Publication: Deep Brain Stimulation in Parkinsons Disease in Nepal
Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Parkinsons disease is a central nervous system degenerative disorder affecting
motor system and characterized by progressive tremor, rigidity, gait abnormalities.
Surgical treatment of Parkinsons disease is based on the changes in the basal ganglio-
thalamocortical circuits which is altered in Parkinsons disease. Currently pallidotomy
and Deep Brain Stimulation are available modes of surgical treatment of Parkinsons
disease.
Objective
To know efficacy of deep brain stimulation in Parkinsons Disease in Nepal.
Method
All patients of idiopathic Parkinsons disease who underwent Deep Brain Stimulation
in Annapurna Neurological Institute and Allied sciences since 2014 were included.
The standard functional coordinates for Subthalamic nucleus and Globus pallidus
internus was used. We used Zamarano-Dujovny (ZD) Fisher Frame with its software.
Patients’ Unified Parkinsons disease rating score, Modified Hoehn and Yahr Staging
and Schwab and England Activities of daily living Scale were evaluated preoperatively
as well as postoperatively.
Result
Ten patients underwent Deep Brain Stimulation. The male is to female ratio was 2:1.
The mean age was 55.4±8.9 years and duration of illness was 5.5±2 years. There
was a significant improvement in the scores for the main motor manifestations of
the disease between the preoperative off-dopa and postoperative off-dopa/on-stim
conditions. There was a significant improvement in Schwab and England Activities
of daily living scale scores in the off-dopa condition between the preoperative score
and the postoperative M6 score.
Conclusion
Our result of Deep Brain Stimulation is quite promising. However, it is very expensive
and requires frequent follow-up for neuromodulation.
KEY WORDS
Deep brain stimulation, Parkinsons disease, Unified parkinsons disease rating score
Description
Shrestha R,1 Taira T,2 Shrestha P,1 Rajbhandari P,1 Acharya S,1 Pant B1
1Department of Neurosurgery,
Annapurna Neurological Institute and Allied Sciences,
Kathmandu, Nepal.
2Department of Neurosurgery,
Tokyo Womens Medical University,
Tokyo, Japan
Keywords
Deep brain stimulation, Parkinsons disease, Unified parkinsons disease rating score