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Seminars in Neurosurgery 2001; 12(2): 139-148
DOI: 10.1055/s-2001-17120
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Neurosurgical Treatment of Movement Disorders: History and Update

Philip L. Gildenberg
  • Department of Neurosurgery and Radiation Oncology, Baylor Medical College, Houston, TX
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Publication History

Publication Date:
13 September 2001 (online)

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ABSTRACT

Surgery for movement disorders began at the beginning of the last century, but did not become practical until the development of stereotactic surgery in 1947. During the subsequent two decades, an amazing amount of empirical surgery defined the potential targets, most of which involved the reverberating extrapyramidal pathways between the globus pallidus and the ventrolateral thalamus. When L-dopa was introduced in 1968, the amount of surgery for Parkinson's disease plummeted, and with it the expertise and interest in surgery for other movement disorders, as well. With the technological and imaging advances that occurred during the subsequent decades, the stage was set for the rebirth of stereotactic surgery when we were reminded that pallidotomy remains a valuable tool in the management of not only parkinsonism, but the side effects of Parkinson medications as well. The increased interest that was generated was additionally stoked by the suggestion that the use of an implanted stimulator might provide the same benefit as producing a lesion but with less risk.

KEYWORD

Stereotactic surgery - pallidotomy - thalamotomy - Parkinson's disease - dystonia - torticollis - L-dopa - deep brain stimulation - history - technology

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