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Stereotactic pallidotomy in the treatment of Parkinson disease: an expert
opinion.

The objective of this workshop was to provide recommendations on several
issues involving pallidotomy for patients with medically intractable
Parkinson disease to physicians, patients, and other health care providers.

An international consortium of experts in neurology, neurosurgery, and
neurophysiology who had extensive experience with pallidotomy were invited
to the workshop.

Participants were sent background materials from the scientific literature
for review-based participant recommendations.

A proposed agenda was circulated to all participants before the workshop,
and the final agenda was based on their recommendations.

Topics were introduced at the workshop by members of the organizing
committee, followed by extensive group discussion.

A draft of a consensus statement, based on the previous day's discussion,
was circulated and further modifications were made.

The final statement was agreed on by all members.

The conclusions of the participants were:

(1) Pallidotomy should be performed only at centers that have a team of
physicians with substantial expertise and experience in the field.

(2) Patients with disabling idiopathic Parkinson disease, without dementia,
and who have exhausted medical therapy should be considered for pallidotomy.

(3) All patients should be examined by means of standardized rating scales
both preoperatively and postoperatively to ensure quality of care at each
center.

(4) Symptoms that respond best to pallidotomy include medication-induced
dyskinesias, rigidity, and tremor, while balance, gait disorders, and
hypophonia are generally less responsive to surgery. Benefits of
pallidotomy appear to be long lasting.

(5) Each institution's complication rate should be discussed before surgery.


Arch Neurol 1999 Sep;56(9):1064-9
Bronstein JM, DeSalles A, DeLong MR
University of California, Los Angeles, School of Medicine, 90024, USA.
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PMID: 10488806, UI: 99416909

<http://www.ncbi.nlm.nih.gov/PubMed/>

janet paterson
52 now / 41 dx / 37 onset
613 256 8340 po box 171 almonte ontario canada K0A 1A0
a new voice: <http://www.geocities.com/SoHo/Village/6263/>
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