Hareket Bozukluklarında Cerrahi Tedavi Yöntemleri: Etki Mekanizmaları ve Kullanım Alanları

Nörolojide hareket bozukluklarına neden olan hastalıkların fizyopatolojisi net olarak anlaşılamamıştır. Tedavide ilk adım tıbbi medikal tedavi olmasına karşın bu tedaviden yeterli yanıt alınamadığında veya yan etki nedeniyle medikal tedavi verilemeyen hastalarda cerrahi tedavi ön plana çıkmaktadır. Cerrahi tedavinin tercih edildiği hareket bozukları arasında başlıcaları esansiyel tremor, Parkinson hastalığı ve distonidir. Lezyon cerrahisi ve derinbeyinstimülasyonu (DBS) şeklinde 2 tip cerrahi tedavi seçeneği vardır. DBS günümüzde morbidite oranının çok daha düşük olması ve geri dönüşümlü olması nedeniyle lezyon cerrahisine göre daha çok tercih edilir. Bununla birlikte konservatif cerrahi yaklaşımlarda belirli hareket bozukluklarının tedavisinde uygulanmaya devam etmektedir. Bu derlemede lezyon cerrahisi ve DBS'in hareket bozukluklarının tedavisindeki yeri tartışılmıştır

Surgical Treatment Methods in Movement Disorders: Mechanisms of Action and Indications

Movement disorders display complex pathophysiologies. The first step in their management is medical treatment. However, if medical treatment is an inadequate or cannot be used because of side effects, surgical treatment should be considered. Surgery is used to treat essential tremors, Parkinson disease, and dystonia. There are two types of surgery currently available: lesioning and neurostimulation. A method called DBS is more preferable than lesioning because its outcomes are reversible and it has a low ratio of morbidity. However, conservative surgical approaches continue to be used for treating some movement disorders. This review discusses lesioning and neurostimulation in the treatment of movement disorders

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