Combined stereotactic unilateral thalamotomy and pallidotomy for Parkinson′s disease

Objective:To examine the efficacy and safety of combined stereotactic unilateral ventralis intermedius thalamotomy (Vim) and internal globus (Gpi) pallidotomy for parkinson′s disease.Methods:Fifty patients who had severe tremor associated with rigidity and bradykinesia underwent unilateral Vim-thalamotomy followed by Gpi at the same site. CRW stereotactic head frame and Philips Gyroscan NT 1,0 tesla MR were used to determine the target.The microelectrode recorded abnomal neurnal activity and was stimulated to test the target.Results:One case had haemorrhage in Gpi region after pallidotomy,the remainder surgery patients followed-up for 6-14 months,the mean UPDRs motor score were 13.2±5.1 and 15.2±2.5, Hoehn and Yahr stage was 1.5±0.5.Over 95% tremor completely abolished.Conclusion:The surgery technique appears to provide excellent relife of the majority of symptoms in patients with severe tremor associated with rigidity and bradykinesia.There is no increased risk of surgery,on the contrary, the complementary therapy which combined stereotactic unilateral thalamotomy and pallidotomy is efficent and safe .