(パーキンソン病などの不随意運動の治療に用いられる手術法)淡蒼球破壊術、淡蒼球手術、淡蒼球切裁

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/17 15:32:48」(JST)

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Pallidotomy is a neurosurgical procedure whereby a tiny electrical probe is placed in the globus pallidus (one of the basal nuclei of the brain), which is then heated to 80 °C (176 °F) for 60 seconds, to destroy a small area of brain cells.^{[citation needed]}

Pallidotomy is an alternative to deep brain stimulation for the treatment of the involuntary movements known as dyskinesias which can become a problem in people with Parkinson's disease after long-term treatment with levodopa — a condition known as levodopa-induced dyskinesia.^[1] It is also sometimes used in alternative to deep brain stimulation to treat difficult cases of essential tremor.^[2]

The Internal globus pallidus can be regarded as an "output structure" of the basal ganglia,^[3] processing input from nucleus accumbens and the striatum and sending input to the cerebral cortex via the thalamus. Thus, it is critical for the functioning of the basal ganglia. Unilateral posteroventral pallidotomy can be effective at reducing Parkinsonism, but is associated with impaired language learning (if performed on the dominant hemisphere) or impaired visuospatial contructional ability (if performed on the non-dominant hemisphere). It can also impair executive functions.^[4] Bilateral pallidotomy will not reduce Parkisonistic symptoms but will cause severe apathy and depression along with slurred, unintelligible speech, drooling, and pseudobulbar palsy.^[5]^[6]

History

Stereotactic pallidotomy was pioneered by Dr. Hirotaro Narabayashi.^{[citation needed]}

References

^ Oertel, W.H.; Berardelli, A.; Bloem, B.R.; Bonuccelli, U.; Burn, D.; Deuschl, G.; et al. (2011). "Late (complicated) Parkinson's disease" (PDF). In Gilhus, Nils Erik; Barnes, Michael R.; Brainin, Michael. European Handbook of Neurological Management I (2nd ed.). Blackwell. pp. 240–1. ISBN 978-1-405-18533-2. Retrieved 31 October 2012.
^ Hooper, Amanda K.; Okun, Michael S.; Foote, Kelly D.; Fernandez, Hubert H.; Jacobson, Charles; Zeilman, Pamela; Romrell, Janet; Rodriguez, Ramon L. (2008). "Clinical Cases where Lesion Therapy Was Chosen over Deep Brain Stimulation". Stereotactic and Functional Neurosurgery 86 (3): 147–52. doi:10.1159/000120426. PMID 18334856.
^ Middleton, Frank A.; Strick, Peter L. (2000). "Basal Ganglia Output and Cognition: Evidence from Anatomical, Behavioral, and Clinical Studies". Brain and Cognition 42 (2): 183–200. doi:10.1006/brcg.1999.1099. PMID 10744919.
^ Trepanier, L. L.; Saint-Cyr, J. A.; Lozano, A. M.; Lang, A. E. (1998). "Neuropsychological consequences of posteroventral pallidotomy for the treatment of Parkinson's disease". Neurology 51 (1): 207–15. doi:10.1212/WNL.51.1.207. PMID 9674804.
^ Merello, M; Starkstein, S; Nouzeilles, MI; Kuzis, G; Leiguarda, R (2001). "Bilateral pallidotomy for treatment of Parkinson's disease induced corticobulbar syndrome and psychic akinesia avoidable by globus pallidus lesion combined with contralateral stimulation". Journal of Neurology, Neurosurgery & Psychiatry 71 (5): 611–4. doi:10.1136/jnnp.71.5.611. PMC 1737599. PMID 11606671.
^ Ghika, Joseph; Ghika-Schmid, Florence; Fankhauser, Heinz; Assal, Gil; Vingerhoets, François; Albanese, Alberto; Bogousslavsky, Julien; Favre, Jacques (1999). "Bilateral simultaneous posteroventral pallidotomy for the treatment of Parkinson's disease: Neuropsychological and neurological side effects". Journal of Neurosurgery 91 (2): 313–21. doi:10.3171/jns.1999.91.2.0313. PMID 10433321.

UpToDate Contents

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1. パーキンソン病の外科治療 surgical treatment of parkinson disease
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4. 舞踏病の概要 overview of chorea
5. 脳深部刺激装置の埋込を行う患者のための麻酔 anesthesia for patients having deep brain stimulator implantation

English Journal

Bilateral pallidotomy for Meige syndrome.

Minkin K1, Gabrovski K2, Dimova P2, Tanova R2, Penkov M3, Todorov Y3, Romansky K3.
Acta neurochirurgica.Acta Neurochir (Wien).2017 Jul;159(7):1359-1363. doi: 10.1007/s00701-017-3178-0. Epub 2017 Apr 19.
PMID 28424916

Stereotactic MR-guided focused ultrasound deep brain lesioning: the resurrection of posteroventral pallidotomy and thalamotomy for Parkinson's disease?

Kinfe TM1.
Acta neurochirurgica.Acta Neurochir (Wien).2017 Jul;159(7):1367-1369. doi: 10.1007/s00701-017-3161-9. Epub 2017 Mar 31.
PMID 28364273

Ablative surgery for Parkinson's disease: Is there still a role for pallidotomy in the deep brain stimulation era?

Spindola B1, Leite MA2, Orsini M3, Fonoff E4, Landeiro JA5, Pessoa BL5.
Clinical neurology and neurosurgery.Clin Neurol Neurosurg.2017 Jul;158:33-39. doi: 10.1016/j.clineuro.2017.04.018. Epub 2017 Apr 23.
PMID 28458056

Japanese Journal

パーキンソン病以外の運動機能異常症状に対する機能的外科治療の位置づけ

平孝臣
臨床神経学 53(11), 966-968, 2013
パーキンソン病や本態性振戦（ET）のような不随意運動疾患以外にも，重度の痙縮，運動麻痺回復などが外科治療の対象となる．ETではposterior subthalamic areaが新たなターゲットとして注目を浴びている．また低侵襲的治療としてMRI内でおこなう経頭蓋集束超音波照射治療が注目されている．全身性ジストニアでは淡蒼球内節のDBSが確立されている．書痙や音楽家の動作特異性局所ジストニアも視 …
NAID 130004505484

パーキンソン病に対する淡蒼球破壊術・視床破壊術後に脳深部刺激術を行った4例

岡雄一,梅村淳,出村光一郎,磯村健一,大沢知士,大喜多賢治,豊田剛成,山脇健盛,山田和雄
Functional neurosurgery : proceedings of the annual meeting of the Japan Society for Stereotactic and Functional Neurosurgery 48(1), 88-89, 2009-06-15
NAID 10029744896

Pallidotomy 後のパーキンソン病に対するSTN-DBSの効果の検討

渡辺充,森下登史,角光一郎,大高稔晴,大渕敏樹,四條克倫,加納利和,永岡右章,小林一太,大島秀規,深谷親,山本隆充,片山容一,鈴木裕
Functional neurosurgery : proceedings of the annual meeting of the Japan Society for Stereotactic and Functional Neurosurgery 48(1), 86-87, 2009-06-15
NAID 10029744890