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It seems if I add “pallidotomy” on to my signature I will be assured of getting two to five direct Email requests for my experience with this surgery. Rather than answer individual requests, let me make my comments on the public forum. I had the pallidotomy in May of 1993 in Sweden by Dr. Lauri Laitinen. My reason for having the pallidotomy can be simply stated as “the continued life with PD was worse than the risk of a poor result from surgery”. In other words, my life with PD had reached a point where I was willing to risk neurosurgery to make it better. Recently I read that the difference between ordinary surgery and neurosurgery was in neurosurgery there is a risk of damage as a result of the surgery. I had a right pallidotomy, which means the left side of my body was effected by the surgery. This was the side most severely affected by the disease. At the time of surgery I was 53 years old, diagnosed with PD for 9 years with as much as another 7 years of PD before diagnosis. It has now been about three years since the surgery. This is how I see myself now. 1. I still do not sweat as I did before surgery. I do sweat easily, but I have not had the magnitude nor frequency of sweating as prior to surgery. 2. My left leg is about 95% rigidity free and has been that way since the surgery. This is true whether I am on medication or off. 3. My left arm did not fare as well. The lesion missed the true target. As a result the arm can still get very rigid when off medication. I would guessamet at a 25 - 50% reduction in rigidity for the left arm. 4. My facial expression can be very descriptive or can be mask like. Much depends on the situation. I can have facial expression. This was most noticed by friends when I returned from Sweden and still commented on by people who knew be before surgery. 5. My medications have not changed in three years. I have added a Paxil for depression which I think I should have done much earlier. 6. It has been three years and most of you know, PD memory systems are not known for long term memory. I have to look at video to remember what I looked like prior to the surgery. I have gained some weight, more than needed. My PD has advanced on the right side and since it is difficult to determine which side is doing what, I will extend this advance to the left side also. Does this mean the surgery is wearing thin? I would say it depends on one’s believe in the surgery. If you don’t believe the surgery, than the surgery is failing. If you believe the surgery, than the surgery is holding out, the PD is crowding things as it advances. There is no question in my mind, that should I not have had the surgery, I would be in much worse shape. 7. Today I do not measure my days by what they might have been should I not have had the surgery. I measure them just like we all measure them, based on yesterday. I am better, worse or no different based on yesterday. I still can have dyskinesia on occasion. It is dominant on the right side. I have dystonia in the right foot once in a while. Would I do it again? Yes for the same reasons as I did it before. Will I have the other side done or will I have the same side redone to improve the left arm? Probably not. Neither is bad enough that they outweigh the risk of neurosurgery at this point. General comments about pallidotomy, thallamotomy and stimulation surgery. The risks of neurosurgery are hemorrhage, infection, misplaced lesion, hospital related problems, etc. For experienced neurosurgeons this may be down around the 3% level. For your yellow pages neurosurgeon, it could be as high as 100%. Experience is key to good results. This is experience in pallidotomy and thallamotomy and other related surgery and not in general stereotactic surgery. Put it this way, if you are on the OR table and the neurosurgeon enters the room with a stack of reference books, you are in trouble. You should be able to ask the surgeon about their experience and length of time performing the surgery. You should be able to talk to their patients. Finally, do understand that surgery will not cure Parkinson’s disease. It will not remove the requirement to take PD medication. It has the potential of reducing the symptoms of the disease. There is risk. If the risk is 5%, that means 5 of every 100 will not get the benefit of the surgery and may actually be worse off. If your PD is so bad that you are willing to take the risk, go for it. Many have had the surgery and are much better off. In the recent newsletter from APDA is an article by Dr. Meland DeLong of Emory. I suggest you read it and understand it. Regards, Alan Bonander 56, 12, infusion, pallidotomy [log in to unmask]