Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson's disease patients

View More View Less
  • 1 Departments of Neurosurgery and Neurology, Mayo Clinic, Rochester, Minnesota
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

✓ Thirty-six patients with Parkinson's disease and medically refractory tremor underwent stereotactic ventrolateralis thalamotomy at the Mayo Clinic between 1984 and 1989. All patients had been or were being treated with carbidopa/levodopa but with unsatisfactory tremor control. Modern stereotactic techniques, including microelectrode recording, were used to treat 36 patients, of whom 31 (86%) had complete abolition of tremor and three patients (5%) had significant improvement. Tremor recurred in two patients within 3 months of surgery; however, the remaining patients suffered no recurrence of tremor during follow-up periods ranging from 14 to 68 months (mean 33 months). Persistent complications (arm dyspraxia, dysarthria, dysphasia, or abulia) were noted in five patients but were a source of disability in only two. It is concluded that thalamotomy in carefully selected patients is a beneficial operation for the control of medically refractory parkinsonian resting tremor.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address reprint requests to: Patrick J. Kelly, M.D., Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905.
  • 1.

    Andrew J, , Fowler CJ, & Harrison MJG: Stereotaxic thalamotomy of 55 cases of dystonia. Brain 106:9811000, 1983 Andrew J, Fowler CJ, Harrison MJG: Stereotaxic thalamotomy of 55 cases of dystonia. Brain 106:981–1000, 1983

    • Search Google Scholar
    • Export Citation
  • 2.

    Barbeau A: Six years of high-level levodopa therapy in severely akinetic parkinsonian patients. Arch Neurol 33:333338, 1976 Barbeau A: Six years of high-level levodopa therapy in severely akinetic parkinsonian patients. Arch Neurol 33:333–338, 1976

    • Search Google Scholar
    • Export Citation
  • 3.

    Bell DS: Speech functions of the thalamus inferred from the effects of thalamotomy. Brain 91:619638, 1968 Bell DS: Speech functions of the thalamus inferred from the effects of thalamotomy. Brain 91:619–638, 1968

    • Search Google Scholar
    • Export Citation
  • 4.

    Berkovic SF, & Bladin PF: Rubral tremor: clinical features and treatment of three cases. Clin Exp Neurol 20:119128, 1984 Berkovic SF, Bladin PF: Rubral tremor: clinical features and treatment of three cases. Clin Exp Neurol 20:119–128, 1984

    • Search Google Scholar
    • Export Citation
  • 5.

    Boshes B, , Arbit J, & Dolkart M, et al: The sixth year after L-dopa: quality of life and insights derived. Trans Am Neurol Assoc 100:166168, 1975 Boshes B, Arbit J, Dolkart M, et al: The sixth year after L-dopa: quality of life and insights derived. Trans Am Neurol Assoc 100:166–168, 1975

    • Search Google Scholar
    • Export Citation
  • 6.

    Bravo GJ, & Cooper IS: A clinical and radiological correlation of the lesions produced by chemopallidectomy and thalamectomy. J Neurol Neurosurg Psychiatry 22:110, 1959 Bravo GJ, Cooper IS: A clinical and radiological correlation of the lesions produced by chemopallidectomy and thalamectomy. J Neurol Neurosurg Psychiatry 22:1–10, 1959

    • Search Google Scholar
    • Export Citation
  • 7.

    Bucy PC: Cortical extirpation in treatment of involuntary movements. Res Publ Assoc Res Nerv Ment Dis 21:551595, 1942 Bucy PC: Cortical extirpation in treatment of involuntary movements. Res Publ Assoc Res Nerv Ment Dis 21:551–595, 1942

    • Search Google Scholar
    • Export Citation
  • 8.

    Bullard DE, & Nashold BS Jr: Stereotaxic thalamotomy for treatment of posttraumatic movement disorders. J Neurosurg 61:316321, 1984 Bullard DE, Nashold BS Jr: Stereotaxic thalamotomy for treatment of posttraumatic movement disorders. J Neurosurg 61:316–321, 1984

    • Search Google Scholar
    • Export Citation
  • 9.

    Canter GJ, & Van Lancker DR: Disturbances of the temporal organization of speech following bilateral thalamic surgery in a patient with Parkinson's disease. J Commun Disord 18:329349, 1985 Canter GJ, Van Lancker DR: Disturbances of the temporal organization of speech following bilateral thalamic surgery in a patient with Parkinson's disease. J Commun Disord 18:329–349, 1985

    • Search Google Scholar
    • Export Citation
  • 10.

    Ciemins VA: Localized thalamic hemorrhage. A cause of aphasia. Neurology 20:776782, 1970 Ciemins VA: Localized thalamic hemorrhage. A cause of aphasia. Neurology 20:776–782, 1970

    • Search Google Scholar
    • Export Citation
  • 11.

    Cooper IS: Neurosurgical treatment of the dyskinesias. Clin Neurosurg 24:367390, 1977 Cooper IS: Neurosurgical treatment of the dyskinesias. Clin Neurosurg 24:367–390, 1977

    • Search Google Scholar
    • Export Citation
  • 12.

    Cooper IS, & Poloukhine N: Chemopallidectomy: neurosurgical technique useful in geriatric parkinsonians. J Geriatr Soc 3:839859, 1955 Cooper IS, Poloukhine N: Chemopallidectomy: neurosurgical technique useful in geriatric parkinsonians. J Geriatr Soc 3:839–859, 1955

    • Search Google Scholar
    • Export Citation
  • 13.

    Côté L: Basal ganglia, the extrapyramidal motor system, and diseases of transmitter metabolism, in Kandel ER, & Schwartz JH (eds): Principles of Neural Science. New York: Elsevier/North-Holland, 1981, pp 347357 Côté L: Basal ganglia, the extrapyramidal motor system, and diseases of transmitter metabolism, in Kandel ER, Schwartz JH (eds): Principles of Neural Science. New York: Elsevier/North-Holland, 1981, pp 347–357

    • Search Google Scholar
    • Export Citation
  • 14.

    Delaney P, & Fermaglich J: Parkinsonism and levodopa: a five-year experience. J Clin Pharmacol 16:652659, 1976 Delaney P, Fermaglich J: Parkinsonism and levodopa: a five-year experience. J Clin Pharmacol 16:652–659, 1976

    • Search Google Scholar
    • Export Citation
  • 15.

    Fenelon F: Essais de traitement neurochirurgical du syndrome parkinsonien par intervention directe sur les boies extrapyramidales immediatement sous-striopallidales. Communication suivie de projection du film d'un des opérés pris avant d'après l'intervention. Rev Neurol 83:437440, 1950 Fenelon F: Essais de traitement neurochirurgical du syndrome parkinsonien par intervention directe sur les boies extrapyramidales immediatement sous-striopallidales. Communication suivie de projection du film d'un des opérés pris avant d'après l'intervention. Rev Neurol 83:437–440, 1950

    • Search Google Scholar
    • Export Citation
  • 16.

    Fisher CM: The pathologic and clinical aspects of thalamic hemorrhage. Trans Am Neurol Assoc 84:5659, 1959 Fisher CM: The pathologic and clinical aspects of thalamic hemorrhage. Trans Am Neurol Assoc 84:56–59, 1959

    • Search Google Scholar
    • Export Citation
  • 17.

    Gillingham FJ, , Kalyanaraman S, & Donaldson AA: Bilateral stereotactic lesions in the management of parkinsonism. J Neurosurg 24:449457, 1966 Gillingham FJ, Kalyanaraman S, Donaldson AA: Bilateral stereotactic lesions in the management of parkinsonism. J Neurosurg 24:449–457, 1966

    • Search Google Scholar
    • Export Citation
  • 18.

    Guiot G, & Brion S: Traitement des mouvements anormaux par la coagulation pallidale. Technique et resultats. Rev Neurol 89:578580, 1953 Guiot G, Brion S: Traitement des mouvements anormaux par la coagulation pallidale. Technique et resultats. Rev Neurol 89:578–580, 1953

    • Search Google Scholar
    • Export Citation
  • 19.

    Guiot G, & Derome P: The principles of stereotaxic thalamotomy, in Schneider RC, , Kahn EA, & Crosby EC, et al (eds): Correlative Neurosurgery, ed 3. Springfield, III: Charles C Thomas, 1982, pp 481505 Guiot G, Derome P: The principles of stereotaxic thalamotomy, in Schneider RC, Kahn EA, Crosby EC, et al (eds): Correlative Neurosurgery, ed 3. Springfield, III: Charles C Thomas, 1982, pp 481–505

    • Search Google Scholar
    • Export Citation
  • 20.

    Guiot G, , Hertzog E, & Rondot P, et al: Arrest or acceleration of speech evoked by thalamic stimulation in the course of stereotaxic procedures for parkinsonism. Brain 84:363379, 1961 Guiot G, Hertzog E, Rondot P, et al: Arrest or acceleration of speech evoked by thalamic stimulation in the course of stereotaxic procedures for parkinsonism. Brain 84:363–379, 1961

    • Search Google Scholar
    • Export Citation
  • 21.

    Hassler R: The influence of stimulations and coagulations in the human thalamus on the tremor at rest and its physiopathologic mechanism, in: Proceedings of the Second International Congress of Neuropathology. Part II. Amsterdam: Excerpta Medica, 1955, pp 637642 Hassler R: The influence of stimulations and coagulations in the human thalamus on the tremor at rest and its physiopathologic mechanism, in: Proceedings of the Second International Congress of Neuropathology. Part II. Amsterdam: Excerpta Medica, 1955, pp 637–642

    • Search Google Scholar
    • Export Citation
  • 22.

    Hassler R, , Mundinger F, & Riechert T: Stereotaxis in Parkinson Syndrome. With an Atlas of the Basal Ganglia in Parkinsonism. Berlin: Springer-Verlag, 1979 Hassler R, Mundinger F, Riechert T: Stereotaxis in Parkinson Syndrome. With an Atlas of the Basal Ganglia in Parkinsonism. Berlin: Springer-Verlag, 1979

    • Search Google Scholar
    • Export Citation
  • 23.

    Hoehn MM, , Crowley TJ, & Rutledge CO: Dopamine correlates of neurological and psychological status in untreated parkinsonism. J Neurol Neurosurg Psychiatry 39:941951, 1976 Hoehn MM, Crowley TJ, Rutledge CO: Dopamine correlates of neurological and psychological status in untreated parkinsonism. J Neurol Neurosurg Psychiatry 39:941–951, 1976

    • Search Google Scholar
    • Export Citation
  • 24.

    Hoehn MM, & Yahr MD: Evaluation of the long term results of surgical therapy, in Gillingham FJ, & Donaldson IML (eds): Third Symposium on Parkinson's Disease. Edinburgh: E & S Livingstone, 1969, pp 274280 Hoehn MM, Yahr MD: Evaluation of the long term results of surgical therapy, in Gillingham FJ, Donaldson IML (eds): Third Symposium on Parkinson's Disease. Edinburgh: E & S Livingstone, 1969, pp 274–280

    • Search Google Scholar
    • Export Citation
  • 25.

    Hoehn MM, & Yahr MD: Parkinsonism: onset, progression, and mortality. Neurology 17:427442, 1967 Hoehn MM, Yahr MD: Parkinsonism: onset, progression, and mortality. Neurology 17:427–442, 1967

    • Search Google Scholar
    • Export Citation
  • 26.

    Horsley V: The function of the so-called motor area of the brain. Br Med J 2:125132, 1909 Horsley V: The function of the so-called motor area of the brain. Br Med J 2:125–132, 1909

    • Search Google Scholar
    • Export Citation
  • 27.

    Kall BA, , Kelly PJ, & Goerss SJ, et al: Methodology and clinical experience with computed tomography and a computer-resident stereotactic atlas. Neurosurgery 17:400407, 1985 Kall BA, Kelly PJ, Goerss SJ, et al: Methodology and clinical experience with computed tomography and a computer-resident stereotactic atlas. Neurosurgery 17:400–407, 1985

    • Search Google Scholar
    • Export Citation
  • 28.

    Kelly PJ: Contemporary stereotactic ventralis lateral thalamotomy in the treatment of parkinsonian tremor and other movement disorders, in Heilbrun MP (ed): Stereotactic Neurosurgery. Vol 2. Concepts in Neurosurgery. Baltimore: Williams & Wilkins, 1988, pp 133148 Kelly PJ: Contemporary stereotactic ventralis lateral thalamotomy in the treatment of parkinsonian tremor and other movement disorders, in Heilbrun MP (ed): Stereotactic Neurosurgery. Vol 2. Concepts in Neurosurgery. Baltimore: Williams & Wilkins, 1988, pp 133–148

    • Search Google Scholar
    • Export Citation
  • 29.

    Kelly PJ: Microelectrode recording for the somatotopic placement of stereotactic thalamic lesions in the treatment of parkinsonian and cerebellar intention tremor. Appl Neurophysiol 43:262266, 1980 Kelly PJ: Microelectrode recording for the somatotopic placement of stereotactic thalamic lesions in the treatment of parkinsonian and cerebellar intention tremor. Appl Neurophysiol 43:262–266, 1980

    • Search Google Scholar
    • Export Citation
  • 30.

    Kelly PJ, , Ahlskog JE, & Goerss SJ, et al: Computer-assisted stereotactic ventralis lateralis thalamotomy with micro-electrode recording control in patients with Parkinson's disease. Mayo Clin Proc 62:655664, 1987 Kelly PJ, Ahlskog JE, Goerss SJ, et al: Computer-assisted stereotactic ventralis lateralis thalamotomy with micro-electrode recording control in patients with Parkinson's disease. Mayo Clin Proc 62:655–664, 1987

    • Search Google Scholar
    • Export Citation
  • 31.

    Kelly PJ, , Alker GJ, & Kall BA, et al: Method of computed tomography-based stereotactic biopsy with arteriographic control. Neurosurgery 14:172177, 1984 Kelly PJ, Alker GJ, Kall BA, et al: Method of computed tomography-based stereotactic biopsy with arteriographic control. Neurosurgery 14:172–177, 1984

    • Search Google Scholar
    • Export Citation
  • 32.

    Kelly PJ, , Derome P, & Guiot G: Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control. Surg Neurol 9:307315, 1978 Kelly PJ, Derome P, Guiot G: Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control. Surg Neurol 9:307–315, 1978

    • Search Google Scholar
    • Export Citation
  • 33.

    Kelly PJ, , Earnest F IV, & Kall BA, et al: Surgical options for patients with deep-seated brain tumors: computer-assisted stereotactic biopsy. Mayo Clin Proc 60:223229, 1985 Kelly PJ, Earnest F IV, Kall BA, et al: Surgical options for patients with deep-seated brain tumors: computer-assisted stereotactic biopsy. Mayo Clin Proc 60:223–229, 1985

    • Search Google Scholar
    • Export Citation
  • 34.

    Kelly PJ, & Gillingham FJ: The long-term results of stereotaxic surgery and L-dopa therapy in patients with Parkinson's disease. A 10-year follow-up study. J Neurosurg 53:332337, 1980 Kelly PJ, Gillingham FJ: The long-term results of stereotaxic surgery and L-dopa therapy in patients with Parkinson's disease. A 10-year follow-up study. J Neurosurg 53:332–337, 1980

    • Search Google Scholar
    • Export Citation
  • 35.

    Kelly PJ, , Kall B, & Goerss S: Stereotactic CT scanning for the biopsy of intracranial lesions and functional neurosurgery. Appl Neurophysiol 46:193199, 1983 Kelly PJ, Kall B, Goerss S: Stereotactic CT scanning for the biopsy of intracranial lesions and functional neurosurgery. Appl Neurophysiol 46:193–199, 1983

    • Search Google Scholar
    • Export Citation
  • 36.

    Kocher U, , Siegfried J, & Perret E: Verbal and nonverbal learning ability of Parkinson patients before and after unilateral ventrolateral thalamotomy. Appl Neurophysiol 45:311316, 1982 Kocher U, Siegfried J, Perret E: Verbal and nonverbal learning ability of Parkinson patients before and after unilateral ventrolateral thalamotomy. Appl Neurophysiol 45:311–316, 1982

    • Search Google Scholar
    • Export Citation
  • 37.

    Krayenbühl H, , Wyss OAM, & Yaşargil MG: Bilateral thalamotomy and pallidotomy as treatment for bilateral parkinsonism. J Neurosurg 18:429444, 1961 Krayenbühl H, Wyss OAM, Yaşargil MG: Bilateral thalamotomy and pallidotomy as treatment for bilateral parkinsonism. J Neurosurg 18:429–444, 1961

    • Search Google Scholar
    • Export Citation
  • 38.

    Laitinen LV: Brain targets in surgery for Parkinson's disease. Results of a survey of neurosurgeons. J Neurosurg 62:349351, 1985 Laitinen LV: Brain targets in surgery for Parkinson's disease. Results of a survey of neurosurgeons. J Neurosurg 62:349–351, 1985

    • Search Google Scholar
    • Export Citation
  • 39.

    Marsden CD, & Parkes JD: Success and problems of long-term levodopa therapy in Parkinson's disease. Lancet 1:345349, 1977 Marsden CD, Parkes JD: Success and problems of long-term levodopa therapy in Parkinson's disease. Lancet 1:345–349, 1977

    • Search Google Scholar
    • Export Citation
  • 40.

    Matsumoto K, , Asano T, & Baba T, et al: Long-term follow-up results of bilateral thalamotomy for parkinsonism. Appl Neurophysiol 39:257260, 1976 Matsumoto K, Asano T, Baba T, et al: Long-term follow-up results of bilateral thalamotomy for parkinsonism. Appl Neurophysiol 39:257–260, 1976

    • Search Google Scholar
    • Export Citation
  • 41.

    Matsumoto K, , Shichijo F, & Fukami T: Long-term follow-up review of cases of Parkinson's disease after unilateral or bilateral thalamotomy. J Neurosurg 60:10331044, 1984 Matsumoto K, Shichijo F, Fukami T: Long-term follow-up review of cases of Parkinson's disease after unilateral or bilateral thalamotomy. J Neurosurg 60:1033–1044, 1984

    • Search Google Scholar
    • Export Citation
  • 42.

    Meyers R: The modifications of alternating tremors, rigidity and festination by surgery of the basal ganglia. Res Publ Assoc Res Nerv Ment Dis 21:602665, 1942 Meyers R: The modifications of alternating tremors, rigidity and festination by surgery of the basal ganglia. Res Publ Assoc Res Nerv Ment Dis 21:602–665, 1942

    • Search Google Scholar
    • Export Citation
  • 43.

    Miyamoto T, , Bekku H, & Moriyama E, et al: Present role of stereotactic thalamotomy for parkinsonism. Retrospective analysis of operative results and thalamic lesions in computed tomograms. Appl Neurophysiol 48:294304, 1985 Miyamoto T, Bekku H, Moriyama E, et al: Present role of stereotactic thalamotomy for parkinsonism. Retrospective analysis of operative results and thalamic lesions in computed tomograms. Appl Neurophysiol 48:294–304, 1985

    • Search Google Scholar
    • Export Citation
  • 44.

    Modesti LM, & Blumetti AE: Long term effects of stereotaxic thalamotomy on parameters of cognitive functioning. Acta Neurochir Suppl 30:401403, 1980 Modesti LM, Blumetti AE: Long term effects of stereotaxic thalamotomy on parameters of cognitive functioning. Acta Neurochir Suppl 30:401–403, 1980

    • Search Google Scholar
    • Export Citation
  • 45.

    Modesti LM, & Van Buren JM: Hemiballismus complicating stereotactic thalamotomy. Appl Neurophysiol 42:267283, 1979 Modesti LM, Van Buren JM: Hemiballismus complicating stereotactic thalamotomy. Appl Neurophysiol 42:267–283, 1979

    • Search Google Scholar
    • Export Citation
  • 46.

    Nagaseki Y, , Shibazaki T, & Hirai T, et al: Long-term follow-up results of selective VIM-thalamotomy. J Neurosurg 65:296302, 1986 Nagaseki Y, Shibazaki T, Hirai T, et al: Long-term follow-up results of selective VIM-thalamotomy. J Neurosurg 65:296–302, 1986

    • Search Google Scholar
    • Export Citation
  • 47.

    Narabayashi H, & Ohye C: Parkinsonian tremor and nucleus ventralis intermedius of the human thalamus, in Desmedt JE (ed): Progress in Clinical Neurophysiology. Vol 5: Physiological Tremor, Pathological Tremors, and Clonus. Basel: S Karger, 1978, pp 165172 Narabayashi H, Ohye C: Parkinsonian tremor and nucleus ventralis intermedius of the human thalamus, in Desmedt JE (ed): Progress in Clinical Neurophysiology. Vol 5: Physiological Tremor, Pathological Tremors, and Clonus. Basel: S Karger, 1978, pp 165–172

    • Search Google Scholar
    • Export Citation
  • 48.

    Ojemann GA, & Ward AA Jr: Abnormal movement disorders, in Youmans JR (ed): Neurological Surgery, ed 2. Philadelphia: WB Saunders, 1982, Vol 6, pp 38213857 Ojemann GA, Ward AA Jr: Abnormal movement disorders, in Youmans JR (ed): Neurological Surgery, ed 2. Philadelphia: WB Saunders, 1982, Vol 6, pp 3821–3857

    • Search Google Scholar
    • Export Citation
  • 49.

    Ojemann GA, & Ward AA Jr: Speech representation in ventrolateral thalamus. Brain 94:669680, 1971 Ojemann GA, Ward AA Jr: Speech representation in ventrolateral thalamus. Brain 94:669–680, 1971

    • Search Google Scholar
    • Export Citation
  • 50.

    Riklan M, & Cooper IS: Psychometric studies of verbal functions following thalamic lesions in humans. Brain Lang 2:4564, 1975 Riklan M, Cooper IS: Psychometric studies of verbal functions following thalamic lesions in humans. Brain Lang 2:45–64, 1975

    • Search Google Scholar
    • Export Citation
  • 51.

    Rossitch E Jr, , Zeidman SM, & Nashold BS Jr, et al: Evaluation of memory and language function pre- and post-thalamotomy with an attempt to define those patients at risk for postoperative dysfunction. Surg Neurol 29:1116, 1988 Rossitch E Jr, Zeidman SM, Nashold BS Jr, et al: Evaluation of memory and language function pre- and post-thalamotomy with an attempt to define those patients at risk for postoperative dysfunction. Surg Neurol 29:11–16, 1988

    • Search Google Scholar
    • Export Citation
  • 52.

    Shapiro DY, , Sadowsky DA, & Henderson WG, et al: An assessment of cognitive function in postthalamotomy Parkinson patients. Confin Neurol 35:144166, 1973 Shapiro DY, Sadowsky DA, Henderson WG, et al: An assessment of cognitive function in postthalamotomy Parkinson patients. Confin Neurol 35:144–166, 1973

    • Search Google Scholar
    • Export Citation
  • 53.

    Speelman JD, & van Manen J: Cerebral palsy and stereotactic neurosurgery: long term results. J Neurol Neurosurg Psychiatry 52:2330, 1989 Speelman JD, van Manen J: Cerebral palsy and stereotactic neurosurgery: long term results. J Neurol Neurosurg Psychiatry 52:23–30, 1989

    • Search Google Scholar
    • Export Citation
  • 54.

    Speelman JD, & van Manen J: Stereotactic thalamotomy for the relief of intention tremor of multiple sclerosis. J Neurol Neurosurg Psychiatry 47:596599, 1984 Speelman JD, van Manen J: Stereotactic thalamotomy for the relief of intention tremor of multiple sclerosis. J Neurol Neurosurg Psychiatry 47:596–599, 1984

    • Search Google Scholar
    • Export Citation
  • 55.

    Spiegel EA, & Wycis HT: Ansotomy in paralysis agitans. Demonstration of results by motion pictures and electromyograms. Trans Am Neurol Assoc 78:178183, 1953 Spiegel EA, Wycis HT: Ansotomy in paralysis agitans. Demonstration of results by motion pictures and electromyograms. Trans Am Neurol Assoc 78:178–183, 1953

    • Search Google Scholar
    • Export Citation
  • 56.

    Stellar S, & Cooper IS: Mortality and morbidity in cryothalamectomy for parkinsonism. A statistical study of 2868 consecutive operations. J Neurosurg 28:459467, 1968 Stellar S, Cooper IS: Mortality and morbidity in cryothalamectomy for parkinsonism. A statistical study of 2868 consecutive operations. J Neurosurg 28:459–467, 1968

    • Search Google Scholar
    • Export Citation
  • 57.

    Tasker RR, , Doorly T, & Yamashiro K: Thalamotomy in generalized dystonia. Adv Neurol 50:615631, 1988 Tasker RR, Doorly T, Yamashiro K: Thalamotomy in generalized dystonia. Adv Neurol 50:615–631, 1988

    • Search Google Scholar
    • Export Citation
  • 58.

    Tasker RR, , Siqueira J, & Hawrylyshyn P, et al: What happened to VIM thalamotomy for Parkinson's disease? Appl Neurophysiol 46:6883, 1983 Tasker RR, Siqueira J, Hawrylyshyn P, et al: What happened to VIM thalamotomy for Parkinson's disease? Appl Neurophysiol 46:68–83, 1983

    • Search Google Scholar
    • Export Citation
  • 59.

    Tomlinson FH, , Jack CR Jr, & Kelly PJ: Sequential magnetic resonance imaging following stereotactic radiofrequency ventralis lateralis thalamotomy. J Neurosurg 74:579584, 1991 Tomlinson FH, Jack CR Jr, Kelly PJ: Sequential magnetic resonance imaging following stereotactic radiofrequency ventralis lateralis thalamotomy. J Neurosurg 74:579–584, 1991

    • Search Google Scholar
    • Export Citation
  • 60.

    Velasco F, , Velasco M, & Ogarrio C, et al: Neglect induced by thalamotomy in humans: a quantitative appraisal of the sensory and motor deficits. Neurosurgery 19:744751, 1986 Velasco F, Velasco M, Ogarrio C, et al: Neglect induced by thalamotomy in humans: a quantitative appraisal of the sensory and motor deficits. Neurosurgery 19:744–751, 1986

    • Search Google Scholar
    • Export Citation
  • 61.

    Vilkki J: Visual hemi-inattention after ventrolateral thalamotomy. Neuropsychologia 22:399408, 1984 Vilkki J: Visual hemi-inattention after ventrolateral thalamotomy. Neuropsychologia 22:399–408, 1984

    • Search Google Scholar
    • Export Citation
  • 62.

    Waltz JM, , Aristizabal G, & Riklan M, et al: Results of cryothalamectomy for parkinsonism in patients over 70. J Am Geriatr Soc 15:18, 1967 Waltz JM, Aristizabal G, Riklan M, et al: Results of cryothalamectomy for parkinsonism in patients over 70. J Am Geriatr Soc 15:1–8, 1967

    • Search Google Scholar
    • Export Citation
  • 63.

    Waltz JM, , Riklan M, & Stellar S, et al: Cryothalamectomy for Parkinson's disease. A statistical analysis. Neurology 16:9941002, 1966 Waltz JM, Riklan M, Stellar S, et al: Cryothalamectomy for Parkinson's disease. A statistical analysis. Neurology 16:994–1002, 1966

    • Search Google Scholar
    • Export Citation
  • 64.

    Zager EL: Neurosurgical management of spasticity, rigidity, and tremor. Neurol Clin 5:631647, 1987 Zager EL: Neurosurgical management of spasticity, rigidity, and tremor. Neurol Clin 5:631–647, 1987

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 337 230 3
Full Text Views 186 4 0
PDF Downloads 98 3 0
EPUB Downloads 0 0 0