Surgical treatment of Parkinson's disease

William C. Koller, Rajesh Pahwa, Kelly E. Lyons, Alberto Albanese

Research output: Contribution to journalArticlepeer-review

Abstract

Stereotaxtic surgery is an effective therapeutic maneuver in the management of advanced Parkinson's disease (PD). Thalamotomy is an effective measure to control tremor but other PD symptoms are not changed. Bilateral operations are associated with a risk of severe speech impairment. Deep brain stimulation (DBS) of the thalamus is as effective as thalamotomy and is associated with fewer side effects. Pallidotomy is effective in reducing contralateral dyskinesias and the cardinal symptoms of PD. Bilateral pallidotomy often results in cognitive dysfunction. Deep brain stimulation of the pallidum replicates the positive effects of pallidotomy and appears to be safer than ablative lesions. Subthalamic DBS is currently under investigation. This procedure may control all PD symptoms, and the dose of levodopa can often be dramatically reduced. Neurotransplantation is a promising surgical approach to PD. However, further investigation is needed to optimize this approach. Copyright (C) 1999 Elsevier Science B.V.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalJournal of the Neurological Sciences
Volume167
Issue number1
DOIs
Publication statusPublished - Aug 1 1999

Keywords

  • Deep brain stimulation
  • Pallidotomy
  • Parkinson's disease
  • Subthalamus
  • Thalamotomy
  • VIM nucleus

ASJC Scopus subject areas

  • Ageing
  • Clinical Neurology
  • Surgery
  • Developmental Neuroscience
  • Neurology
  • Neuroscience(all)

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