Regresar

Deep brain stimulation: A breakthrough in the treatment of movement disorders

Abstract:

Over the last 20 years, it became clear that deep brain stimulation is a breakthrough in the treatment of drug-resistant movement disorders. Stimulation acts by functional inhibition of certain pathologically hyperactive nuclei. Of advantage is that the patient himself can change stimulation parameters depending on his actual status, thus reaching optimal quality of life. This option has been available for years in Hungary, as well. It is a safe, effective and cost-effective alternative in the symptomatic management of drug-refractory Parkinson's disease, essential tremor, and primary dystonia. Before surgery, a comprehensive investigation including clinical diagnosis, severity, surgery contraindications, and expected benefit has to be performed. Based on the results of international multicenter studies, bilateral subthalamic nucleus stimulation may improve - besides symptoms, such as tremor, rigidity, bradykinesia and levodopa-induced side effects - also quality of life in Parkinson's disease. In essential tremor, stimulation of the ventral intermediate nucleus of the thalamus is capable of spectacularly decreasing tremor. For primary dystonias, stimulation of the pallidum can improve drug-resistant symptoms and quality of life, and it substantially reduces social dependency and the amount of nursing required. In childhood dystonias, surgery may be performed at an age of as low as seven years.