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Send reply to: Parkinson's Information Exchange Network <[log in to unmask]> From: Don Berns <[log in to unmask]> Subject: Surgery for PD To: [log in to unmask] Date sent: Tue, 28 Mar 2000 09:44:45 -0500 > Joan Dykstra, > > Based on my own experience which includes: > -personally having a bi-lateral pallidotomy in Dec 1993 > -working weekly with well over 300 PD patients over four years > -attending a Pallidotomy Accord Conf. for neurosurgeons at Princeton in > April of 1998 -setting in on several surgeries as an observor > > There is one surgeon who is the very best. > Dr. Robert Iacono > Neuroscience Clinic > 245 terracina blvd. #209A > Redlands, CA > 909-792-8188 > > > Don Berns Karen Berns > B.S.M.E., clay pot, M.Div. Assoc. Pastor-Pleasant Hills Community > Wounded Healer, P.D. D. Min. Presbyterian Church > Parish Associate PHCPC 199 Old Clairton Rd. > Pittsburgh, PA 15236 > Check out Don's pallidotomy story on website: > http://www.geocities.com/SoHo/Village/6263/pienet/hithgang/hitdonb1.html > For more info on this life changing operation for persons with P.D. See: > www.pallidotomy.com > > > Blessings on you as you pursue the medical treatment you need to treat > your PD. > > > Don Berns > Dr. Iacono may be one of the better surgeons for performing pallidotomies, but the experts in surgery for Parkinson's disease these days believe that pallidotomy is no longer the "gold standard" for the surgical treatment of this condition. Please refer to the transcript of the recent neurosurgical meeting in San Francisco where the newer techniques in PD surgery were discussed (including tissue transplants and stimulation procedures). I posted this transcript on this List several months ago (and it is available in the Archives). Basically: 1. Pallidotomy is useful in "pre-treatment of dystonias" (quote from Dr. Gary Heit at Stanford), but, over the long haul, leads to more speech problems in PD patients. The early pallidotomy cases are beginning to relapse. 2. Fetal tissue transplant surgery is not yet ready for clinical use. The experiences (Dr. Stanley Fahn) suggest that it worsens dyskinesias. 3. The current "gold standard" is deep brain stimulation, either in the pallidum or the subthalamic nucleus. Pallidotomy is no longer considered good treatment for PD, at least by people such as Dr. Heit, except for the exception (dystonia) above. Best, Bob ********************************************** Robert A. Fink, M. D., F.A.C.S., P. C. 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 Telephone: 510-849-2555 FAX: 510-849-2557 WWW: http://www.dovecom.com/rafink/ mailto:[log in to unmask] "Ex Tristitia Virtus" *********************************************