Pallidotomy

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

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

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

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

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

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

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

• Parkinson's disease
• Basal ganglia
• Deep brain stimulation