Pallidotomy: Difference between revisions

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'''Pallidotomy''' is a neurosurgical procedure wherein a part of the brain called the [[Globus pallidus]] is lesioned. This procedure is primarily used to treat symptoms of [[Parkinson's disease]], such as rigidity, bradykinesia, and tremor. It can also be used to treat other neurological conditions like [[Dystonia]] and [[Huntington's disease]].
{{Short description|Surgical procedure for treating Parkinson's disease}}


== History ==
[[File:Basal_ganglia.svg|thumb|right|Diagram of the basal ganglia, showing the location of the globus pallidus.]]


The procedure was first performed in the 1940s and 1950s, but fell out of favor with the advent of [[Levodopa]] therapy. However, it saw a resurgence in the 1990s due to advancements in imaging technology and the understanding of the pathophysiology of Parkinson's disease.
'''Pallidotomy''' is a neurosurgical procedure that involves the precise destruction of a small part of the [[globus pallidus]], a component of the [[basal ganglia]] in the brain. This procedure is primarily used to treat the symptoms of [[Parkinson's disease]] and other movement disorders.


== Procedure ==
==History==
Pallidotomy was first developed in the mid-20th century as a treatment for [[Parkinson's disease]]. The procedure gained popularity in the 1990s with the advent of modern imaging techniques that allowed for more precise targeting of the globus pallidus.


During a pallidotomy, a small hole is drilled in the skull and an electrode is passed into the globus pallidus. The electrode is then heated to create a small lesion, which helps to alleviate the symptoms of Parkinson's disease.
==Indications==
Pallidotomy is indicated for patients with Parkinson's disease who experience severe motor symptoms that are not adequately controlled by medication. These symptoms may include [[tremor]], [[rigidity]], and [[bradykinesia]].


== Risks and Complications ==
==Procedure==
The procedure is typically performed under local anesthesia with the patient awake, allowing for real-time feedback during surgery. A small hole is drilled in the skull, and a probe is inserted into the globus pallidus. The target area is then lesioned using heat generated by radiofrequency energy.


Like any surgical procedure, pallidotomy carries certain risks. These include infection, bleeding, and damage to surrounding brain tissue. In rare cases, the procedure can cause cognitive and behavioral changes.
==Mechanism of Action==
The globus pallidus is part of the basal ganglia, which play a crucial role in the regulation of voluntary movement. In Parkinson's disease, the normal functioning of the basal ganglia is disrupted, leading to the characteristic motor symptoms. By lesioning a part of the globus pallidus, pallidotomy aims to restore balance in the basal ganglia circuitry, thereby alleviating symptoms.


== Effectiveness ==
==Outcomes==
Pallidotomy can lead to significant improvement in motor symptoms for many patients. However, the procedure is not without risks, and potential complications include [[speech disorders]], [[cognitive impairment]], and [[hemiparesis]].


Studies have shown that pallidotomy can significantly improve the symptoms of Parkinson's disease, particularly in patients who do not respond well to medication. However, it is less effective at treating the non-motor symptoms of the disease.
==Alternatives==
 
Other surgical options for treating Parkinson's disease include [[deep brain stimulation]] (DBS), which involves the implantation of electrodes in the brain to modulate neural activity. Unlike pallidotomy, DBS is reversible and adjustable.
== See Also ==


==Related pages==
* [[Parkinson's disease]]
* [[Basal ganglia]]
* [[Deep brain stimulation]]
* [[Deep brain stimulation]]
* [[Thalamotomy]]
* [[Neurosurgery]]


[[Category:Neurosurgical procedures]]
[[Category:Neurosurgery]]
[[Category:Parkinson's disease]]
[[Category:Parkinson's disease]]
[[Category:Medical treatments]]
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Latest revision as of 10:50, 15 February 2025

Surgical procedure for treating Parkinson's disease


Diagram of the basal ganglia, showing the location of the globus pallidus.

Pallidotomy is a neurosurgical procedure that involves the precise destruction of a small part of the globus pallidus, a component of the basal ganglia in the brain. This procedure is primarily used to treat the symptoms of Parkinson's disease and other movement disorders.

History[edit]

Pallidotomy was first developed in the mid-20th century as a treatment for Parkinson's disease. The procedure gained popularity in the 1990s with the advent of modern imaging techniques that allowed for more precise targeting of the globus pallidus.

Indications[edit]

Pallidotomy is indicated for patients with Parkinson's disease who experience severe motor symptoms that are not adequately controlled by medication. These symptoms may include tremor, rigidity, and bradykinesia.

Procedure[edit]

The procedure is typically performed under local anesthesia with the patient awake, allowing for real-time feedback during surgery. A small hole is drilled in the skull, and a probe is inserted into the globus pallidus. The target area is then lesioned using heat generated by radiofrequency energy.

Mechanism of Action[edit]

The globus pallidus is part of the basal ganglia, which play a crucial role in the regulation of voluntary movement. In Parkinson's disease, the normal functioning of the basal ganglia is disrupted, leading to the characteristic motor symptoms. By lesioning a part of the globus pallidus, pallidotomy aims to restore balance in the basal ganglia circuitry, thereby alleviating symptoms.

Outcomes[edit]

Pallidotomy can lead to significant improvement in motor symptoms for many patients. However, the procedure is not without risks, and potential complications include speech disorders, cognitive impairment, and hemiparesis.

Alternatives[edit]

Other surgical options for treating Parkinson's disease include deep brain stimulation (DBS), which involves the implantation of electrodes in the brain to modulate neural activity. Unlike pallidotomy, DBS is reversible and adjustable.

Related pages[edit]