Stereotactic Surgery For Parkinson Disease

Since the 1970's when Sinemet came onto the scene stereotactic surgery was almost completely abandoned. However, when it was noticed that the effect of the medication can wear off, it is now being used again, particularly also in view of the fact that neurosurgical methods have become more precise and techniques more sophisticated with the use of CT and MRI scans.

Ref. 1 and 2 summarize this topic. In Ref. 2 the authors have presented data on 13 patients who were treated with posteroventral pallidotomy. 77% of the patients had either an excellent or good result, the rest a fair result. Surgeries were well tolerated and there were no deaths.

The authors felt that stereotactic procedures for Parkinson disease are a good alternative in cases where levodopa wears off or where side effects of the medications become intolerable. Often the improvement after stereotactic surgery holds up for up to 4 years. The authors of Ref.2 showed significant statistical improvements in the following: complete tremor relief, complete rigidity relief, complete relief of slow body motion and significant improvement in motor function of all muscle groups.

Here is a link to a neurosurgical site, which shows a picture of the set-up for stereotactic surgery.

Home Page

Neurological disease

Parkinsons

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. NC Reynolds Jr. et al. WMJ 2000 Jun 99(3): 57-61.

2. EJ Herrera et al. Acta Neurochir(Wien) 2000;142(2):169-175.

3. DB Jacques et al. Stereotact Funct Neurosurg 1999, 72(2-4): 219-224.

Last Modified: Jan. 27, 2008