In a message dated 96-11-26 02:49:35 EST, you write:
>1. Which patients are the best candidates for Pallidotomy? Can you be too
>old? Do you have to be in a certain state of health?
I'll answer your question based on what I learned when my husband had
experimental bi-lateral pallidal stimulations, which is very similar to
pallidotomy. In fact, we were given a choice of pallidotomy or pallidal
stim.
We were told that:
(a) pallidotomy patients have to be in relatively good health (aside
from the Parkinson's, of course).
(b) they should be at a point medication-wise where the meds are no
longer effective in providing good quality of life.
(c) (This one is IMPORTANT) They must function well mentally in order
to communicate RELIABLY to the surgeon during the surgery -the patient is
awake during it. The patient must be able to tell the doctor if he/she sees
flashes of light, feels "funny", and in what way, etc. We know of one
patient whose surgery was stopped after it began because it became evident
that she couldn't communicate reliably.
(d) They must have the physical stamina to tolerate several hours awake
on the operating table (wearing a stereotactic device, or "halo" to
immobilize the head). It's quite tiring.
Hope this helps. Pallidotomy can offer a tremendous of relief of
symptoms, although it is NOT a cure, and the patient will probably continue
to take about the same amount of medication as before - but if dyskinesia was
a severe side effect of the Sinemet, that side effect will be greatly
reduced. If the patient is a good candidate for the surgery, the results will
be well worth it, but if you find a good neurosurgeon, do pay attention when
he/she describes the risks - there ARE risks involved.
Good luck. Margie and Dick Swindler Lawrence, Ks
