Efficacy and safety of simultaneous bilateral pallidotomy in advanced Parkinson's disease.
BACKGROUND
Although unilateral pallidotomy is generally considered a safe and effective neurosurgical treatment for advanced Parkinson's disease (PD), controversies concerning efficacy and adverse effects of bilateral posteroventral pallidotomy (PVP) exist and need to be resolved.


METHODS
We studied 8 patients with advanced PD who underwent simultaneous bilateral PVP. The patients were assessed preoperatively, immediately after surgery, and 6 and 12 months later.


RESULTS
Dyskinesia was almost entirely abolished immediately after surgery, as well as being significantly lower 1 year later (p < 0.05). The 'off' medication score of the Unified Parkinson's Disease Rating Scale motor part (UPDRS III) was significantly improved after surgery (p < 0.05) but increased gradually after 6 months. The off medication score of activities of daily living tended to improve immediately after surgery, but it returned to preoperative levels at 12 months. There were no major complications of surgery.


CONCLUSIONS
Simultaneous bilateral PVP may be a safe and highly effective method of reducing levodopa-induced dyskinesia. Our results suggest that simultaneous bilateral PVP may be a reasonable therapeutic option for advanced PD with severe levodopa-induced dyskinesia.
Chung
Sun J
SJ
Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Hong
Seok Ho
SH
Kim
Sung R
SR
Lee
Myoung C
MC
Jeon
Sang Ryong
SR
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects; D020820:Dyskinesias / Q000209:etiology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D016634:Radiosurgery; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa