Movement disorders

Movement disorders

Prior to the development of levodopa drug therapy , surgical ablation of the subthalamic nucleus (STN) or globus pallidus interna (GPi) was a mainstay of management for Parkinson’s disease. Inhibition of the action of these centres remains a - valuable tool later in the course of the disease as the therapeu - tic window using levodopa narrows, but this is now achieved using deep brain stimulation with electrodes. This o ff ers the advantage of an adjustable and reversible e ff ect and can be y performed bila terally where equivalent lesioning surgery would probably result in deficits. Deep brain stimulation is also an option for other move - ment disorders where less invasive approaches are ine ff ective. These include dystonias, which may be amenable to bilateral GPi stimulation, and essential tremor, where the ventralis inter - mediate n ucleus (Vim) of the thalamus is a preferred target. Movement disorders

Prior to the development of levodopa drug therapy , surgical ablation of the subthalamic nucleus (STN) or globus pallidus interna (GPi) was a mainstay of management for Parkinson’s disease. Inhibition of the action of these centres remains a - valuable tool later in the course of the disease as the therapeu - tic window using levodopa narrows, but this is now achieved using deep brain stimulation with electrodes. This o ff ers the advantage of an adjustable and reversible e ff ect and can be y performed bila terally where equivalent lesioning surgery would probably result in deficits. Deep brain stimulation is also an option for other move - ment disorders where less invasive approaches are ine ff ective. These include dystonias, which may be amenable to bilateral GPi stimulation, and essential tremor, where the ventralis inter - mediate n ucleus (Vim) of the thalamus is a preferred target. Movement disorders

Prior to the development of levodopa drug therapy , surgical ablation of the subthalamic nucleus (STN) or globus pallidus interna (GPi) was a mainstay of management for Parkinson’s disease. Inhibition of the action of these centres remains a - valuable tool later in the course of the disease as the therapeu - tic window using levodopa narrows, but this is now achieved using deep brain stimulation with electrodes. This o ff ers the advantage of an adjustable and reversible e ff ect and can be y performed bila terally where equivalent lesioning surgery would probably result in deficits. Deep brain stimulation is also an option for other move - ment disorders where less invasive approaches are ine ff ective. These include dystonias, which may be amenable to bilateral GPi stimulation, and essential tremor, where the ventralis inter - mediate n ucleus (Vim) of the thalamus is a preferred target.