Movement disorders are neurological syndromes where they may be excess of movement or a paucity of movement that is not connected to weakness, paralysis of spasticity of the muscles. They affect the speed, fluency or smoothness, quality, and ease of movement.Parkinson’s disease is the best known movement disorder. It affects one in 500 individuals and in most cases is caused by genetic predisposition or exposure to certain drugs and toxins.
Surgery for Movement Disorder
- Surgery has become a well-established form of therapy in movement disorders such as in Parkinson’s disease(PD) and essential tremor (ET),especially for patients with symptoms that are refractory to medications or who have intolerable side effects related to medical therapy.Other movement disorders also appear to benefit from stereotactic surgery including dystonia, tremors associated with multiple sclerosis,and tics seen in Tourette’s syndrome (TS).
- Stereotactic Radiosurgery
The risks associated with this surgery are similar to those of pallidotomy and thalamotomy. Unlike making a permanent cut in the brain tissue however, the stimulation may be turned off if undesirable side effects occur.
Stereotactic radiosurgery has offered a new ray of hope to the patients who cannot undergo traditional surgery either because of their frail health or because the tumor is located in an area which s too risky to access.
This operation involves placing an electrode in a part of the brain called the thalamus. An electrode is a special coated wire which sends an electrical signal. This electrode is one part of a three-part system that provides electrical stimulation to the thalamus. The system includes:
- The electrode
- A wire that is tunneled under the scalp to a site just below the collarbone
- A pulse generator
Following symptoms are occured in movement disorder:
- Dopamine agonists may cause nausea,
Parkinson's disease may be treated using a number of different medications. Botulinum toxin injection therapy (BOTOX therapy) is used to treat some types of movement disorders (e.g.,spasmodic torticollis,blepharospasm,myoclonus,tremorr).
The procedure is done under general anesthesia in the supine position, with a wedge under the shoulder and with the head put aside so that the space behind the ear is freely accessible. The operation begins with a slightly curved incision just behind the ear, after which the muscle attachment is detached. Hair behind the ear is shaved and a small part of your skull is removed. The nerve is identified and pieces of Teflon are placed between the nerve and the offending blood vessel(s). The small area of bone removal is then covered with a thin metal mesh.