Speelman Johannes D, Schuurman Richard, de Bie Rob M A, Esselink Rianne A J, Bosch D Andries
Neurological Department, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Mov Disord. 2002;17 Suppl 3:S84-8. doi: 10.1002/mds.10147.
The role of the motor thalamus as surgical target in stereotactic neurosurgery for different kinds of tremor is discussed. For tremor in Parkinson's disease, the subthalamic nucleus becomes more and more often the surgical target, because this target also gives relief of other and more incapacitating symptoms (hypokinesia, rigidity). Stimulation is as effective in tremor suppression as coagulation but has less adverse events and permits bilateral surgery. In selected cases, thalamotomy can still be indicated.
本文讨论了运动丘脑在不同类型震颤的立体定向神经外科手术中作为手术靶点的作用。对于帕金森病震颤,丘脑底核越来越常成为手术靶点,因为该靶点还能缓解其他更具致残性的症状(运动迟缓、僵硬)。刺激在抑制震颤方面与凝固一样有效,但不良事件较少,且允许进行双侧手术。在某些特定情况下,丘脑切开术仍可作为选择。