Motor cortex stimulation for movement disorders

Transcranial Magnetic Stimulation [TMS] of the motor cortex reduces rigidity, improves bradykinesia, motor performance and gait in Parkinson's Disease. It improves also focal dystonia. Extradural Motor Cortex Stimulation [EMCS], in cases of Central Pain due to basal ganglia and brain stem damage, gave satisfactory relief of associated involuntary movements (choreoatethosis, tremor) improving motor performance. Unilateral EMCS relieves also dystonic thalamic hand and reduces bilaterally myoclonia in idiopathic intentional myoclonus. EMCS has been employed in 29 cases of advanced Parkinson's disease. Any symptom of PD [tremor, rigor, motor dexterity (bilaterally) bradykinesia posture, gait, arising from chair, freezing] be may improved. Improvement of different symptoms is variable and unpredictable. Some patient is unresponsive. L-dopa induced dyskinesia, painful dystonia, motor fluctuation are satisfactorily controlled. L-dopa daily dosage may be reduced. The method is minimally invasive, devoid of major complications. Very old patients in poor conditions also are eligible for the procedure.