Objective: Characterize patients with idiopathic Parkinson’s disease undergoing posteroventral pallidotomy. Assess improvement in motor symptoms after pallidotomy.

Background: Parkinson’s disease is a neurodegenerative disease with progression of symptoms although drug treatment. Many patients are candidates for surgical procedures such as stereotactic pallidotomy, wich improves motor symptoms. Factor in the reduced likelihood of complications is the appropriate selection of candidates for surgery.

Methods: Description of eleven patients with Parkinson’s disease with stereotactic posteroventral pallidotomy, one year follow up. Demographic and clinics characteristics are described, measured changes in motor symptoms, neuroimaging, video recording pre and postoperative.

Results: It was included eleven patients with Parkinson’s disease with stereotactic posterovenral pallidotomy, from April 2013 until December 2014. All are men. Age range 37-61 years (Average 48 years).Average of evolution of motor symptoms was 6 years. Motor symptoms were predominant tremor 72%, bradykinesia 54%, rigidity 54% and dyskinesias 27%. The most frequent motor fluctuations were wearing off 90%, freezing gait 45%, unexpected end of dose 27%, delay effect 18% and no on 18%. Hoehn and Yahr pre surgical average was 3.5 and the postoperative was between 2 and 2.5. The average score UPDRS section III, pre surgery was 97 points and in the postoperative 3 months was 39 points, 6 months 41 points and 12 months 45 points. Three left pallidotomy and eight right pallidotomy was performed. Schwab & England in pre surgical was 50% and 12 months after surgery 80-90%. Reduction to mild dyskinesias observed. The average dose pre surgical of Levodopa was 1000 mg/day, in the postoperative dose was 500-750 mg/day. No one patient had visual or motor deficits. One patient had bleeding at the site of the lesion demonstrated on CT after surgery without associated deficit.

Conclusions: In patients with Parkinson’s disease with stereotactic pallidotomy, was observed clinical improvement of motor symptoms, with major effect in the first 6 months after pallidotomy. Levodopa dose it was reduced to 50%. Morbidity low and no mortality was observed. Therefore it is a procedure if performed in appropriate candidates is efficacious and with safe results. References. Alkhani and A.M.Lozano. Pallidotomy for Parkinson’s disease: a review of contemporary literatura. J Neuroscisurg (2001);94:43-49.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/stereotactic-pallidotomy-for-parkinsons-disease-in-el-salvador-one-year-follow-up/