VENTROPOSTERIOR MEDIAL PALLIDOTOMY IN PATIENTS WITH ADVANCED PARKINSONS-DISEASE

IN A PRELIMINARY study, the effects of ventroposterior medial pallidot omy were evaluated in five patients with advanced Parkinson's disease in whom medical therapy had failed. The mean age was 67.0 +/- 5.6 year s, and the mean Hoehn and Yahr stage when ''off'' was 3.9 +/- 1.3. Thr ee patients received unilateral pallidotomies; two of these received a nother pallidotomy after 8 weeks. Two other patients received staged b ilateral pallidotomies. No significant differences in overall function could be seen before and after the first surgical procedure. All thre e patients with peak-dose dyskinesias or dystonia had marked contralat eral reduction in these symptoms. Ventroposterior medial pallidotomy c an ameliorate peak-dose dyskinesias in patients with advanced Parkinso n's disease, Overall functional improvement is not remarkable.