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Vol. 15. Issue 1.
Pages 5-16 (January 2004)
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Vol. 15. Issue 1.
Pages 5-16 (January 2004)
Tratamiento quirúrgico de la enfermedad de Parkinson
Surgical treatment for Parkinson's disease
J. Guridi
, M.C. Rodríguez-Oroz, M. Manrique
Servicio de Neurocirugía. Departamento de Neurociencias. Clínica Universitaria. Universidad de Navarra. Pamplona
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Resumen

Desde hace varios años, estamos asistiendo a un renovado interés en el tratamiento quirúrgico de la enfermedad de Parkinson. Esto ha sido debido, por un lado, a la progresión de la enfermedad y a que el tratamiento farmacológico no puede aliviar la aparición de complicaciones motoras y disquinesias que ocurren tras algunos años. En segundo lugar, al avance de las técnicas quirúrgicas, como la mejora en la técnicas estereotácticas con una disminución en la morbilidad quirúrgica. Por último, a la aparición de la estimulación cerebral a alta frecuencia que permite no lesionar estructuras cerebrales. En esta revisión mostramos la eficacia de los diferentes tratamientos quirúrgicos que actualmente se están realizando en los pacientes con esta enfermedad. Lesión, estimulación cerebral profunda y reinervación son revisados y discutidos.

Palabras clave:
Enfermedad de Parkinson
Palidotomía
Subtalamotomía
Estimulación cerebral profunda
Reinervación dopaminérgica
Summary

In the past years there has been an increasing inte-rest in the surgical therapies for Parkinson's disease. This renewed interest is related to differents factors. First, pharmacological treatments are still unable to alter substantially the progression of the disease and after a few years they generally cause motor compli-cations and dyskinesias. Secondly, the great advances in the surgical techniques, especially with the improve-ment of stereotactic surgery, have decreased morbidity in recent years. Finally, the introduction of deep brain stimulation, now allows surgical treatment without damaging brain structures. In this review, different surgical treatments are summarized. Ablative surgery, deep brain stimulation and reinervation therapies are described.

Key words:
Parkinson's disease
Palidotomy
Subthalamotomy
Deep Brain Stimulation (DBS)
Dopaminergic reinervation

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