Posteroventral medial pallidotomy in levodopa-unresponsive parkinsonism

Joachim K. Krauss, Joseph Jankovic, Eugene C. Lai, Gayle M. Rettig, Robert G. Grossman

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Parkinsonism in a 42-year-old patient, which was presumably related to peripheral trauma, did not respond to levodopa therapy. Observation: We treated the patient with microelectrode-guided unilateral posteroventral medial pallidotomy and followed up with magnetic resonance imaging and prospective clinical evaluation. Pallidotomy resulted in marked improvement of right-sided parkinsonian symptoms and functional disability at 4.5 months after surgery. Microelectrode recording during pallidotomy revealed discharge patterns that were similar to those seen in patients with Parkinson disease. Post-operative magnetic resonance imaging confirmed the location of the lesion in the posteroventral medial pallidum. Conclusions: Posteroventral pallidotomy usually has limited benefit in patients with degenerative atypical parkinsonism who do not respond to levodopa therapy. Nevertheless, pallidotomy can be an effective treatment for other levodopa- unresponsive parkinsonian disorders.

Original languageEnglish (US)
Pages (from-to)1026-1029
Number of pages4
JournalArchives of neurology
Issue number8
StatePublished - 1997

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology


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