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Opciones terapéuticas actuales para los trastornos del movimiento en la enfermedad de Parkinson.
Resumen
Los trastornos del movimiento como la enfermedad de Parkinson, temblor y distonías, son algunas de las más comunes condiciones neurológicas que afectan a millones de pacientes. Aunque la medicación se ha mantenido como terapia para esta enfermedad, la neurocirugía ha jugado un papel importante en su manejo en los pasados 50 años. La cirugía es ahora una viable y segura opción para pacientes con enfermedad de Parkinson medicamente intratable, temblor esencial y distonías. El campo de la Neurocirugía Funcional ha sido ampliado y renacido en los últimos 20 años. Este desarrollo ha sido impulsado por el progreso en la neurobiología de los trastornos del movimiento, avances en las técnicas quirúrgicas, invención, desarrollo terapéutico y abordajes innovadores. El crecimiento en nuestro conocimiento de los circuitos neurales de la enfermedad ha determinado y refinado nuestros blancos quirúrgicos y nos guiará al descubrimiento de dianas adicionales para la exploración quirúrgica e investigaciones clínicas. La evolución de las herramientas y técnicas de la neurocirugía estereotáxica han facilitado abordajes seguros y mínimamente invasivos que permiten a los neurocirujanos llegar a varias estructuras cerebrales con fiel exactitud. Esto, unido a los rápidos avances en la capacidad y tecnologías de las imágenes, jugarán un importante papel en mejorar nuestra capacidad para visualizar estructuras cerebrales con incomparable resolución. Las lesiones aprendidas desde la experiencia quirúrgica de los trastornos del movimiento están ya siendo aplicadas al tratamiento quirúrgico de trastornos psiquiátricos y otros trastornos neurológicos crónicos.
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