Ventroposterior Medial Pallidotomy in Patients with Advanced Parkinson's Disease

Abstract

IN A PRELIMINARY study, the effects of ventroposterior medial pallidotomy were evaluated in five patients with advanced Parkinson's disease in whom medical therapy had failed. The mean age was 67.0 ± 5.6 years, and the mean Hoehn and Yahr stage when “off” was 3.9 ± 1.3. Three patients received unilateral pallidotomies; two of these received another pallidotomy after 8 weeks. Two other patients received staged bilateral pallidotomies. No significant differences in overall function could be seen before and after the first surgical procedure. All three patients with peak-dose dyskinesias or dystonia had marked contralateral reduction in these symptoms. Ventroposterior medial pallidotomy can ameliorate peak-dose dyskinesias in patients with advanced Parkinson's disease. Overall functional improvement is not remarkable.