For these reasons, and because of advances in imaging techniques and a more complete understanding of the neuro-physiological mechanism structures involved in movement disorders, the surgical management of Parkinson's disease with stereotactic intervention is now much more frequently recommended than just two to three years ago. For a short time, adrenal gland transplantation into the caudate nucleus was thought to be an effective treatment for Parkinson's disease. Today, thalamotomy is considered to provide the best relief for tremor, when tremor is the most troublesome aspect of the disease. Thalamotomy is less effective for bradykinesia and dyskinesias. When thalamotomy is employed, approximately 85 percent to 90 percent of patients have relief of tremor, while only about 50 percent have improvement of rigidity and bradykinesia.
Neurological complications are usually temporary.
When bradykinesia, rigidity, or drug-induced dyskinesias are the most disabling symptoms, pallidotomy is the procedure of choice. Pallidotomy also improves tremor. Over 70 percent of patients are improved for at least one year. Serious complications occur in less than five percent of patients. M.D. Dementia is common in Parkinson's disease, occurring in up to 40 percent of affected patients.