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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los autores valoraron el efecto terap&#233;utico de palidotom&#237;a y palido-talamotom&#237;a combinada guiada por MR y microelectrodos en 33 pacientes con enfermedad de Parkinson&#44; cuyos s&#237;ntomas fueron resistentes al tratamiento farmacol&#243;gico&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los pacientes fueron evaluados en base a los test estandarizados a nivel internacional que se efectuaron antes y despu&#233;s de la operaci&#243;n&#58; al 2&#176; d&#237;a&#44; as&#237; como a lo largo de 12 meses&#44; con un intervalo de 3 meses entre ellos&#46; Los pacientes fueron divididos en dos grupos&#59; en los del grupo &#8220;A&#8221;&#44; los s&#237;ntomas parkinsonianos&#44; incluso el temblor&#44; disminuyeron despu&#233;s de una palidotom&#237;a&#46; En los pacientes del grupo &#8220;B&#8221;&#44; el temblor no disminuy&#243; tras la palidotom&#237;a&#44; raz&#243;n por la cual &#233;sta se complement&#243; con una talamotom&#237;a&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Con la ayuda de la escala UPDRS III se obtuvieron los siguientes resultados&#58; despu&#233;s de la palidotom&#237;a en &#8220;fase on&#8221; el promedio preoperatorio de 51&#44;2 disminuy&#243; a 29&#44;5 al 2&#176; d&#237;a&#44; a 26 a los 3&#44; 6 y 9 meses&#44; y a 28&#44;7 a los 12 meses despu&#233;s de la operaci&#243;n&#59; en &#8220;fase off&#8221; el promedio preoperatorio de 64&#44;3 declin&#243; a 31&#44;6 al 2&#176; d&#237;a&#44; a 26 a los 3&#44; 6 y 9 meses&#44; y a 30&#44;5 a los 12 meses despu&#233;s de la operaci&#243;n&#46; Despu&#233;s de la palidotalamotom&#237;a en &#8220;fase on&#8221; el promedio preoperatorio de 43&#44;5 disminuy&#243; a 27&#44;9 al 2&#176; d&#237;a&#44; a 22&#44;9 a los 3 meses&#44; a 22&#44;8 a los 6 meses&#44; y a 24&#44;5 a los 9 y 12 meses despu&#233;s de la operaci&#243;n&#46; De igual manera&#44; en &#8220;fase off&#8221; el promedio preoperatorio de 62&#44;6 declin&#243; a 38 al 2&#176; d&#237;a&#44; a 30 a los 3 meses&#44; a 31&#44;8 a los 6 meses&#44; y a 33&#44;8 a los 9 y 12 meses despu&#233;s de la operaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Para aquellos pacientes&#44; en quienes la palidotom&#237;a no fue suficiente en el control del temblor&#44; la palido-talamotom&#237;a fue efectiva&#46; Los s&#237;ntomas cl&#237;nicos&#44; de acuerdo con las escalas utilizadas&#44; mejoraron significativamente en los dos grupos &#40;student t&#58; P<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#59; sin embargo&#44; las lesiones bilaterales conllevan un alto riesgo de morbilidad&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Authors evaluated the therapeutic effect of the MRI and microelectrodeguided stereotactic pallido- and pallido-thalamotomy in 33 patients with Parkinson&#39;s disease &#40;PD&#41;&#44; whose symptoms were refractory to pharmacological therapy&#46;</p> <span class="elsevierStyleSectionTitle">Matherial and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The patients were evaluated according to the internationally standardized rating scales &#40;UPDRS part II&#44; III&#44; Schawb &#38; England&#44; Hoehn &#38; Yahr&#44; and Fahn&#41; at six timepoints&#58; before the operation&#44; and 2 days&#44; 3&#44; 6&#44; 9 and 12 months postoperatively&#46; The patients were divided into 2 groups&#46; Those in group A had relief of all main parkinsonian symptoms after pallidotomy including tremor&#46; The patients in group B had no relief of tremor after pallidotomy&#46; For them the pallidotomy was completed by thalamotomy in the same sitting&#44; which had resulted in cessation of tremor&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The following results were obtained by using the UPDRS part III&#58; after pallidotomy &#8220;On state&#8221; mean&#58; preoperative 51&#44;2&#44; postoperative at 2<span class="elsevierStyleSup">nd</span> day 29&#44;5 at 3&#44; 6 and 9<span class="elsevierStyleSup">th</span> month 26&#44; and at 12<span class="elsevierStyleSup">th</span> month 28&#44;7&#46; &#8220;Off state&#8221; mean&#58; preoperative 64&#44;3&#44; postoperative at 2<span class="elsevierStyleSup">nd</span> day 31&#44;6&#44; at 3&#44; 6 and 9<span class="elsevierStyleSup">th</span> month 26&#44; and at 12<span class="elsevierStyleSup">th</span> months 30&#44;5&#46; After pallidothalamotomy &#8220;On state&#8221; mean&#58; preoperative 43&#44;5&#44; postoperative at 2<span class="elsevierStyleSup">nd</span> day 27&#44;9&#44; at 3<span class="elsevierStyleSup">rd</span> month 22&#44;9&#44; at 6<span class="elsevierStyleSup">th</span> month 22&#44;8&#44; and at 9 and 12<span class="elsevierStyleSup">th</span> month 24&#44;5&#46; &#8220;Off state&#8221; mean&#58; preoperative 62&#44;6&#44; postoperative at 2<span class="elsevierStyleSup">nd</span> day 38&#44; at 3<span class="elsevierStyleSup">rd</span> month 30&#44; at 6<span class="elsevierStyleSup">th</span> month 31&#44;8 and at 9 and 12<span class="elsevierStyleSup">th</span> month 33&#44;8&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">For those patients&#44; whose tremor was not successfully controlled by pallidotomy&#44; the combined pallido-thalamotomy was effective&#46; The clinical symptomps&#44; according to the rating scales&#44; improved significantly in both groups &#40;student t&#58; P<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#44; but bilateral lesioning carried higher surgical morbidity&#46;</p>"
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Tratamiento de la enfermedad de Parkinson con palidotomía y palido-talamotomía estereotáctica guiada por microelectrodos
Microeletrode guided stereotactic pallidotomy and pallido-thalamotomy for treatment of Parkinson's disease
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, T. Dóczi, I. Baths
Department of Neurosurgery. University of Pécs. Hungary

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