Parkinson's Disease: Surgical Treatments: Pallidotomy and Thalamotomy

Generally, surgery is only considered as a treatment for Parkinson's disease when medication cannot adequately control symptoms. Two surgical approaches used for Parkinson's are pallidotomy and thalamotomy.

What Is Pallidotomy?

It is thought that the part of the brain called the globus pallidus becomes overactive in Parkinson's disease. This overactivity acts like a brake and slows or diminishes bodily movement. Pallidotomy surgery permanently destroys the overactive globus pallidus to lessen the symptoms of Parkinson's disease. This treatment can eliminate rigidity and significantly reduce tremor, bradykinesia, and balance problems. Pallidotomy can also enhance medication treatment in people with an advanced form of Parkinson's disease.

What Is Thalamotomy?

It is thought that the abnormal brain activity that causes tremor is processed through the thalamus. Thalamotomy destroys part of the thalamus to block the abnormal brain activity from reaching the muscles and causing tremor. Because thalamotomy is used only to control tremors, it is not generally recommended as a treatment for Parkinson's disease.

Although thalamotomy and pallidotomy surgeries are still done today, they are done less frequently because of the risk of serious side effects and the availability of deep brain stimulation, which is safer and has fewer complications.

Reviewed by the doctors at The Cleveland Clinic Neuroscience Center