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Barbara wished Dr Iacono had fixed her "speller" at the same time of a great pallidotomy. I just want to assure you that Dr Iacono did not switch prefixes on the word "lateral" preceding the word pallidotomy in Barbara's head. Barbara said she had a monolatrial palllidotomy mono - a combining form meaning (a) one, single, alone (b) in chemistry, the presence of one atom or group of that to the name of which it is attached. uni - a combining form meaning one bi - A prefix meaning (a) two, twice, double (b) in anatomy, connection with or relation to each of two symmetrically paired parts (c) in chemistry, presence of two atoms or equivalents (of a component) or presence (of this component) in double the usual proportion or in double the proportion of the other component. tri - a combining form meaning three There seems to be an inconsistency in applying the prefix. Mono and bi seem to go together and uni and tri go together. Since this is not the way they are used, our memory will be called upon one more time. The actual medical terms for the pallidotomy are: unilateral pallidotomy: Means to apply the procedure called pallidotomy to only one side of the brain. Sometimes the word unilateral is omitted and the actual side of the brain is given such as left or right pallidotomy. In the left pallidotomy, the lesion is placed in the left side of the brain and effects the muscle movement on the opposite side (right side) of the body. A right pallidotomy thus effects the left side of the body with a lesion on the right side of the brain. bilateral pallidotomy: Means to apply the procedure to both sides of the brain. This term is used when both the left and right pallidotomy is performed during the same surgical operation. To my knowledge there is not a word that means two pallidotomies performed, one left and one right, but at two separate times. ipsilateral: Situated on the same side, as for example paralytic (or similar) symptoms which occur on the same side as the lesion causing them. The word ipsilateral is used to reference symptoms that appear on the same side as the pallidotomy. Since a left pallidotomy effects the right side of the body, the ipsilateral symptoms are those symptoms appearing the left side of the body. Thus in a technical paper one might read: A unilateral pallidotomy was performed reducing symptoms by as much as 95% without changing ipsilateral symptoms. This just means the pallidotomy worked well on the target side and had no crossover, good or bad, to the other side. The following three words should now be well etched in your brain: Unilateral Pallidotomy - one sided pallidotomy Bilateral Pallidotomy - two sided pallidotomy Ipsilateral symptoms - symptoms appearing on same side as site of lesion (Monolateral I am sure, was understood by all. Now you know what happens when one cannot sleep.) Regards, Alan Bonander