Udi,
There are many variables to consider when analyzing Pallidotomies -
individual
symptoms experienced before the Pallidotomy, the age of patient, other
complicating
medical factors, size and location of lesion. Because Parkinson's Disease
affects
individuals in uniquely different ways, so will Pallidotomies affect
individuals in
equally uniquely different ways.
Research shows
that Pallidotomies are extremely effective in alleviating tremor and
dyskinesias,effective, to a slightly lesser degree, in reducing
rigidity,bradykinesia,
freezing episodes and "on-off" phenomenom. Balance is sometimes improved,
depending on what's causing the balance problems. Speech, swallowing and
drooling
are usually not improved. Initial improvement is sometimes experienced in
speech
but is temporary.
The most important factor to consider in determining outcome is the
location and
size of the lesion. If the lesion is well placed within the oppropriate area
of the
Globus Pallidum and is of sufficient size to destroy all of the cells
involved in abnormal
movement,then the improvement should be immediate and long-term.
Emory University is currently involved in a NIH funded study to look at
long-term
effects of Pallidotomies. Given all the factors and variables stated above,
we have
found the benefits derived from the Pallidotomy to continue to be present 4
years
later! With well-placed lesions, improvements are observed at the time of
lesioning.
It is not uncommon to experience additional improvements for up to 6 months
post-op.
I hope this answers some of your questions!
Terrie
