EFFICACY, STABILITY AND PREDICTORS OF OUTCOME OF PALLIDOTOMY FOR PARKINSONS-DISEASE - 6-MONTH FOLLOW-UP WITH ADDITIONAL 1-YEAR OBSERVATIONS

We tested the efficacy, stability and predictors of outcome of unilate ral pallidotomy used to treat patients with Parkinson's disease inadeq uately controlled with pharmacotherapy (IP). The surgical procedure wa s as simple as possible; we used CT rather than MRI, and we omitted mi croelectrode recording. We studied 24 patients with IP; 22 of these pa tients had drug-induced dyskinesias. There was a significant and stabl e improvement in all the major parkinsonian motor signs in the OFF (me dication) state on the contralateral side. In the ON (medication) stat e peak-nose dyskinesias were alleviated on the contralateral side. The only significant and stable change on the ipsilateral side was improv ement in dyskinesias less marked than on the contralateral side. The i mprovement in Unified Parkinson's Disease Rating Scale motor scores in the OFF stare increased with age. The improvement in total dyskinesia scores occurred irrespective of age, bur increased with duration of d isease, duration of dyskinesias and baseline severity of dyskinesias. Five patients had transient neurological complications while facial pa resis was permanent in one subject. Our results are similar to those o btained by others who used the rime consuming microelectrode recording technique for localization By simplifying the procedure in the way th at we describe, the operation could become available to a greater numb er of patients.