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A problem related to eligibility for pallidotomies: my mother was recently evaluated for a pallidotomy and told that she wasn't sufficiently bad off. That is, Sinamet seems to be controlling her tremor enough to exclude her from consideration. The problem is that we believe the Sinamet is greatly aggravating her mental confusion. She can't keep track of time, she asks questions over and over, she hallucinates, is withdrawn and without motivation--all very opposite to her former personality. Her life is reduced to the house, and her husband is under enormous pressure. She is miserable. I can't help but feel that the specialists in Philadelphia ignored or were oblivious to this dimension of life with Parkinson's. I understand that post-pallidotomy treatment also includes continued Sinamet, but we are grasping at straws and hope that a lower dose might permit her some regained mental clarity and some restoration of her former vibrant life. I am frustrated that the medical thought about pallidotomy does not seem to consider that tremor alone is not the only problem, that the drugs can be ruinous, and getting off of them a major goal. If they even acknowledged the problem their ultimate judgement to refuse pallidotomy would seem more acceptable, but it seems that they don't even think about it. Controlling tremor appears to be the goal, and everything else (like mental incompetence) a relatively minor side issue. Never mind that the "relatively minor side issue" has become an all-consuming worry and round-the-clock job for all those around her. Has anyone else confronted this problem re surgical responses to PD? Thoughts? Virginia Tilley [log in to unmask]