Pallidotomy is typically reserved for patients whose condition is unsatisfactorily controlled on conventional treatment. Relative poor predictors include older age, multiple medical problems, impaired cognition and marked freezing of gait. Reduction in dyskinesias is the most dramatic benefit followed by reduction in tremor, rigidity and bradykinesia. Gait improves moderately but freezing of gait, speech and swallowing often respond less dramatically. Then, an electrode is inserted through a small burr hole, and the target is heated resulting in a small lesion.
Results are almost immediate, and the recovery time is brief and typically uncomplicated.
Transplant studies are ongoing, including the use of fetal pig transplants to avoid the numerous difficulties with human fetal research. The placement of growth factors into the brain is another exciting area of active research. Hanna PA, Cardoso F, Jankovic J. Basal Ganglia and Movement Disorders. Neurology Secrets, 2nd ed.