Pérez-Suárez Javier, Torres Díaz Cristina V, López Manzanares Lydia, Navas García Marta, Pastor Jesús, Barrio Fernández Patricia, G de Sola Rafael
Department of Neurosurgery, University Hospital La Princesa, Madrid, Spain.
Stereotact Funct Neurosurg. 2017;95(3):137-141. doi: 10.1159/000454891. Epub 2017 Apr 22.
Although there are few reports of radiofrequency lesions performed through deep brain stimulation (DBS) electrodes in patients with movement disorders, experience with this method is scarce.
We present 2 patients who had been previously treated with DBS of subthalamic nuclei (STN) and the ventral intermediate (VIM) nucleus of the thalamus for Parkinson's disease and essential tremor, respectively, and underwent a radiofrequency lesion through their DBS electrodes after developing a hardware infection. The authors conduct a review of the literature regarding this method.
Both patients had a good clinical outcome after 20 and 8 months, respectively, as assessed by a reduction in Fahn-Tolosa-Marin Scale and Unified Parkinson's Disease Rating Scale scores. The second patient underwent a second DBS system implantation surgery after his radiofrequency treatment to optimize his management, achieving optimal clinical control with lower current and drug requirements than before the radiofrequency intervention. No adverse effects were observed.
Radiofrequency lesions through DBS electrodes allow the creation of small and localized lesions. Its effectiveness and low-risk profile, in addition to its low cost, make this procedure suitable and a possible alternative in the therapeutic repertoire for the surgical treatment of movement disorders.
尽管关于在运动障碍患者中通过脑深部电刺激（DBS）电极进行射频损伤的报道较少，但这种方法的经验稀缺。
我们介绍了2例患者，他们之前分别因帕金森病和特发性震颤接受了丘脑底核（STN）和丘脑腹中间核（VIM）的DBS治疗，并在发生硬件感染后通过其DBS电极进行了射频损伤。作者对有关该方法的文献进行了综述。
分别在20个月和8个月后评估，两名患者的临床结果均良好，表现为法恩-托洛萨-马林量表和统一帕金森病评定量表评分降低。第二名患者在射频治疗后接受了第二次DBS系统植入手术以优化治疗管理，与射频干预前相比，以更低的电流和药物需求实现了最佳临床控制。未观察到不良反应。
通过DBS电极进行射频损伤可形成小的局限性损伤。其有效性、低风险特征以及低成本，使得该手术适合且可能成为运动障碍外科治疗方法中的一种替代选择。
