Parrent A G, Tasker R R, Dostrovsky J O
Division of Neurosurgery, University Hospital, London, Ontario, Canada.
Acta Neurochir Suppl (Wien). 1993;58:45-7. doi: 10.1007/978-3-7091-9297-9_9.
We report our experience with lidocaine microinjection into the thalamus in 10 patients undergoing stereotactic thalamotomy for the treatment of Parkinsonian or non-Parkinsonian tremor. 18 injection sites in 4 patients with Parkinson's disease and 22 sites in 6 patients with other forms of tremor have been compared with respect to the effect of microstimulation. In over two thirds of cases the test microinjection replicated the effects of microstimulation. Long term follow up will be required to determine whether lesions made on the basis of lidocaine induced tremor suppression will result in a lower rate of tremor recurrence than those based on stimulation induced tremor suppression. In those patients in whom stimulation induced tremor suppression occurs but tremor arrest cannot be produced with lidocaine microinjection, chronic thalamic stimulation may be an alternative for the long term control of tremor in these patients.
我们报告了对10例接受立体定向丘脑切开术治疗帕金森病或非帕金森病震颤患者进行丘脑利多卡因微注射的经验。对4例帕金森病患者的18个注射部位和6例其他形式震颤患者的22个部位进行了微刺激效果的比较。在超过三分之二的病例中，试验性微注射复制了微刺激的效果。需要长期随访以确定基于利多卡因诱导的震颤抑制所形成的损伤是否会比基于刺激诱导的震颤抑制所形成的损伤导致更低的震颤复发率。在那些刺激诱导震颤抑制但利多卡因微注射不能使震颤停止的患者中，慢性丘脑刺激可能是长期控制这些患者震颤的一种替代方法。
