What is pallidotomy?

In Parkinson's disease, a part of the brain called the globus pallidus is overactive. This causes a decrease in the activity of a different part of the brain that controls movement.

In a pallidotomy, the surgeon destroys a tiny part of the globus pallidus by creating a scar. This reduces the brain activity in that area. It may help relieve movement symptoms such as tremor and stiffness.

Before surgery, detailed brain scans using MRI are done to find the precise location for treatment.

Surgery on one side of the brain affects the opposite side of the body. If you have tremor in your right hand, for instance, the left side of your brain will be treated.

Pallidotomy may reduce tremor, muscle stiffness, slow movement, and other motor symptoms. It may also improve balance.

Permanent problems from pallidotomy can include:

• Changes in behavior or personality.
• Trouble speaking well.
• Trouble swallowing.
• Weakness of the facial muscles that can cause drooping.
• Problems with vision.

Short-term problems can include:

• Weakness of the facial muscles that can cause drooping.
• Trouble speaking well.
• Confusion.
• Sleepiness.

The surgery usually requires a 2-day hospital stay. Most people recover completely within about 6 weeks.

Pallidotomy may be an option when a person with advanced Parkinson's disease has:

• Severe motor problems. These include sudden, jerky movements and on-off responses. These can occur with long-term levodopa treatment.
• Severe problems that medicine can't control. These may include a disabling tremor, stiffness, or slow movement.