Seventy years with the globus pallidus: Pallidal surgery for movement disorders between 1947 and 2017

ABSTRACT The year 2017 marks the 70th anniversary of the birth of human stereotactic neurosurgery. The first procedure was a pallidotomy for Huntington's disease. However, it was for Parkinson's disease that pallidotomy was soon adopted worldwide. Pallidotomy was abandoned in the late 1950s in favor of thalamotomy because of the latter's more striking effect on tremor. The advent of levodopa put a halt to all surgery for PD. In the mid‐1980s, Laitinen reintroduced the posteroventral pallidotomy of Leksell, and this procedure spread worldwide thanks to its efficacy on most parkinsonian symptoms including levodopa‐induced dyskinesias and thanks to basic scientific work confirming the role of the globus pallidus internus in the pathophysiology of PD. With the advent of deep brain stimulation of the subthalamic nucleus, pallidotomy was again abandoned, and even DBS of the GPi has been overshadowed by STN DBS. The GPi reemerged in the late 1990s as a major stereotactic target for DBS in dystonia and, recently, in Tourette syndrome. Lately, lesioning of the GPI is being proposed to treat refractory status dystonicus or to treat DBS withdrawal syndrome in PD patients. Hence, the pallidum as a stereotactic target for either lesioning or DBS has been the phoenix of functional stereotactic neurosurgery, constantly abandoned and then rising again from its ashes. This review is a tribute to the pallidum on its 70th anniversary as a surgical target for movement disorders, analyzing it...
Source: Movement Disorders - Category: Neurology Authors: Tags: Historical Review Source Type: research

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This article reviews scales that have been developed for, validated in, and/or frequently used across multiple movement disorders with a focus on assessment of motor and nonmotor symptoms of Parkinson disease. Rating scales used in other disease states include those for essential tremor, dystonia (generalized dystonia, cervical dystonia, and blepharospasm), Tourette syndrome, Huntington disease, tardive dyskinesia, Wilson disease, ataxia, and functional movement disorders. Key features of each scale as well as cited criticisms and limitations of each scale are also discussed. Lastly, the article briefly discusses the emerg...
Source: Neurologic Clinics - Category: Neurology Authors: Source Type: research
ConclusionsDifferent patterns of sleep disturbances are observed in HD patients: insomnia, difficulties in falling asleep, frequent nocturnal awakenings, and excessive daytime sleepiness are the most common sleep problems reported by patients with HD. In several HD studies, specific changes in sleep architecture and in circadian melatonin secretion were identified in laboratory testing.Sleep disorders in HD have diverse and complex determinants, the most significant of which includes damage to brain areas that are responsible for the proper sleep pattern and circadian rhythm regulation. Sleep and circadian rhythm disorders...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Source: Movement Disorders - Category: Neurology Tags: Abstract Source Type: research
ABSTRACT The year 2017 marks the 70th anniversary of the birth of human stereotactic neurosurgery. The first procedure was a pallidotomy for Huntington's disease. However, it was for Parkinson's disease that pallidotomy was soon adopted worldwide. Pallidotomy was abandoned in the late 1950s in favor of thalamotomy because of the latter's more striking effect on tremor. The advent of levodopa put a halt to all surgery for PD. In the mid‐1980s, Laitinen reintroduced the posteroventral pallidotomy of Leksell, and this procedure spread worldwide thanks to its efficacy on most parkinsonian symptoms including levodopa‐induce...
Source: Movement Disorders - Category: Neurology Authors: Tags: Historical Review Source Type: research
Source: Movement Disorders - Category: Neurology Tags: Abstract Source Type: research
CONCLUSIONS: Based on our data, intraoperative CT scan is fast, safe, and a useful tool in the evaluation of the position of the implanted lead. It also reduces the patient's discomfort derived from the transfer of the patient from the operating room to the radiological department. However, intraoperative CT should not be considered as a substitute for postoperative MRI. PMID: 27583182 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
In the last 25 years neuromodulation by deep brain stimulation gained widely acceptance starting in the field of movement disorders and getting further indications in pain syndroms and mood disorders. Surgical interventions should only be considered being a treatment option after proving ineffectiveness of conservative therapy forms. The highly acclaimed success of deep brain stimulation in Parkinsons disease, essential tremor, dystonia, chorea huntington, tourette syndrome, cannot be translated 1:1 to neuropathic pain syndromes.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Authors: di Biase L, Munhoz RP Abstract INTRODUCTION: Deep brain stimulation effectiveness is well recognized for different movement disorders including Parkinson's disease, dystonia and essential tremor, however several other diseases in this field may benefit from the technique although experience is sparse and evidences of benefit and risks are not established. AREAS COVERED: In this review, we explored available evidence for effectiveness and safety of DBS in selected hyperkinetic movement disorders, including tardive dyskinesia, Huntington's disease, neuroacanthocytosis, myoclonus-dystonia, Tourette syndro...
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research
This article provides an overview of burden of neurological diseases in Canada to set the stage for the in-depth systematic reviews of the 14 priority neurological conditions presented in subsequent articles in this issue. PMID: 27153747 [PubMed - as supplied by publisher]
Source: Neurotoxicology - Category: Neurology Authors: Tags: Neurotoxicology Source Type: research
CONCLUSIONS: FDA has currently approved use of deep brain stimulation for treatment of essential tremor, Parkinson’s disease, dystonia and Obsessive-Compulsive Disorder where it has acquired great achievement. The future of DBS is encouraging with a great potential to treat a wide array of diseases. Study Supported: NoneDisclosure: Dr. Davis has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: History of Neurology Source Type: research
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