Subtalamotomía bilateral diferida en enfermedad de Parkinson: evaluación motora, cognitiva y conductual

Modern surgical techniques have proven to be an effective procedure for control of parkinsonian symptoms resistant to drug treatment. Radiofrequency ablation procedures represent an option for properly selected cases. 9 patients were selected with a diagnosis of Parkinson's disease (PD) between 2010 and 2013 with white bilateral subthalamic nucleus in two-stage. The results, comparing before and after 6 months of the second subthalamotomy (one year between the 2 assessments), yielded the following results: UPDRS II «off» 25.2 vs. 12.3 (51.2%); UPDRS III «off» 60.7 vs. 25 (58.89%); UPDRS IV vs. 10.4 2.3 (77.8%); decreased total dose of L -dopa than 60% (vs. 1439 vs. 505 mg); reduction of tremor, rigidity and bradykinesia (68, 67 and 60% respectively) and significant improvement on scales that measure quality of life as PDQ-39 44% (41.37 vs. 23.10). At the cognitive level (n = 8) showed no significant changes domain except for verbal reasoning. The results suggest a marked benefit of cardinal symptoms with reduction of motor fluctuations in time and «off». A very low rate of overall complications was also evidenced.