STEREOTAXIC TREATMENT OF MOVEMENT-DISORDE RS

Stereotactic surgery for movement disorders is currently undergoing a re-evaluation. A new understanding of the pathophysiology makes the su rgical lesion a logical step for the aleviation of both hyperkinetic s ymptoms such as tremor and hypokinetic symptoms like bradykinesia. Adv ances in imaging and electrophysiological control render these procedu res more accurate and safer. Indications are medically refractory, Par kinsonean tremor, essential tremor, cerebellar tremor, bradykinesia an d L-Dopa induced dyskinesis. The standard procedure is ablative surger y, i.e. thalamotomy for tremors and pallidotomy for bradykinesia, dyst onia and L-Dopa induced dyskinesias. Deep brain stimulation is a novel alternative for selected patients which is currently evaluated. Neura l transplantation of autologus,fetal or genetically manipulated cell s uspensions into the striatum for the time being is experimental.