Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Int Rev Neurobiol. 2011;98:151-71. doi: 10.1016/B978-0-12-381328-2.00006-7.
Many patients treated chronically with l-dopa for Parkinson disease (PD) become functionally disabled by l-dopa-induced dyskinesias (LID). Evolved from early empirical procedures, modern stereotactic surgical lesioning techniques and deep brain stimulation (DBS) can effectively treat LID while simultaneously improving the cardinal motor symptoms of PD. Here we review the common surgical targets used to treat LID, and compare their relative efficacy. We explain the anti-dyskinetic action of surgery at each of these targets based on evolving models of basal ganglia function. Finally, we discuss the appropriate selection of patients with LID for surgery and address relevant technical and management issues in these patients.
许多接受左旋多巴（l-dopa）慢性治疗的帕金森病（PD）患者会因左旋多巴诱导的运动障碍（LID）而丧失功能。现代立体定向手术损毁技术和深部脑刺激（DBS）源自早期的经验性程序，可以有效治疗 LID，同时改善 PD 的主要运动症状。在这里，我们回顾了用于治疗 LID 的常见手术靶点，并比较了它们的相对疗效。我们根据基底神经节功能的不断发展的模型来解释这些靶点的手术抗运动障碍作用。最后，我们讨论了 LID 患者进行手术的适当选择，并解决了这些患者相关的技术和管理问题。
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