Treatment of functional disorders with gamma knife thalamotomy

Gamma knife (GK) thalamotomy for functional disorders, primarily Parkinson disease and central pain, are described herein. The goal was to extend our present indications for selective thalamotomy. Our target for tremor surgery is about 45% of the thalamic length. Thus, this principle was applied to deciding the GK thalamotomy target. In most of our cases, the protocol was 130 Gy, delivered in one shot with a 4-mm collimator. The time courses of thalamic lesion changes and clinical improvement after irradiation were assessed. Thus, despite thalamic reaction changes being variable, we achieved a clinical success rate of approximately 80% with negligible complications.