Frequency of Improvement in Muscular Rigidity after Pallidotomy in Medically Refractive Parkinsonian Patients
Objective: To find out frequency of improvement in muscular rigidity after Pallidotomy in Parkinsonian patients who are medically refractory.
Material and Methods: This prospective descriptive study conducted in Neurosurgical Unit II, Punjab Institute of Neuro-Sciences, LGH, Lahore, during the period of one year from March 2015 to February 2016. They were evaluated before admission by history and thorough examination and then investigated with a CT scan and MRI of the brain. This study included patients as young as 30 years to as old as 65 years. Those patients who had trauma, stroke, demyelination or lesion in basal ganglia were excluded from the study.
Results: 75 patients were included in the study with no lost to follow up. At the time of presentation, baseline rigidity graded as 3 in 37 (49.3%) and grade 4 in 38 (50.67%) patients. Reduction in rigidity at ≥ 25%, was considered significant improvement. At 3 months follow up 49 (65.3%) patients had UPRDS grade 1 while 26 (34.7%) had (Unipied Parkinson’s Disease Rating Score) UPRDSS grade 2 and no patient shown UPRDS grade 3 or 4. Out of 37 patients who had UPRDS grade 3 at baseline, 32 had grade 1 while 5 had grade 2 after Pallidotomy. Out of 38 patients, who had UPRDS grade 4 at baseline, 17 had UPRDS grade 1 while 21 had UPRDS grade 2 after pallidotomy. The difference was calculated to be significantly high (p < 0.001).
Conclusion: Pallidotomy is one of the successful surgical procedures to reduce Parkinsonian muscular rigidity.
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