Summary
In the course of stereotaxic thalamotomy by Leksell's open system in 20 cases of abnormal movement, recording and stimulation of the subcortical structures have been performed by means of two semimicro-electrodes introduced parallel to the frontal plane. Taking advantage of simultaneous recording and electrical stimulation through these two electrodes, several critical points in the caudate nucleus and thalamus have been clearly delineated. Thus in each individual case an outline of the thalamic configuration in the frontal plane could be obtained, so that the final therapeutic lesion was placed with good precision at the lowermost border of VL or Vim nucleus. It has been shown that the physiologically determined minimum lesion resulted in satisfactory alleviation of the abnormal movements without notable untoward effects.
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References
Albe-Fessard, D., Arfel, G., Guiot, G., Activités électriques caractéristiques de quelques structures cérébrales chez l'homme. Ann. Chir.17 (1963), 1185–1214.
Andy, O. J., Jurko, M. F., Fred, R. S. Jr., Subthalamotomy in treatment of parkinsonian tremor. J. Neurosurg.20 (1963), 860–870.
Buchwald, J. S., Grover, F. S., Amplitudes of background fast activity characteristic of specific brain sites. J. Neurophysiol.33 (1970), 148–159.
Cooper, I. S., Samra, K., Bergmann, L., The thalamic lesion which abolishes tremor and rigidity of parkinsonism. A radiologico-clinico-anatomic correlative study. J. Neurol. Sci.8 (1969), 69–84.
Dewulf, A., Anatomy of the normal human thalamus. Amsterdam-London-New York: Elsevier Publishing Company. 1971.
Fukamachi, A., Ohye, C., Saito, Y., Narabayashi, H., Estimation of the neurol noise within the human thalamus. Presented at the 2nd Meeting of the European Society for Stereotactic and Functional Neurosurgery (to be published).
—, Ohye, C., Narabayashi, H., Delineation of the thalamic nuclei with a microelectrode in stereotaxic surgery for parkinsonism and cerebral palsy. J. Neurosurg.39 (1973), 214–225.
Grover, F. S., Buchwald, J. S., Correlation of cell size with amplitude of background fast activity in specific brain nuclei. J. Neurophysiol.33 (1970), 160–171.
Guiot, G., Arfel, G., Derome, P., La chirurgie stéréotaxique des tremblements de repos et d'attitude. Gazette Med.75 (1968), 4029–4056.
Jasper, H. H., Bertrand, G., Thalamic units involved in somatic sensation and voluntary and involuntary movements in man. In: The Thalamus, pp. 365–390. New York: Columbia Univ. Press 1966.
Leksell, L., Stereotaxis and radiosurgery. An operative system. Springfield, Ill.: Ch. C Thomas. 1971.
Mundinger, F., Riechert, T., Die Stereotaktischen Hirnoperationen zur Behandlung extrapyramidaler Bewegungsstörungen (Parkinsonismus und Hyperkinesen) und ihre Resultate (Teil A). Neurol. Psychiat.31 (1963), 1–65.
Narabayashi, H., Kubota, K., Reconsideration of ventrolateral thalamotomy for hyperkinesis. In: Progress in Brain Research, Vol. 21 B, pp. 339–349 (T. Tokizane and J. P. Schade, eds.). Amsterdam: Eisevier. 1966.
—, Ohye, C., Nucleus ventralis intermedius of human thalamus. Trans. Amer. Neurol. Ass.99 (1975), 232–233.
Ohye, C., Functional organization of the human thalamus. Clinical Physiol.1 (1971), 243–257. (Jap.)
—, Fukamachi, A., Narabayashi, H., Spontaneous and evoked activity of sensory neurons and their organization in the human thalamus. Z. Neurol.203 (1972), 219–234.
—, Kubota, K., Hongo, T., Nagao, T., Narabayashi, H., Ventrolateral and subsubventrolateral thalamic stimulation. Arch. Neurol. (Chic.)11 (1964), 427–434.
—, Nakamura, R., Fukamachi, A., Narabayashi, H., Recording and stimulation of the ventralis intermedius nucleus of the human thalamus. Conf. Neurol.37 (1975), 258.
Saito, Y., Ohye, C., Automatically controlled recording and processing of thalamic unit discharges in human stereotaxic operation. Conf. Neurol.36 (1974), 314–325.
Spiegel, E. A., Wycis, H. T., Szekely, E. G., Adams, J., Flanagan, M., Baird, H. W., Campotomy in various extrapyramidal disorders. J. Neurosurg.20 (1963), 871–884.
Taren, J., Guiot, G., Derome, P., Trigo, J. C., Hazards of stereotaxic thalamectomy: Added safety factor in corroborating X-Ray target localization with neurophysiological methods. J. Neurosurg.29 (1968), 173–182.
Velasco, F., Molina-Negro, P., Electrophysiological topography of the human diencephalon. J. Neurosurg.38 (1973), 204–214.
—, Molina-Negro, P., Bertrand, C., Hardy, J., Further definition of the subthalamic target for arrest of tremor. J. Neurosurg.36 (1972), 184–191.
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Ohye, C., Fukamachi, A., Miyazaki, M. et al. Physiologically controlled selective thalamotomy for the treatment of abnormal movement by Leksell's open system. Acta neurochir 37, 93–104 (1977). https://doi.org/10.1007/BF01401928
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DOI: https://doi.org/10.1007/BF01401928