Pallidotomy, thalamotomy and deep brain stimulation for severe Parkinson's disease
Development and Evaluation Committee
Record ID 32000008155
English
Authors' objectives:
To summarise the available evidence on the use of pallidotomy, thalamotomy and deep brain stimulation for severe Parkinson's disease.
Authors' recommendations:
Pallidotomy: A recently published good quality trial shows that pallidotomy offers benefits to patients with severe Parkinsonian dyskinesias. The clinical consensus is that these benefits are likely to last for several years. The perhaps unavoidably small size of the trial and the fact that the outcomes reported to date are hard to assess in terms of quality of life makes the value for money of the procedure difficult to assess. The place of pallidotomy in the management of severe Parkinson-s disease is likely to change with the development of deep brain stimulation. It should only be undertaken in centres with expertise in the operation and in the context of rigorous evaluation.
Thalamotomy: Thalamotomy is a long established operation for which no randomised controlled trials have been found. Its use is supported by the consensus of clinicians expert in the area as a treatment for severe disabling tremor. For such patients, even a small improvement in quality of life might represent good value for money. The place of thalamotomy in the management of severe Parkinson-s disease is changing with the development of deep brain stimulation. It should only be undertaken in centres with expertise in the operation and in the context of rigorous evaluation.
Deep brain stimulation: The Committee recognised that deep brain stimulation (DBS) comprises a rapidly evolving set of treatments which may offer benefit to severely disabled patients. It is very costly, and at present, there is insufficient evidence to reach a conclusion on its efficacy.
Authors' methods:
Overview
Details
Project Status:
Completed
URL for project:
http://www.wihrd.soton.ac.uk
Year Published:
1999
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England
MeSH Terms
- Costs and Cost Analysis
- Electric Stimulation
- Thalamus
- Globus Pallidus
- Parkinson Disease
Contact
Organisation Name:
Wessex Institute for Health Research and Development
Contact Address:
Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662
Copyright:
Wessex Institute for Health Research and Development (WIHRD)
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