Uses Ablative brain surgery

1 uses

1.1 parkinson s disease
1.2 cluster headaches
1.3 psychiatric disorders

uses
parkinson s disease

parkinson s disease (pd) progressive degenerative disease of basal ganglia, characterized loss of dopaminergic cells of substantia nigra, pars compacta (snc). surgical ablation has been used treat parkinson s disease. in 1990s, pallidum common surgical target. unilateral pallidotomy improves tremor , dyskinesia on 1 side of body (opposite side of brain surgery), bilateral pallidotomy found cause irreversible deterioration in speech , cognition.

two other rapidly evolving or potential surgical approaches parkinson s disease deep brain stimulation (dbs) , restorative therapies.

deep brain stimulation surgical treatment involving implantation of neurostimulator medical device, called brain pacemaker , sends electrical impulses specific parts of brain. generally, deep brain stimulation surgery considered preferable ablation because has same effect , adjustable , reversible.

the advent of deep brain stimulation has been important advance in treatment of parkinson’s disease. dbs may employed in management of medication-refractory tremor or treatment-related motor complications, , may benefit between 4.5% , 20% of patients @ stage of disease course. dbs @ high frequency has behavioral effects similar of lesioning.

in australia, patients pd reviewed specialized dbs teams assess benefits , risks associated dbs each individual. aim of these guidelines assist neurologists , general physicians identify patients may benefit referral dbs team. common indications referral motor fluctuations and/or dyskinesias not adequately controlled optimised medical therapy, medication-refractory tremor, , intolerance medical therapy. referral consideration of dbs recommended optimised medical therapy fails offer satisfactory motor control.

the thalamus potential target treating tremor; in countries, subthalamic nucleus, although not in united states due severe side effects. stimulation of portions of thalamus or lesioning has been used various psychiatric , neurological conditions, , when practiced movement disorders target in motor nuclei of thalamus. thalamotomy surgical option in treatment of parkinson s disease. however, rigidity not controlled after successful thalamotomy, replaced hypotonia. furthermore, significant complications can occur, example, left ventral-lateral thalamotomy in right-handed patient results in verbal deterioration while right thalamotomy causes visual-spatial defects. however, patients whom dbs not feasible, ablation of subthalamic nucleus has been shown safe , effective. dbs not suitable patients. patients suffer immunodeficiencies example of situation in dbs not suitable procedure. however, major reason why dbs not performed cost. because of high cost, dbs cannot performed in regions of world not wealthy. in case of such circumstances, permanent lesion in subthalamic nucleus (stn) created more favourable surgical procedure. surgical procedure going done on non-dominant side of brain; lesion might favored evade numerous pacemaker replacements. more so, patients gain relief stimulation devoid of side effects , need pacemaker change may have lesion performed on them in same position. stimulation parameters act guide preferred size of lesion. in order identify part of brain destroyed, new techniques such micro electrode mapping have been developed.

cluster headaches

cluster headaches occur in cyclical patterns or clusters — gives condition of name. cluster headache 1 of painful types of headache. cluster headache called alarm clock headache because commonly awakens in middle of night intense pain in or around eye on 1 side of head. bouts of frequent attacks may last weeks months. when drug treatment fails, invasive nerve stimulation procedure shows promise. cluster headaches have been treated ablation of trigeminal nerve, have not been effective. other surgical treatments cluster headaches under investigation.

psychiatric disorders

ablative psychosurgery continues used in few centres in various countries. in there few centres including massachusetts general hospital carry out ablative psychosurgical procedures. belgium, united kingdom, , venezuela other examples of countries technique still used.

in people s republic of china, surgical ablation used treat psychological , neurological disorders, particularly schizophrenia, including clinical depression, , obsessive-compulsive disorder. official xinhua news agency has since reported china s ministry of health has banned procedure schizophrenia , severely restricted practice other conditions. in recent studies, deep brain stimulation (dbs) beginning replace ablative brain surgery severe psychiatric conditions treatment resistant, such obsessive-compulsive disorder.