Neurosurgical Aspect of Management of Movement Disorders

Background People with movement disorders can experience involuntary movement such as tremor, abnormal posture, slowness, walking difficulty, and stiffness due to neurological conditions. Aim of the Work to conduct a meta-analysis of surgical treatment of patients with movement disorder diseases and help patients for living normal life and performing all sports and hand skill work without any limitation of movement, and improve surgical management, learn indication of surgery, patient selection, techniques, and complications among functional neurosurgeons. Methods Searching procedures will be conducted focusing on the following sources: electronic databases: Medline; 2) Bibliographies and 3) Hand searches of journals: -Online internet search from the electronic database of Medline via PubMed, “Related articles” function will be used to obtain any relevant articles. Additionally, references of the articles included in the analysis were reviewed for any other citations. After screening full text of the included studies the following data was extracted from each primary study: study design, full reference of article including author, year and source, population description: criteria for diagnosis, severity of disease. Intervention: Thalamotomy and DBS alone. Comparative Group (if relevant) and outcome. Results The efficacy in reducing drug-resistant tremor was non-significantly equal among DBS group and thalamotomy group. Cognitive changes were nonsignificantly less among DBS than thalamotomy groups. Gait disturbances were non-significantly lower among DBS than among thalamotomy group. Ataxia risk was non-significantly lower among DBS than among thalamotomy group. Dysarthria risk was non-significantly different among DBS and thalamotomy groups. Hypresthesia risk was non-significantly lower among DBS than among thalamotomy groups. Seizures risk was non-significantly higher among DBS group than among thalamotomy group. Paresis risk was non-significantly lower among DBS than among thalamotomy groups. Psychiatric disturbances risk was non-significantly different among DBS and thalamotomy groups. Intracerebral hemorrhage was significantly lower among DBS than among thalamotomy. That mean DBS is Equal in efficacy and less adverse effects but more expensive than thalamotomy. Conclusion Net result of complications of Thalamic stimulation is less than thalamotomy due to our meta-analysis which show that the incidence of intra cerebral hemorrhage is more in thalamotomy than thalamic stimulation, and the incidence of ataxia, gait disturbance, hypoesthesia and paresis are more in thalamotomy than thalamic stimulation but the incidence of seizers is higher in thalamic stimulation than thalamotomy. But there are another complication which is different in results between both such as dysarthria and psychiatric disturbance.