapeutic tool in Parkinson's disease. AIM: To assess the results of a series of patients with Parkinson's disease treated with micro-electrode guided subthalamic nucleus stimulation. MATERIAL AND METHODS: Twenty patients with idiopathic Parkinson's disease were studied (10 males). Three months after surgery, we analyzed the change in motor disturbances, medication need to control symptoms and quality of life. RESULTS: We observed a significant improvement in all the assessed variables. Motor involvement determined as OFF hours and expressed as percentage of the day changed from 30 ± 15 to 10 ± 7% in the preoperative and postoperative periods, respectively. ON hours without dyskinesia changed from 17 ± 16 to 78 ± 21%. ON hours with dyskinesia changed from 53 ± 23 to 12 ± 15%. Medication need changed from 1,505 ± 499 to 1,214 ± 528 levodopa equivalents. Parkinson's Disease Questionnaire 39 score changed from 62.9 ± 22.7 to 34.3 ± 18.5. During the 5-year follow-up a continuous improvement of symptoms was observed. CONCLUSIONS: Micro-electrode guided subthalamic nucleus functional surgery in patients with Parkinson's disease has good immediate and late results.
Assuntos
Estimulação Encefálica Profunda/métodos , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/cirurgia , Estimulação Encefálica Profunda/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Background: Deep brain stimulation is an essential therapeutic tool in Parkinson's disease. Aim: To assess the results of a series of patients with Parkinson's disease treated with micro-electrode guided subthalamic nucleus stimulation. Material and Methods: Twenty patients with idiopathic Parkinson's disease were studied (10 males). Three months after surgery, we analyzed the change in motor disturbances, medication need to control symptoms and quality of life. Results: We observed a significant improvement in all the assessed variables. Motor involvement determined as OFF hours and expressed as percentage of the day changed from 30 ± 15 to 10 ± 7% in the preoperative and postoperative periods, respectively. ON hours without dyskinesia changed from 17 ± 16 to 78 ± 21%. ON hours with dyskinesia changed from 53 ± 23 to 12 ± 15%. Medication need changed from 1,505 ± 499 to 1,214 ± 528 levodopa equivalents. Parkinson's Disease Questionnaire 39 score changed from 62.9 ± 22.7 to 34.3 ± 18.5. During the 5-year follow-up a continuous improvement of symptoms was observed. Conclusions: Micro-electrode guided subthalamic nucleus functional surgery in patients with Parkinson's disease has good immediate and late results.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/cirurgia , Estimulação Encefálica Profunda/métodos , Qualidade de Vida , Índice de Gravidade de Doença , Estudos Retrospectivos , Resultado do Tratamento , Estimulação Encefálica Profunda/efeitos adversosRESUMO
A dos décadas de la aparición de las primeras publicaciones sobre los usos terapéuticos de la toxina botulínica (TB), presentamos una revisión sobre la situación de esta terapia en pacientes con distonía, analizando efectividad, seguridad y complicaciones. Se comentan aspectos en controversia tales como: valor de la determinación de anticuerpos, correlación de éstos con la respuesta clínica y homologación de las unidades de TB, para las formulaciones de tipos A y B, disponibles en el mercado.