ABLATIVE FUNCTIONAL NEUROSURGERY IN THE TREATMENT OF MOVEMENT DISORDERS: CIREN EXPERIENCE, CUBA
2nd International Conference on NEUROSCIENCE AND NEUROLOGICAL DISORDERS
April 11-12, 2019 | Barcelona, Spain
Nelson Quintanal Cordero
International Center of Neurological Restoration, Cuba
Scientific Tracks Abstracts : J Neurol Neurorehabil Res
Abstract:
Introduction: Effectiveness and safety of ablative surgery for movement disorders depend, among others, on
the location of lesions in the nuclear regions of interest and the volume of these lesions.
Material and Methods: We describe the methods of radiofrequency ablation that are developed in the CIREN
in the approach to the subthalamic nucleus (STN), internal globus pallidus (GPi) and ventralis intermedius
nucleus (VIM) of the thalamus, performed on patients diagnosed with Parkinson’s disease (PD), dystonia and
essential tremor. These methods efficacy and safety were evaluated by clinical findings and by checking postoperative
lesions (location, shape and dimensions) by magnetic resonance images (MRI).
Results: A total of 1103 ablative surgeries were performed in 1015 patients over a twenty- year period, divided
into 425 subthalamotomies, 549 pallidotomies and 129 VIM thalamotomies. The anatomical location method
and electrophysiological confirmation were sufficient to perform the procedure. The subthalamic nucleus lesion
was effective in controlling the cardinal manifestations of PD with predominantly contralateral and axial
effects. The pallidotomy in PD was effective mainly for the control of rigidity and dyskinesias. Bilateral Pallidotomy
in a single surgical time is effective in patients with generalized dystonia. VIM thalamotomy has good effect
in the treatment of essential tremor and in PD with predominance of tremor.
Biography:
Nelson Quintanal Cordero is a head and board member of neurosurgery at International Center of Neurological Restoration. (CIREN) Havana, Cuba.
E-mail: nquintanal@neuro.ciren.cu
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