Pallidotomy the Second Time Around

[Sid Roberts <sirobert@xxxxxxxxxx>]

Just received my copy of the _Harvard Health Letter_ via snail
mail (Vol 21 #11, Sept 1996) with an article on "Pallidotomy
the Second Time Around"(pp 4-6).  It offers no new information
to those of us who have been long time members  of this List.
The article does, however, emphasize that pallidotomy has been
hyped in the media ("Prime Time Live," "60 Minutes," "Wall Street
Journal," and etc) as a surgical cure for Parkinson's disease,
but it is not a cure.  Parkinson's specialists bemoan the fact
that these glowing accounts of the operation have raised
expectations that "can't always be met."  "An air of a visit to
Lourdes surrounds it, and there are waiting lists at institutions
where the operation is performed."  "People see this on
television and think 'Oh, great!  I can have this operation and
be cured of my Parkinson's disease.' Even though it is NOT a
cure, more and more hospitals are hiring surgeons and touting
this procedure for which they charge some $20 to $40 thousand US
dollars.

Let me excerpt a few passages from this _Harvard Health Letter_.
Of the some million Americans suffering Parkinsons only 5-10% are
considered good candidates for a pallidotomy.  "These are people
who have lived with Parkinson's for many years and have developed
significant fluctuations in movement as a result of long-term
treatment with the drug Sinemet.  Sometimes after they take a
pill they may have uncontrollable flinging about of arms or legs
(dyskinesia); other times the drug seems to have no effect, and
they move with frustrating slowness if at all (bradykinesia)."

Dr. Tarsy of Deaconess and Beth Israel, a Parkinson's specialist,
is quoted as saying: "Ironically, pallidotomy has turned out to
be especially good at reducing or eliminating the side effects of
Sinemet, the very drug that made surgical treatments for
Parkinson's disease obsolete more than 25 years ago. In some
cases, of course, that can be a major victory."

"At best pallidotomy relieves symptoms mainly on one side of the
body, because operating on both sides of the brain is very risky.
It is not helpful for people ho never responded well to Sinemet
in the first place and is generally not recommended for those
who have tremor as their main symptom, who aare quite old and
have very advanced disease, or who exhibit signs of dementia."

More from this article later.  (Wish I had a scanner!)

--------------------
  Sid Roberts   66/dx2
  sirobert@xxxxxxxxxx       Youngstown, Ohio