OBJECTIVES: With the advent of new antiparkinsonian drug therapy and promising results from subthalamic and pallidal stimulation, this study evaluated the long term efficacy of unilateral pallidotomy, a technique which has gained popularity over the past decade for the management of advanced Parkinson's disease. METHODS: The 15 patients reported here are part of the original cohort of 24 patients who underwent posteroventral pallidotomy for motor fluctuations and disabling dyskinesias 3 years ago as part of a prospective study. Evaluation scales included the unified Parkinson's disease rating scale, the Goetz dyskinesia scale, and the Purdue pegboard test. RESULTS: When compared with the prepallidotomy scores, the reduction in the limb dyskinesias and off state tremor scores persisted on the side contralateral to pallidotomy at the end of 3 years (dyskinesias were reduced by 64% (p<0.01) and tremor by 63% (p<0.05). Other measures tended to deteriorate. The dosage of antiparkinsonian medications did not change significantly from 3 months prepallidotomy to 3 years postpallidotomy. CONCLUSIONS: Although unilateral pallidotomy is useful in controlling the contralateral dyskinesias and tremor 3 years after surgery, all other early benefits disappear and activities of daily living continue to worsen.
OBJECTIVES: With the advent of new antiparkinsonian drug therapy and promising results from subthalamic and pallidal stimulation, this study evaluated the long term efficacy of unilateral pallidotomy, a technique which has gained popularity over the past decade for the management of advanced Parkinson's disease. METHODS: The 15 patients reported here are part of the original cohort of 24 patients who underwent posteroventral pallidotomy for motor fluctuations and disabling dyskinesias 3 years ago as part of a prospective study. Evaluation scales included the unified Parkinson's disease rating scale, the Goetz dyskinesia scale, and the Purdue pegboard test. RESULTS: When compared with the prepallidotomy scores, the reduction in the limb dyskinesias and off state tremor scores persisted on the side contralateral to pallidotomy at the end of 3 years (dyskinesias were reduced by 64% (p<0.01) and tremor by 63% (p<0.05). Other measures tended to deteriorate. The dosage of antiparkinsonian medications did not change significantly from 3 months prepallidotomy to 3 years postpallidotomy. CONCLUSIONS: Although unilateral pallidotomy is useful in controlling the contralateral dyskinesias and tremor 3 years after surgery, all other early benefits disappear and activities of daily living continue to worsen.
Authors: W G Ondo; J Jankovic; E C Lai; C Sankhla; M Khan; L Ben-Arie; K Schwartz; R G Grossman; J K Krauss Journal: Neurology Date: 1998-01 Impact factor: 9.910
Authors: R J Uitti; R E Wharen; M F Turk; J A Lucas; M J Finton; N R Graff-Radford; K B Boylan; S J Goerss; B A Kall; C H Adler; J N Caviness; E J Atkinson Journal: Neurology Date: 1997-10 Impact factor: 9.910
Authors: K Kazumata; A Antonini; V Dhawan; J R Moeller; R L Alterman; P Kelly; D Sterio; E Fazzini; A Beric; D Eidelberg Journal: Neurology Date: 1997-10 Impact factor: 9.910
Authors: D Masterman; A DeSalles; R W Baloh; R Frysinger; D Foti; E Behnke; C Cabatan-Awang; A Hoetzel; P M Intemann; L Fairbanks; J M Bronstein Journal: Arch Neurol Date: 1998-09
Authors: Adriana M Strutt; Eugene C Lai; Joseph Jankovic; Farah Atassi; Elizabeth M Soety; Harvey S Levin; Robert G Grossman; Michele K York Journal: Surg Neurol Date: 2008-06-02