BACKGROUND: Posteroventral medial pallidotomy sometimes produces striking improvement in @entity1 with advanced @entity191 , but the studies to date have involved small numbers of @entity1 and short-term follow-up. METHODS: Forty @entity1 with @entity191 underwent serial, detailed assessments both after drug withdrawal ("off" period) and while taking their optimal medical regimens ("on" period). All @entity1 were examined preoperatively and 39 were examined at six months; 27 of the @entity1 were also examined at one year, and 11 at two years. RESULTS: The percent improvements at six months were as follows: off-period score for overall motor function, 28 percent (95 percent confidence interval, 19 to 38 percent), with most of the improvement in the contralateral limbs; off-period score for activities of daily living, 29 percent (95 percent confidence interval, 19 to 39 percent); on-period score for contralateral @entity910 , 82 percent (95 percent confidence interval, 72 to 91 percent); and on-period score for ipsilateral @entity910 , 44 percent (95 percent confidence interval, 29 to 59 percent). The improvements in @entity910 and the total scores for off-period @entity304 , contralateral @entity2845 , and @entity2003 were sustained in the 11 @entity1 examined at two years. The improvement in ipsilateral @entity910 was lost after one year, and the improvements in postural stability and gait lasted only three to six months. Approximately half the @entity1 who had been dependent on assistance in activities of daily living in the off period before surgery became independent after surgery. The complications of surgery were generally well tolerated, and there were no significant changes in the use of medication. CONCLUSIONS: In late-stage @entity191 , pallidotomy significantly reduces @entity3034 -induced @entity910 and off-period disability. Much of the benefit is sustained at two years, although some improvements, such as those on the ipsilateral side and in axial symptoms, wane within the first year. The on-period symptoms that are resistant to dopaminergic therapy do not respond to pallidotomy.

Posteroventral medial pallidotomy in advanced XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity3034 :: ('MESH:D007980', 'Chemical') :: ['levodopa'] @entity2003 :: ('MESH:D009127', 'Disease') :: ['rigidity'] @entity304 :: ('MESH:D010302', 'Disease') :: ['parkinsonism'] @entity910 :: ('MESH:D004409', 'Disease') :: ['dyskinesias'] @entity191 :: ('MESH:D010300', 'Disease') :: ["Parkinson's disease"] @entity2845 :: ('MESH:D018476', 'Disease') :: ['bradykinesia']
@entity191 :: (MESH:D010300,Disease) :: ['Parkinson's disease']
