RESUMEN
In this article we investigate the changes observed in the scales that quantify the quality of life (PDQ-39) in patients that have already completed 1 and 2 years of bilateral subthalamic stimulation (DBS-STN). Fourteen patients were evaluated 1 year after DBS-STN; the evaluation was repeated on 11 of them, 2 years after surgery. All of them suffered from Parkinson's disease with a 14.3 (+/-5.7) years history of motor complications. Patients were selected according to CAPSIT criteria. All of them were implanted bilateral electrodes in the subthalamic nucleus. The parameters applied were UPDRS II, UPDRS III, PDQ-39, and the scale of quality of life for caregivers (SQLC). Scorings in motor scales (UPDRS III) improved 45% in relation to the first year, and 48% in relation to the second year (P < 0.001). Patient's quality of life (PDQ-39 summary index) improvement was 62% 2 years after surgery (P < 0.001), and caregivers' quality of life improvement was 68% (P = 0.002) by the same time. DBS-STN is a therapy that efficiently improves the quality of life of selected patients with Parkinson's disease. This improvement is still present 2 years after surgery and has a positive impact on caregivers quality of life.
Asunto(s)
Terapia por Estimulación Eléctrica , Enfermedad de Parkinson/psicología , Enfermedad de Parkinson/terapia , Calidad de Vida , Núcleo Subtalámico/fisiología , Anciano , Cuidadores , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/cirugía , Índice de Severidad de la Enfermedad , Núcleo Subtalámico/cirugía , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Clinical outcomes of Parkinson's disease patients treated for 12 months with STN-DBS were analyzed. PATIENTS ADN METHODS: Twelve patients were selected using the CAPSIT protocol criteria and placement of electrodes in the appropriate target was performed according to results of fusion image techniques and intraoperative microrecording. RESULTS: A reduction in motor UPDRS (44 %) and activities of daily living (58 %) scores during <
Asunto(s)
Terapia por Estimulación Eléctrica/instrumentación , Lateralidad Funcional/fisiología , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Núcleo Subtalámico/fisiopatología , Anciano , Antiparkinsonianos/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/tratamiento farmacológico , Calidad de Vida , Resultado del TratamientoRESUMEN
INTRODUCTION: To investigate neuropsychiatric changes in Parkinson's disease (PD) patients after 12 months of bilateral subthalamic deep brain stimulation (DBS-STN). SUBJECTS: Nine out of 23 patients with PD subjected to DBS-STN were included. The mean follow-up of this cohort was 12 months, mean disease duration 14.2 5.5 years and mean UPDRS motor score in <
Asunto(s)
Terapia por Estimulación Eléctrica , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Núcleo Subtalámico/fisiología , Actividades Cotidianas , Adulto , Anciano , Antiparkinsonianos/uso terapéutico , Estudios de Cohortes , Depresión , Electrodos Implantados , Femenino , Humanos , Levodopa/uso terapéutico , Masculino , Memoria/fisiología , Persona de Mediana Edad , Destreza Motora/fisiología , Pruebas Neuropsicológicas , Calidad de Vida , Estadística como AsuntoRESUMEN
Twenty-eight patients with focal (arm or leg) or hemidystonia due to tumour, arteriovenous malformation, infarction, haemorrhage or hemiatrophy are described. All had typical dystonic movements and/or postures, identical to those seen in idiopathic (primary) torsion dystonia. The site(s) of the lesion responsible, as defined by CT (computerized tomography) scan or pathological examination, was in the contralateral caudate nucleus, lentiform nucleus (particularly the putamen) or thalamus, or in a combination of these structures. Review of 13 other patients in the literature with hemidystonia and lesions defined by CT scan, and of 7 other patients with pathologically discrete lesions associated with hemidystonia, also indicated involvement of these structures. Dystonia may be due to abnormal input from thalamus to premotor cortex, due to lesions either of the thalamus itself, or of the striatum projecting by way of the globus pallidus to the thalamus.
Asunto(s)
Distonía/etiología , Adolescente , Adulto , Anciano , Brazo , Malformaciones Arteriovenosas/complicaciones , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Neoplasias Encefálicas/complicaciones , Núcleo Caudado/irrigación sanguínea , Infarto Cerebral/complicaciones , Niño , Cuerpo Estriado/lesiones , Cuerpo Estriado/patología , Distonía/diagnóstico por imagen , Distonía/patología , Femenino , Pie , Glioma/patología , Mano , Humanos , Pierna , Masculino , Persona de Mediana Edad , Tálamo/irrigación sanguínea , Tálamo/patología , Tomografía Computarizada por Rayos XRESUMEN
We present two patients aged 66 and 69, with a rapidly progressive disease (10 and 15 months' duration) in which the presenting symptom was instability of gait. Later dementia was also a prominent feature. One case had myoclonus. Repeated EEGs showed symmetrical slowing in one case and periodic generalised bursts of triphasic waves at 1 cps superimposed upon a slow (3-4 cps) background activity in the other. The pathological findings consisted of classical Creutzfeld-Jakob disease (CJD), Kuru plaques (KP) were disseminated in the brain, but were more numerous in the cerebellum, putamen and thalamus. Neurons with large vacuoles in the cytoplasm were numerous in the putamen, thalamus and anterior horns. Stress is laid upon the common findings in both CJD and Kuru (K) (clinical features, pathological data, lack of antibody response, transmissibility, change in pattern on transmission). The possibility of a common origin of the two diseases is discussed.