|
(Continued from page 45)
neurologist is present for testing. A thin electrode lead is placed into the target. Sometimes, instantly, the patient's symptoms resolve, just due to the placement, however they usually return after 6 weeks. The electrodes are tested for stimulation and side effects and adjusted if necessary. Then the electrodes are sealed into place and tunneled under the skin to behind the ear where a connection is made to the wires that go to the chest. The patient undergoes general anesthesia at this time for comfort. In the chest a third incision is made where the pace maker size generator is placed in the soft tissue below the clavicle. The individual goes to the recovery room for 2 hours, has a CT scan and if all goes well, goes to the floor in preparation for going home in the morning.
OUTCOMES & COMPLICATIONS
690 patients undergoing pallidotomy for PD from 8 large studies since 1992 were reviewed for side effects. They were: dysarthria 8%-50%, visual changes 2.5%, transient facial weakness 1.8%, hemiparesis 0.6%, euphoria 0.6%, infarct 0.6%, seizure 0.5%, depression 0.3%, foot apraxia 0.3%, abscess 0.3%, swallowing problems and disinhibition 0.1%. The PD patients usually have improvement in their activities of daily living as measured by the pre and post op UPDRS scores in falling, freezing, tremor, rigidity, posture, gait, bradykinesia and on off states.
|
|
