PMID: 10945808 Long term outcome of unilateral pallidotomy: follow up of 15 patients for 3 years.

[janet paterson <janet313@xxxxxxxxxxx>]

Long term outcome of unilateral pallidotomy: follow up of 15 patients for 3
years.

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.


J Neurol Neurosurg Psychiatry 2000 Sep;69(3):337-344
Pal PK, Samii A, Kishore A, Schulzer M, Mak E, Yardley S, Turnbull IM,
Calne DB
Vancouver Hospital and Health Sciences Centre, Vancouver, BC, Canada V6T 2B5.
PMID: 10945808

janet paterson
53 now / 44 dx cd / 43 onset cd / 41 dx pd / 37 onset pd
tel: 613 256 8340 url: ";
email: janet313@xxxxxxxxxxx smail: POBox 171 Almonte Ontario K0A 1A0 Canada