珍屯医学

标题: 苍白球切开术 [打印本页]

作者: 大江 时间: 2019-10-3 00:01
标题: 苍白球切开术
苍白球切开术是一种神经外科手术，其中将一个微小的电探针置于苍白球（大脑的基底核之一）中，然后将其加热到80°C（176°F）60秒，以破坏小范围的脑细胞。

苍白球切开术是深部脑刺激的替代疗法，用于治疗称为运动障碍的非自愿运动，长期使用左旋多巴治疗帕金森氏病可能会成为一个问题，这种疾病被称为左旋多巴诱发的运动障碍。[1]有时也可以用它代替深部脑刺激来治疗困难的原发性震颤病例。[2]

内部苍白球可被视为基底神经节的“输出结构”，[3]处理伏隔核和纹状体的输入，并通过丘脑将输入发送到大脑皮层。因此，对于基底神经节的功能至关重要。单侧后腹苍白球切开术可有效减轻帕金森病，但与语言学习受损（如果在优势半球上进行）或视觉空间结构能力受损（如果在非优势半球上进行）相关。它还可能损害执行职能。[4]双侧苍白球切开术不会减轻帕金森病症状，但会引起严重的冷漠和沮丧，以及言语不清，言语不清，流口水和假性球囊麻痹。[5] [6]

参考：
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 (eds.). 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.

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