A specialty in the practice of medicine that focuses on surgical treatments for diseases and disorders of the brain and other structures of the nervous system. For most people with Parkinson’s disease, surgery becomes a viable treatment option only when anti-parkinson’s medications and other medical treatments do not control symptoms. Surgical therapies to treat the symptoms of Parkinson’s disease include pallido-tomy and thalamotomy, in which the neurosur-geon uses ablation to create lesions, or scar tissue, in brain structures that control movement. deep brain stimulation of either the thalamus, sub-thalamic nucleus, or pallidum is currently a more popular procedure because it lacks the irreversibil-ity of ablation, can be titrated to provide benefit and avoid side effects, and has much less risk of side effects when a bilateral procedure is necessary. Because brain function and the course of Parkinson’s disease are unique to each individual, surgical therapies have variable success. And because Parkinson’s is progressive, symptoms may eventually return. Many people who have surgical treatment for Parkinson’s experience long-term relief of symptoms such as tremors, bradykinesia (slowed movement), akinesia (inability to move), and other dyskinesias (abnormal, involuntary movements).
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