The first line of treatment of Parkinson’s disease is still
medical. Most clinical studies as to the efficacy of pharmacological agents are
based on the context of having mild, moderate and advanced disease. Thus, surgical
treatment of PD has been reserved
only for patients with both severe motor impairment from PD and motor
complications in the form of fluctuations and dyskinesias.
In a
review of literature of all researches done worldwide from 2001 to 2004, the
following surgical interventions have been undertaken, namely:
1.
Unilateral Pallidotomy
2.
Pallidal Stimulation
3.
Thalatomy
4.
Thalamic Stimulation
5. Subthalatomy
6. Subthalamic Nucleus Stimulation (STN)
7. Human
fetal mesencephalic transplantation
8. Fetal
porcine cell transplantation
Of the
above surgical procedures, unilateral pallidotomy and subthalamic nucleus
stimulation (STN) have been found to be efficacious for symptomatic control of
parkinsonism. However, only the former, i.e., unilateral pallidotomy, has been
shown to be likely efficacious in the treatment of motor complications like
dyskinesias and fluctuations. Thus, they are said to be clinically useful in
the treatment of PD but with associated risk which are acceptable under
specialized monitoring.
Pallidal
stimulation has been observed to be likely efficacious for the symptomatic
control of parkinsonism. It might possibly be useful for clinical practice but
also with acceptable risk with specialized monitoring.
Human
fetal mesencephalic transplantation has been observed to be non-efficacious in
the symptomatic control of parkinsonism as well as in the treatment of motor
complications. It also has an unacceptable risk of developing severely
disabling dyskinesias predominantly affecting the legs which occurred generally
6 – 12 months after surgery thus requiring another surgical intervention.
The rest
of the surgical procedures are still in the investigational stages and with
insufficient data as to merit any clinical usefulness.
References:
Vitek JL,
Bakay RAE, Freeman A, et al. Randomized trial of
pallidotomy
versus medical therapy for Parkinson’s disease. Ann
Neurol
2003;53:558 –569.
Katayama
Y, Kasai M, Oshima H, et al. Subthalamic nucleus
stimulation
for Parkinson’s disease: benefits observed in levodopa intolerant
patients.
J Neurosurg 2001;95:213–221
Olanow CW,
Goetz CG, Kordower JH, et al. A double-blind
controlled
trial of bilateral fetal nigral transplantation in Parkinson’s
disease.
Ann Neurol 2003;54:403– 414.
My husband was diagnosed with early onset Parkinson's disease at 68. His symptoms were shuffling of feet, slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle. Things were tough for me, I too was diagnosed of COPD but now we both finally free from these diseases with the help of total cure herbal foundation, He now walks properly and all symptoms has reversed. He had trouble with balance especially at night, getting into the shower and exiting it is difficult. Getting into bed is also another thing he finds impossible. We had to find a better solution for his condition which has really helped him a lot,The biggest helped we had was totalcureherbsfoundation .c om They walked us through the proper steps, im highly recommending this herbal formula to anyone who needs help.
ReplyDeleteAfter was running around from doctor to doctor before we finally get rid of her PD ,at age 74 my mother noticed that her handwriting was getting smaller and I was writing faster as well. She also noticed a small tremor in her left hand. The doctor went over her different symptoms and he suspected she either had a small stroke or the beginnings of Parkinson 's disease. After finding a neurologist and some testing she was diagnosed with the beginning stages of Parkinson’s disease. That was 3 years ago. She take Sinimet four times a day to control the symptoms, which include falling, imbalance, gait problems, swallowing difficulties, and slurring of speech,This year, our family doctor started her on multivitamincare. org PD Herbal mixture, 15 weeks into treatment she improved dramatically. At the end of the full treatment course, the disease is totally under control. No case of dementia, hallucination, weakness, muscle pain or tremors.
ReplyDeletemy husband Parkinson's disease is totally reversed! all thanks to tree of life herbal clinic visit (www .treeoflifeherbalclinic .com)
ReplyDelete