Dear Bev McNeill,
In answer to your query regarding pallidotomy vs a D.B.S. there is no
question but that I would have a pallidotomy. Why?
1. Because it is a permanent fix.
2. I am not very keen about having a foreign body placed within
my brain with leads going down to a battery pack under my
collarbone or side.
3. There is no maintenance with a pallidotomy. (change
batteries, possibility of leads coming disconnected)
I had a plastic amaya shunt placed beneath my scalp in conjunction with
an adrenal implant surgery in 1987 and believe me it was a relief to have it
removed shortly before my pallidotomy.
I don't know the answer to which one offers the most reduction in
medications. My sense is they would be comparable.
In a D.B.S. the electrodes would be placed in the postero-ventral area of
the globus pallidus which is the same target area as the pallidotomy. Other
stimulation devices have been placed in the thalamus, but my sense is that when
the term Deep Brain Stimulation is used the doctors are referring to a
stimulation device being placed in the thalamus. I am not aware of any stims
which have been implanted in both sides at once.
The pallidotomy does offer the advantage of being able to be done on both
sides at once, but Dr Iacono is the only one doing this procedure on a regular
basis that I am aware of. Although recently I heard that Dr. Jaimie Henderson
in St. Louis had performed a simultaneous bilateral pallidotomy. Someone also
told me that a doctor in Portland Oregon had done bilateral so maybe it is
beginning to catch on.
We have done one D.B.S. at Loma Linda University bout 1 1/2 years ago on
a woman whom I asked about 4 months ago, *If you had it to do over again would
you opt for a Pallidotomy or the stim?*
Her reply was immediate. *I d have a Pallidotomy.*
Your questions concerning whether DBS is the same as the procedure called
Bilateral Chronic Electrodes of Ventroposteral Pallidum is one I do not know the
answer nor do I know the answer the pulse generator in DBS is the same as the
Medtronic device used in the thalamus stimulus surgery.
You also should talk with Joanne and Don Sandstrome or look up previous
posts. Don has had the thalamus stimulation implant and seems to be very
pleased with it.
Don
Dr. Don Berns
4943 Del Monte Rd.
La Canada, CA 91011
818-790-8812
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