Fox M W, Ahlskog J E, Kelly P J
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
J Neurosurg. 1991 Nov;75(5):723-30. doi: 10.3171/jns.1991.75.5.0723.
Thirty-six patients with Parkinson's disease and medically refractory tremor underwent stereotactic ventrolateralis thalamotomy at the Mayo Clinic between 1984 and 1989. All patients had been or were being treated with carbidopa/levodopa but with unsatisfactory tremor control. Modern stereotactic techniques, including microelectrode recording, were used to treat 36 patients, of whom 31 (86%) had complete abolition of tremor and three patients (5%) had significant improvement. Tremor recurred in two patients within 3 months of surgery; however, the remaining patients suffered no recurrence of tremor during follow-up periods ranging from 14 to 68 months (mean 33 months). Persistent complications (arm dyspraxia, dysarthria, dysphasia, or abulia) were noted in five patients but were a source of disability in only two. It is concluded that thalamotomy in carefully selected patients is a beneficial operation for the control of medically refractory parkinsonian resting tremor.
1984年至1989年间，36例患有帕金森病且药物治疗难以控制震颤的患者在梅奥诊所接受了立体定向丘脑腹外侧切开术。所有患者均曾接受或正在接受卡比多巴/左旋多巴治疗，但震颤控制效果不佳。采用现代立体定向技术，包括微电极记录，对36例患者进行治疗，其中31例（86%）震颤完全消失，3例（5%）有显著改善。2例患者在术后3个月内震颤复发；然而，其余患者在14至68个月（平均33个月）的随访期间未出现震颤复发。5例患者出现持续性并发症（手臂失用症、构音障碍、失语症或意志缺失），但仅2例导致残疾。结论是，在精心挑选的患者中进行丘脑切开术是控制药物难治性帕金森静止性震颤的有益手术。
