Suitability of Parkinson's Patients for Surgery in the North East Coast of Peninsular Malaysia: A Prospective Nalysis
Jafri Malin Abdullah, and Abdullah M.R., (2003) Suitability of Parkinson's Patients for Surgery in the North East Coast of Peninsular Malaysia: A Prospective Nalysis. Malaysian Journal of Medical Sciences, 10 (1). pp. 74-77. ISSN 1394195X
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Official URL: http://www.medic.usm.my/publication/mjms/
Universiti Sains Malaysia, School of Medical Sciences, Neuroscience Unit
Universiti Sains Malaysia, School of Medical Sciences, Dept. of Community Medicine
There is no report in the English literature on the criteria for neuroablation or neuroaugmentation for the treatment of Parkinson’s disease in a developing country like Malaysia. A prospective study of patients with Parkinson’s disease from the north-eastern peninsular Malaysia was done to assess their suitability of surgery. Age, race, duration of illness and dementia were considered important factors towards the success of such surgical procedures. A mathematical model is suggested for future cases deemed to be suitable for neuroaugmentative or ablative surgery.All 42 patients registered in the year 2000 were selected from the Hospital Records ICD-9 and follow up prospectively. Univariate and multivariate analyses were done covering various important criteria ie age, sex, medical illness and dementia in the context of clinical assessment for surgery. Suitability for surgery was defined as those patients with rigidity, tremor or bradykinesia and suitable for stereotactic functional neurosurgery which consisted of pallidotomy, thalamotomy
(neuroablative) or deep brain stimulation neuroagmentative. This research also supports other findings that dementia may be an absolute contraindication for surgery (6,12-15). The findings also showed that
Chinese patients older than 60 years with 2 years or more of illness may also be another contraindication for surgery. For Malay patients contraindication for surgery in non-demented patients are a combination of age as well as duration of illness but with definitely higher age and longer duration of illness compared to Chinese patients. However we could not define a cut off point from this study. This would require a larger study group for a conclusion to be made.
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