Journal of Korean Neurosurgical Society
- 제30권8호
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- Pages.976-980
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- 2001
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
파킨슨씨병 환자에서 편측 담창구파괴술의 효과
Efficacy of Unilateral Pallidotomy for Parkinson's Diesease
- 조우진 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 이경진 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 지철 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 박성찬 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 박해관 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 조정기 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 조경근 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 나형균 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 강준기 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터) ;
- 최창락 (가톨릭대학교 의과대학 신경외과학교실, 가톨릭뇌신경센터)
- Cho, Woo Jin (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Lee, Kyung Jin (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Ji, Cheul (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Park, Sung Chan (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Park, Hea Kwan (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Jo, Jung Ki (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Cho, Kyung Keun (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Rha, Hyung Kyun (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Kang, Joon Ki (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University) ;
- Choi, Chang Rak (Catholic Neuroscience Center, Department of Neurosurgery, College of Medicine, The Catholic University)
- 투고 : 2001.02.21
- 심사 : 2001.06.05
- 발행 : 2001.08.28
초록
Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.
키워드