Study Design: Prospective study
Objective: To report efficacy of unilateral combined stereotactic radiofrequency pallidotomy and thalamotomy for Idiopathic Parkinson’s disease.
Methods: Between June 2017 to December 2019, 62 patients with idiopathic Parkinson’s disease underwent stereotactic radiofrequency pallidotomy and thalamotomy. Pre-operatively clinical assessment using the UPDRS and Hoen and Yahr scale for PD. Post-operatively clinical assessment using the UPDRS and Hoen and Yahr scale for PD, complications in 1,6,12 and 24 months.
Results: 60 patients completed two-year follow-up and fulfilled our criteria were recruited. The mean age was 57.47±9.90. The average UPDRS off motor assessment results showed reduction after 1 month from 60.16 to 30.88 and at 24-month follow-up was 41.6. The average Yahr and Hoen scale 3.63 to 1.19 after 1-month and 24 months was 1.87. The average UPDRS constancy of tremors improved after 1-month from 3.53 to 0.75. Improvement in constancy of tremors reached 75% of cases after 24-month with average 1.62. the average UPDRS rigidity score improved at 1-month follow-up from 3.31 to 1.21. Total improvement of rigidity reached 63% after 24-month. 2 patients had post-operative thalamic hematoma presented with hemiplegia, which was conservatively managed, and improved after 1-month with little deficit. 51.6% had gait imbalance at 6-month follow-up. 22.5% showed dysarthria immediately while 12.9% totally resolved after 1-month follow-up. No recorded cases of infection, CSF leaks or cognitive dysfunction.
Conclusion: Our data suggest that Unilateral combined stereotactic radiofrequency pallidotomy and thalamotomy for Idiopathic PD is effective procedure.