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Levodopa-induced dyskinesias treated by pallidotomy
J Jankovic1, E Lai, L Ben-Arie
1Baylor College of Medicine, Dir. of Parkinson's Disease Ctr. and Movement Disorders Ctr., 6550 Fannin #1801, Houston, TX 77030, USA. josephj@bcm.tmc.edu
Journal of the Neurological Sciences
|September 29, 1999
Summary
Stereotactic posteroventral pallidotomy significantly reduced levodopa-induced dyskinesia (LID) in Parkinson
Area of Science:
- Neurosurgery
- Neurology
- Movement Disorders
Background:
- Levodopa-induced dyskinesia (LID) is a common complication of Parkinson's disease treatment.
- The efficacy of pallidotomy for LID has not been extensively studied.
Purpose of the Study:
- To evaluate the effectiveness and safety of stereotactic, unilateral, posteroventral pallidotomy in treating medically intractable LID.
Main Methods:
- Stereotactic posteroventral pallidotomy was performed on 42 patients with Parkinson's disease and LID.
- Patients were followed for up to 9 months post-surgery.
- Levodopa dosage remained constant pre- and post-surgery.
Main Results:
- Significant reduction in time spent with dyskinesia (37.0% to 17.3%) and 'on' time with dyskinesia (71.0% to 22.9%).
- Reduction in troublesome dyskinesia from 86% to 12% of patients.
- Improvement in LID-related disability and pain scores (UPDRS).
Conclusions:
- Pallidotomy is an effective treatment for medically intractable LID.
- The procedure demonstrated a favorable safety profile with no persistent disabling complications.