Present Role of Stereotactic Thalamotomy for Parkinsonism

Abstract

14 cases of unilateral and 5 cases of bilateral thalamotomy for parkinsonism were reviewed, with 32–144 months’ (mean 67.8) and 54–212 months’ (mean 110) follow-up, respectively, after the initial operation. Rigidity and tremor disappeared in approximately 80% of cases and was reduced in the remaining 20%. 68% improved by one or two grades in the Hoehn-Yahr scale after operation. Thalamotomy abolished dyskinesias and on-off phenomena on the operated sides. 36% of cases discontinued levodopa therapy after operation. CT study of the lesions suggested that destruction of a large part of basal Vop was most important to obtain the best results.

The use of thalamotomy in the treatment of levodopa-induced dyskinesia

“…1971). However several authors note that patients with a previous thalamotomy have not gone on to develop levodopa induced dyskinesia (Hughes 1971, Tasker 1983, Matsumoto 1976, Narabayashi 1984, Miyamoto 1985. The complication of thalamotomy most commonly described is post-operative dysphasia, especially a difficulty in word finding, which does appear to improve a little with time.…”