Sandoval LI, Jiménez F, Soto J, Velasco F, Carrillo-Ruíz JD, Gómez P, Suárez R

Language: Spanish
References: 20
Page: 20-25
PDF size: 71.56 Kb.

ABSTRACT

Introduction: Parkinson’s disease (PD) affects nearly 1 % of the population over 50 years worldwide. The diagnosis of this disease is based on clinical characteristics wich include: tremor, rigidity, bradikinesia and postural instability. Pharmacological treatment sometimes is insufficient to alleviate this symptoms, and some patients will requiere surgery to treat them. Deep brain stimulation (DBS) of the bilateral subthalamic nucleus (STN) has been considered the gold standar for the surgical treatment of PD. Nonetheless pallidotomy, prelemniscal radiations (RAPRL) ablation and thalamotomy, are surgical techniques that had been proved their efficacy for the treatment of PD. The Functional and Stereotactic Neurosurgery and Radiosurgery (FNSR) Unit of the General Hospital Mexico (GHM) was the first medical center in our country to operate on patients with PD in the 70’s decade. So far the outcome of the surgery in general, has not been published yet. The main purpose of this paper is to describe the surgical results of the patients with PD operated on at the FNSR during the period 1992-2009. Materials and methods: 33 medical files were reviewed and considered for this paper, at the FNSR. For the statistical analysis we use de median, media, standar deviation and Wilcoxon test to evaluate the results. We also made statistical correlations to define a positive one based on clinimetrics and type of surgery used for each patient. Results: The age of the patients was in the range between 38 and 83 years old. The median test of the presurgical Hoen and Yahr (HY) scale was 3, compared to 2 postoperative (P ‹ 0.0001). The surgical target internal globus pallidus was the most frequently used, but we cannot find a significant correlation between this and the UPDRS and HY scales. Discussion: Currently there is no the optimal surgical treatment for PD, however the surgical techniques used, ablation or DBS, has proven to be very effective in the treatment of some of the symptoms of PD. Our unit is a main medical center in the country to perform this kind of surgeries, but we do not have the whole clinical information through this decades of the patients that had been treated at the FNSR. This is because most clinical records are eliminated of the hospital archive. We report on 33 patients that were operated on at our unit, in different surgical targets, and our clinical results are very similar to other’s autors series. The most frequent surgical type of procedure was ablation, instead of DBS; this was because of economic reasons. Conclusion: An alectronic database is needed to preserve the clinical and surgical records of our patients.

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