Krishnan Syam, Pisharady Krishnakumar Kesava
Comprehensive Care Center for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Ann Indian Acad Neurol. 2017 Jul-Sep;20(3):199-206. doi: 10.4103/aian.AIAN_244_17.
The treatment of motor manifestations of Parkinson's disease (PD) is essentially a trade-off between adequate relief of motor symptoms and prevention and control of motor complications, particularly levodopa-induced dyskinesia (LID). Progression of PD is paralleled by a progressive difficulty in achieving the balance. Functional neurosurgical procedures provide sustained relief of LID in carefully selected patients when further tailoring of medical therapy fails to achieve this goal. Though deep brain stimulation (DBS) has superseded lesioning surgeries, pallidotomy still has a role in those patients in whom DBS is not feasible for financial or other reasons.
帕金森病(PD)运动症状的治疗本质上是在充分缓解运动症状与预防和控制运动并发症(尤其是左旋多巴诱导的异动症,LID)之间进行权衡。PD的进展伴随着实现这种平衡的难度逐渐增加。当进一步调整药物治疗无法实现这一目标时,功能性神经外科手术可为精心挑选的患者提供LID的持续缓解。尽管脑深部电刺激(DBS)已取代毁损手术,但对于因经济或其他原因无法进行DBS的患者,苍白球切开术仍具有一定作用。