Role of Ablative Stereotactic Procedures in Functional Neurosurgery

Abstract

Ablation ofthe target was performed via radiofrequency generator under local anaethesia.

Results

The results of the study showed that ablative stereotactic procedures are effective in management of well selected cases of functional neuropsychiatric disorders as evidenced by improvement in patients' scores 6 months post-operatively after stereotactic ablation of the appropriate target: • Globus pallidus internus: 30% improvement in UPDRS III (motor scale) in the Off symptoms of rigidity and bradykinesia and 45% improvement in the UPDRS IV in the On state dyskinesia on the side contralateral to the lesion in patients with severe Parkinson's disease. • Ventralis Intermedius nucleus of the thalamus: 80-90% reduction of parkinsonian

and essential tremor respectively.

• Globus pallidus internus: 50 % reduction in BMFDRS scores in patients with primary dystonia. • Cingulate gyrus and anterior capsule: moro than 50% improvement in 75% of patients with intractable obsessive compulsive disorders • Frontalleucotomy : 50 % improvement in the symptoms of patients with self aggression syndromes. The study also included 2 case reports showing effectiveness and safety of bilateral subthalamic lesions in a patient with severe Parkinson's disease and of medial thalamotomy in a patient with chronic neuropathic pain.