Stereotactic pallidotomy in the treatment of Parkinson disease: an expert opinion.

The objective of this workshop was to provide recommendations on several issues involving pallidotomy for patients with medically intractable Parkinson disease to physicians, patients, and other health care providers. An international consortium of experts in neurology, neurosurgery, and neurophysiology who had extensive experience with pallidotomy were invited to the workshop. Participants were sent background materials from the scientific literature for review-based participant recommendations. A proposed agenda was circulated to all participants before the workshop, and the final agenda was based on their recommendations. Topics were introduced at the workshop by members of the organizing committee, followed by extensive group discussion. A draft of a consensus statement, based on the previous day's discussion, was circulated and further modifications were made. The final statement was agreed on by all members. The conclusions of the participants were: (1) Pallidotomy should be performed only at centers that have a team of physicians with substantial expertise and experience in the field. (2) Patients with disabling idiopathic Parkinson disease, without dementia, and who have exhausted medical therapy should be considered for pallidotomy. (3) All patients should be examined by means of standardized rating scales both preoperatively and postoperatively to ensure quality of care at each center. (4) Symptoms that respond best to pallidotomy include medication-induced dyskinesias, rigidity, and tremor, while balance, gait disorders, and hypophonia are generally less responsive to surgery. Benefits of pallidotomy appear to be long lasting. (5) Each institution's complication rate should be discussed before surgery.
AuthorsJ M Bronstein, A DeSalles, M R DeLong
JournalArchives of neurology (Arch Neurol) Vol. 56 Issue 9 Pg. 1064-9 (Sep 1999) ISSN: 0003-9942 [Print] UNITED STATES
PMID10488806 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
  • Counseling
  • Globus Pallidus (surgery)
  • Humans
  • Neurosurgical Procedures (methods, standards)
  • Parkinson Disease, Secondary (surgery)
  • Patient Education as Topic
  • Patient Selection
  • Stereotaxic Techniques

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: