PARKINSONS (SEVERE) Tx-SURGERY

SUMMARY

1. Destructive surgery: unilateral thalamotomy (reduces tremor on the contralateral side); unilateral posteroventral pallidotomy (improves dyskinesias, stiffness, & “freezing”).

2. Subthalamic nucleus DBS: effectively reduces tremor, rigidity, and bradykinesia & allows for a reduction in PD medications by 1/2.

3. Thalamic DBS: effectively reduces tremor on the contralateral side. However, long-term SE: worsening bradykinesia, rigidity & gait.

4. Pallidal DBS: controls all the cardinal symptoms of PD.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].