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Posted by CCF Neurosurgery MD on November 26, 1997 at 10:50:02:
In Reply to: lazer surgery for Parkinson's disease posted by George Stan, Jr. MD on November 25, 1997 at 13:14:31:
: There was an article recently in my alumni bulliten from the Cleveland Clinic regarding the use of lazer treatment and the MRI in the treatment of Parkinsons disease. can you fill me in on its use and results at the clinic and which doctor there is performing the procedure? Dr.Doa operated on my uncle, I believe in 1960, in which alcohol was injected intrcranilly with minima
Dear Dr. Stan,
Functional procedures in neurosurgery have been around for years. They are
useful in treating patients with Parkinson's, tremors from various causes,
and obsessive-compulsive disorder, to name a few.
Parkinson's disease has been treated successfully for some years with a procedure
called a pallidotomy. This is done stereotactically by placing a probe into
the globus pallidus and using electric current to fashion a lesion. Pallidotomy
is effective in treating the tremor associated with Parkinson's and can dramatically
improve a patients level of functioning and quality of life. It will not
improve the bradykinesia or masked facies, nor will it improve response to
L-dopa (Sinimet). The procedure is done with the patient awake to allow the
surgeon to evaluate the patient during the operation.
We don't use lasers for pallidotomies, but what you may have heard is that ra
radiation may be used for functional procedures. We opened a new Gamma Knife
center at the Cleveland Clinic and have begun to treat functional disorders
with radiation. The idea is the same - to create a small lesion in the Globus
Pallidus - and improve the tremor associated with Parkinson's. A stereotactic
frame is placed on the patient's head and, after an MRI and planning on computers
with the Gamma Knife software, the patient is treated. The procedure is done
as an outpatient and the patient goes home the same day. Of note, the effects
are not immediately visible as the lesioning effects of the radiation take
On a broader scale, the Gamma Knife, and other modes of radiation delivery,
is becoming an appealing option in a number of disease processes. It can be
an excellent option for the elderly patient or one with significant comorbid
factors that make formal surgery and anesthesia a higher risk.
Dr. Gene Barnett has performed a number of functional procedures at the Cleveland
Clinic using the Gamma Knife. An appointment can be made by calling 216-444-562.
We hope this information proves useful.
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