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Principles and Practice of Stereotactic Radiosurgery pp 549–558Cite as

Movement Disorders: Deep-Brain Stimulation Perspective

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Abstract

The introduction and technical refinements of deep-brain stimulation (DBS) for the treatment of movement disorders over the past 15 years have resulted in a renaissance in the field of functional neurosurgery. For patients with medically refractory movement disorders, DBS procedures have largely replaced neuroablative techniques in the treatment of patients with movement disorders. This shift away from ablative procedures is multifactorial, but among the more important factors are its proven efficacy, the dramatic reversibility of the effects of neurostimulation, and the perceived minimally invasive nature of DBS compared with destructive procedures. Opposing this trend, however, has been the rise in the past decade in the use of Gamma Knife (GK) and occasionally linear accelerator (linac)-based radiosurgical units to perform thalamotomies and pallidotomies. The benefits of radiosurgical ablations include the fact that it is even less invasive than traditional surgical approaches, thus virtually eliminating the risk of hemorrhage, infection, and hardware-related complications. In addition, Gamma Knife radiosurgery is less time-consuming than microelectrode-guided radiofrequency lesioning and can be performed in patients who are at higher surgical risks for open procedures, such as patients with medical comorbidities or patients who cannot tolerate an awake procedure.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Pennsylvania, Philadelphia

    John Y. K. Lee MD (Assistant Professor and Medical Director)

  2. Penn Gamma Knife at Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA, USA

    John Y. K. Lee MD (Assistant Professor and Medical Director)

  3. Department of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Joshua M. Rosenow MD (Assistant Professor of Neurosurgery, Director of Stereotactic and Functional Neurosurgery)

  4. Northwestern Memorial Hospital, Chicago, IL, USA

    Joshua M. Rosenow MD (Assistant Professor of Neurosurgery, Director of Stereotactic and Functional Neurosurgery)

  5. Brain Neuromodulation Center, Jane and Lee Seidman Chair in Functional Neurosurgery, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Ali R. Rezai MD (Director)

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  1. John Y. K. Lee MD
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  2. Joshua M. Rosenow MD
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Editors and Affiliations

  1. Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA

    Lawrence S. Chin MD (Professor and Chairman) (Professor and Chairman)

  2. Department of Radiation Oncology, University of Maryland Medical School, Baltimore, MD, USA

    William F. Regine MD (Professor and Chairman) (Professor and Chairman)

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Lee, J.Y.K., Rosenow, J.M., Rezai, A.R. (2008). Movement Disorders: Deep-Brain Stimulation Perspective. In: Chin, L.S., Regine, W.F. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-71070-9_56

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