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Document Type

Original Article

Abstract

Background: Since its inception in the early 1950s, the radiofrequency (RF) ablative technique has served a crucial function in the treatment of movement problems. Ablative surgery is encouraging since it doesn't require substantial perioperative care, doesn't run the risk of hardware issues, and it expenses less than deep brain stimulation. Aim of the work: This study is to evaluate the efficacy and safety of RF ablative surgery for medically intractable movement disorders. Patients and Methods: This study was conducted retrospectively on 20 patients with medically refractory movement disorders who had undergone macrostimulation-guided RF ablative surgery in the institutions affiliated with Al-Azhar University between December 2018 and March 2021. Results: Thirty-five radiofrequency ablative treatments were performed on twenty patients, with an overall average age of 53.75 years, including Thirteen male and Seven female patients. There was a noticeable improvement in the contralateral rigidity (68.24%), tremors (84.29%), and bradykinesia (75.36%), bringing the overall UPDRS-III-off stage from pre-op 46.11 to post-op 14.89. The BFMDRS total movement score improved from a mean 46.5 prior to surgery to 29 one month later, representing a 37.63% improvement. Additionally, the disability score decreased from 14.25 prior to surgery to 11, which represents a 22.8% improvement. Conclusions: For carefully chosen PD patients with no additional risk, the combination of macrostimulation guided unilateral Vim thalamotomy and PVP technique looks like to be an acceptable and cost-effective treatment for patients with tremor, rigidity, and bradykynesia who are refractory to medical treatment.

Keywords

Dystonia; Macrostimulation; Pallidotomy; Parkinsonism; Thalamotomy

Subject Area

Neurosurgery

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