Zager E L
Neurosurgical Service, Massachusetts General Hospital, Boston.
Neurol Clin. 1987 Nov;5(4):631-47.
In this review, the authors present a critical overview of the historical development, indications, complications, operative techniques, and results of procedures for the alleviation of the major dyskinesias. Emphasis is placed upon recent refinement of technique, particularly stereotaxis, as well as neurophysiologic stimulation and recording, computerized tomographic scanning (CT) and magnetic resonance imaging (MRI). Specific disorders that may be amenable to surgical therapy include spasticity secondary to spinal cord pathology, cerebral palsy, and multiple sclerosis; the tremor and rigidity of Parkinson's disease; essential tremor; dystonia; spasmodic torticollis; post-traumatic and postinfarction intention tremor; cerebral palsy with tremor; hemiballismus; myoclonus; and dyskinesias induced by L-DOPA.
在这篇综述中,作者对缓解主要运动障碍的手术方法的历史发展、适应证、并发症、手术技术及结果进行了批判性概述。重点介绍了技术的最新改进,特别是立体定向技术,以及神经生理刺激与记录、计算机断层扫描(CT)和磁共振成像(MRI)。可能适合手术治疗的特定疾病包括脊髓病变继发的痉挛、脑瘫和多发性硬化症;帕金森病的震颤和强直;特发性震颤;肌张力障碍;痉挛性斜颈;创伤后和梗死后意向性震颤;伴有震颤的脑瘫;偏身投掷症;肌阵挛;以及左旋多巴诱发的运动障碍。