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Barbara and Listmembers: Posted below is a respond by Patrick Kelly, M. D., Professor and Chairman of Neurosurgery at New York University School of Medicine concerning the present status of pallidotomy in PD. It is re-posted with Dr. Kelly's permission. I have suggested to Dr. Kelly that he sign on to this List and he said that he would do so. Dr. Kelly is one of the leading academic neurosurgeons in the world and will make an excellent addition to this List. ----------------------------------------------------------------------- Pallidotomy I admit that I was skeptical about this procedure, knowing that most who practiced stereotactic pallidotomy in the early 60's began doing thalamotomy where the results for tremor were better and the localization by neurophysiologic methods more precise. Of course, L-Dopa put them all out of business. I've done thalamotomies for tremor for over 20 years in patients with medically refractory tremor or in patients unable to take L-Dopa. I heard several reports on the retreaded pallidotomy procedure and was skeptical that it could help bradykinesia-the real disabling symptom of Parkinson's disease. I was skeptical until I started doing the pallidotomy procedures myself. I agree now that it's a good operation and the results on bradykinesia, foot cramping, drug induced dyskinesia and rigidity have been impressive. How long will they persist? I really don't know. This is being studied. Will the procedure "cure" Parkinson's disease? Get real. It defies the imagination to think that creating yet another lesion in a sick brain is going to cure the disease or stop it's progression. Slow its progression? This needs to be studied in a prospective randomized trail with matched sets of patients-di fficult to do. In my opinion, however, pallidotomy is a good operation if carefully performed. PJ Kelly \--------------------------------------------------------------\ \ Patrick Kelly, MD \ Internet: [log in to unmask] \ \ NYU Medical Center \ Phone: (212)-263-8002 \ \ New York, N Y \ \ \ \ \ \--------------------------------------------------------------\ ------------------------------------------------------------------------ Best wishes to all, Bob -- ******************************************************** Robert A. Fink, M. D., F.A.C.S. Phone: 510-849-2555 Neurological Surgery FAX: 510-849-2557 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 USA E-Mail: [log in to unmask] CompuServe: 72303,3442 America Online: BobFink "Ex Tristitia Virtus" ********************************************************