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Percutaneous Injection of the Thalamus in Parkinsonism: A Preliminary Report: Relief of Bilateral Facial Grimaces

Percutaneous Injection of the Thalamus in Parkinsonism: A Preliminary Report: Relief of Bilateral... Abstract Injection of the thalamus through a cranial bur hole is performed for rigidity and tremor,1-3 spasticity,4 intractable pain,5,6 dystonia musculorum deformans,7 or hemiballismus.8 Some of the more precise stereotaxic methods take several hours. With the cannula and balloon technique, there is a mortality rate of 2.4%, and an additional complication rate (usually hemiplegia) of 3%.2 Furthermore, only about one out of three Parkinsonians are accepted for the procedure.9 We had had previous experience with radiologically planned and controlled percutaneous placement of a needle through the foramen ovale into the region of the Gasserian ganglion and subsequent injection of procaine, followed by alcohol.10,11 We report here a similar approach to making lesions in the thalamus, thalamolysis, primarily to relieve contralateral rigidity and tremor of Parkinsonism. The target (a mathematical point) in the ventrolateral nucleus of the thalamus is determined by measurement from the References 1. Bravo, G. J., and Cooper, I. S.: A Clinical and Radiological Correlation of the Lesions Produced by Chemopallidectomy and Thalamectomy , J. Neurol. Neurosurg. & Psychiat. 22:1 ( (Feb.) ) 1959. 2. Cooper, I. S., and Bravo, G. J.: Chemopallidectomy and Chemothalamectomy , J. Neurosurg. 15:244 ( (May) ) 1958. 3. Spiegel, E. A., and Wycis, H. T.: Stereoencephalotomy: Principles and Methods, in Premier Congrés Internationale de Neurochirurgie, Brussels, 1957, p. 91. 4. Spiegel, E. A.; Wycis, H. T., and Baird, H. W., III: Long-Range Effects of Electropallido Ansotomy in Extrapyramidal and Convulsive Disorders , Neurology 8:734 ( (Aug.) ) 1958. 5. Wycis, H. T.; Folkerts, J. F., and Spiegel, E. A.: Treatment of Post-Herpetic Trigeminal Neuralgia by Mesencephalotomy or Combined Mesencephalothalamotomy , Zentralbl. Neurochir. 18:188, 1958. 6. Hassler, R.: Functional Anatomy of the Thalamus, VI Congr. Latino-Americano de Neurocirurgia, Montevideo, 1955, p. 754. 7. Cooper, I. S.: Dystonia Musculorum Deformans Alleviated by Chemopallidectomy and Chemopallidothalamectomy , A.M.A. Arch. Neurol. & Psychiat. 81:5 ( (Jan.) ) 1959. 8. Martin, J. P., and McCaul, I. R.: Acute Hemiballismus Treated by Ventrolateral Thalamolysis , Brain 82:104 ( (March) ) 1959. 9. Cooper, I. S.: Personal communication to the authors, 1958. 10. Ecker, A., and Perl, T.: Alcoholic Gasserian Injection for Relief of Tic Douloureux , Neurology 8:461 ( (June) ) 1958. 11. Perl, T., and Ecker, A.: Radiologically Controlled Placement of a Needle in the Trigeminal Root for the Treatment of Tic Douloureux , Am. J. Roentgenol. 82:830 ( (Nov.) ) 1959. 12. Spiegel, E. A., and Wycis, H. T.: Stereoencephalotomy (Thalamotomy and Related Procedures) , New York, Grune & Stratton, Inc., 1952, pp. 55, 123, 127. 13. Riley, H. A.: An Atlas of the Basal Ganglia, Brain Stem, and Spinal Cord Based on Myelin-Stained Material , Baltimore, Williams & Wilkins Company, 1943, pp. 264, 270, 516. 14. Schwab, R. S.: England, A. C., and Peterson, E.: Akinesia in Parkinson's Disease , Neurology 9:65 ( (Jan.) ) 1959. 15. Monnier, M.: Les résultats de la coagulation du thalamus chez l'homme (noyau ventroposterior), in Röntgendiagnostische Probleme bei intrakraniellen Geschwülsten , Acta Neurochir ., (Suppl. 3) , 1955, p. 291. 16. Gerstmann, J., and Schilder, P.: Über organisch bedingte Tics , Med. Klin. 19:896 ( (June 30) ) 1923. 17. Clauss, J. L., and Balthasar, K.: Zur Kenntnis der generalisierten Tic-Krankheit (maladie des tics, Gilles de la Tourette'sche Krankheit) , Arch. Psychiat. 191:398, 1954. 18. Hess, W. R.: Hypothalamus und Thalamus , Stuttgart, Georg Thieme Verlag, 1956, p.47. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Percutaneous Injection of the Thalamus in Parkinsonism: A Preliminary Report: Relief of Bilateral Facial Grimaces

Archives of Neurology , Volume 3 (3) – Sep 1, 1960

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1960.00450030049005
Publisher site
See Article on Publisher Site

Abstract

Abstract Injection of the thalamus through a cranial bur hole is performed for rigidity and tremor,1-3 spasticity,4 intractable pain,5,6 dystonia musculorum deformans,7 or hemiballismus.8 Some of the more precise stereotaxic methods take several hours. With the cannula and balloon technique, there is a mortality rate of 2.4%, and an additional complication rate (usually hemiplegia) of 3%.2 Furthermore, only about one out of three Parkinsonians are accepted for the procedure.9 We had had previous experience with radiologically planned and controlled percutaneous placement of a needle through the foramen ovale into the region of the Gasserian ganglion and subsequent injection of procaine, followed by alcohol.10,11 We report here a similar approach to making lesions in the thalamus, thalamolysis, primarily to relieve contralateral rigidity and tremor of Parkinsonism. The target (a mathematical point) in the ventrolateral nucleus of the thalamus is determined by measurement from the References 1. Bravo, G. J., and Cooper, I. S.: A Clinical and Radiological Correlation of the Lesions Produced by Chemopallidectomy and Thalamectomy , J. Neurol. Neurosurg. & Psychiat. 22:1 ( (Feb.) ) 1959. 2. Cooper, I. S., and Bravo, G. J.: Chemopallidectomy and Chemothalamectomy , J. Neurosurg. 15:244 ( (May) ) 1958. 3. Spiegel, E. A., and Wycis, H. T.: Stereoencephalotomy: Principles and Methods, in Premier Congrés Internationale de Neurochirurgie, Brussels, 1957, p. 91. 4. Spiegel, E. A.; Wycis, H. T., and Baird, H. W., III: Long-Range Effects of Electropallido Ansotomy in Extrapyramidal and Convulsive Disorders , Neurology 8:734 ( (Aug.) ) 1958. 5. Wycis, H. T.; Folkerts, J. F., and Spiegel, E. A.: Treatment of Post-Herpetic Trigeminal Neuralgia by Mesencephalotomy or Combined Mesencephalothalamotomy , Zentralbl. Neurochir. 18:188, 1958. 6. Hassler, R.: Functional Anatomy of the Thalamus, VI Congr. Latino-Americano de Neurocirurgia, Montevideo, 1955, p. 754. 7. Cooper, I. S.: Dystonia Musculorum Deformans Alleviated by Chemopallidectomy and Chemopallidothalamectomy , A.M.A. Arch. Neurol. & Psychiat. 81:5 ( (Jan.) ) 1959. 8. Martin, J. P., and McCaul, I. R.: Acute Hemiballismus Treated by Ventrolateral Thalamolysis , Brain 82:104 ( (March) ) 1959. 9. Cooper, I. S.: Personal communication to the authors, 1958. 10. Ecker, A., and Perl, T.: Alcoholic Gasserian Injection for Relief of Tic Douloureux , Neurology 8:461 ( (June) ) 1958. 11. Perl, T., and Ecker, A.: Radiologically Controlled Placement of a Needle in the Trigeminal Root for the Treatment of Tic Douloureux , Am. J. Roentgenol. 82:830 ( (Nov.) ) 1959. 12. Spiegel, E. A., and Wycis, H. T.: Stereoencephalotomy (Thalamotomy and Related Procedures) , New York, Grune & Stratton, Inc., 1952, pp. 55, 123, 127. 13. Riley, H. A.: An Atlas of the Basal Ganglia, Brain Stem, and Spinal Cord Based on Myelin-Stained Material , Baltimore, Williams & Wilkins Company, 1943, pp. 264, 270, 516. 14. Schwab, R. S.: England, A. C., and Peterson, E.: Akinesia in Parkinson's Disease , Neurology 9:65 ( (Jan.) ) 1959. 15. Monnier, M.: Les résultats de la coagulation du thalamus chez l'homme (noyau ventroposterior), in Röntgendiagnostische Probleme bei intrakraniellen Geschwülsten , Acta Neurochir ., (Suppl. 3) , 1955, p. 291. 16. Gerstmann, J., and Schilder, P.: Über organisch bedingte Tics , Med. Klin. 19:896 ( (June 30) ) 1923. 17. Clauss, J. L., and Balthasar, K.: Zur Kenntnis der generalisierten Tic-Krankheit (maladie des tics, Gilles de la Tourette'sche Krankheit) , Arch. Psychiat. 191:398, 1954. 18. Hess, W. R.: Hypothalamus und Thalamus , Stuttgart, Georg Thieme Verlag, 1956, p.47.

Journal

Archives of NeurologyAmerican Medical Association

Published: Sep 1, 1960

References