Indication and results of stereotactic surgery for advanced Parkinson's disease

In the past decade there has been a resurgence of interest in neurosurgical interventions for the treatment of medically intractable Parkinson's disease. The reasons for this development include improved surgical techniques, a better understanding of the pathophysiology of Parkinson's disease providing the scientific rationale for such interventions, and the clinical problems of long-term levodopa treatment. Among the modern stereotactic procedures that are now available for the treatment of patients with advanced Parkinson's disease and levodopa-induced side effects, the effects of pallidotomy are best studied. More recently, chronic high-frequency stimulation of the internal pallidum and subthalamic nucleus have been proposed as surgical alternatives. This article reviews the most recent reports concerning the indication and results of stereotactic surgery for the treatment of advanced Parkinson's disease.