From Big Medical Encyclopedia

TALAMOTOMIYA (Greek thalamos room, lat. thalamus a visual hillock + Greek tome a section, a section) — the stereotaxic operation performed for the purpose of destruction of kernels and conduction paths of a thalamus.

T. apply in modern stereotaxic neurosurgery (see) to treatment of many organic diseases and defeats of c. N of the village of Talamotomiyu make in case of inefficiency of prolonged conservative treatment at parkinsonism (see), the deforming muscular dystonia (see. the Torsion dystonia ), spastic to a wryneck (see), cerebral palsy (see. Children's paralyzes), multiple sclerosis (see), gepato-tserebraljny dystrophies (see), a chorea of Gentington (see Gentington хоре^я), an essential tremor, a cerebellar dyssynergia of Hunt (see M an ozzhechok), myoclonias (see), a myoclonus epilepsy (see), pain syndromes, napr, a thalamic pain syndrome (see the Thalamus), a phantom pain syndrome (see the Phantom of amputated), kauzalgiya (see), and also at a row mental diseases! and nek-ry forms of epilepsy (see). However in recent years apply stimulation methods of treatment more and more widely. At the same time by a stereotaxic method (see) enter into the corresponding kernels of a thalamus on a long term electrodes and for an appreciable length of time make electric stimulation of the specified structures.

T. represents destruction of different kernels and conduction paths thalamus (see). At hyperkinesias (parkinsonism, the deforming muscular dystonia, an essential tremor, multiple sclerosis, etc.) usually make stereotaxic destruction of a ventrolateral-ny kernel of a thalamus and subtalamiche-sky kernel, including an uncertain zone (zona incerta) and the fields Hi and Forel's H2 (see Kampotomiya). Various pain syndromes serve as the indication for destruction of a back lateral ventral kernel of a thalamus, a median kernel, parafascicular kernels, kernels of a pillow of a thalamus. At an atypical epileptiform neuralgia make destruction of a zadnemedialny ventral kernel of a thalamus. At nek-ry mental diseases destruction of medial and front kernels, and also kernels of a pillow of a thalamus is effective. In nek-ry cases still big selectivity of destruction a podjyader, being a part of this kernel of a thalamus is necessary. E.g., at dominance in a wedge, a picture of a disease of muscular rigidity carry out destruction of one, and at dominance of a tremor — others a podjyader, being a part of a ventrolateralny kernel. Thus, at different diseases and patol. states make destruction of both specific, and nonspecific kernels of a thalamus.

At hyperkinesias of extrapyramidal character (parkinsonism, the deforming muscular dystonia, cerebral palsy, etc.). T. gives resistant considerable effect approximately at 70 — 85% of patients. Destruction of specific touch kernels of a thalamus leads to elimination of heavy pain syndromes (including so-called central pains) approximately at 30 — 65% of patients, however in many cases a recurrence is possible. Impact on a ventrolateralny kernel of a thalamus in most cases causes the termination or an urezheniye of generalized epileptic seizures. At nek-ry mental diseases (separate forms of schizophrenia, an aggressive syndrome, persuasive neurosises, sexual deviations, etc.) T. can significantly reduce pathological symptomatology.

Complications after T. are observed seldom. There can be passing hemiparesis, disturbances of sensitivity and mentality. Frequency of resistant complications of various character no more than 2%, and a postoperative lethality makes 1-3%.

Bibliography: Kandel E. I. Functional and stereotaxic neurosurgery, M., 1981; Cooper I. S. Involuntary movement disorders, N. Y., 1969; H a s-sler R., Mundinger F. Rie-chert T. Stereotaxis in Parkinson syndrome, B. — N. Y., 1979.

E. I. Kandel.