This is a translation of version 1, published on June 5, 1999. The latest version of this report is not available in English.
Neurosurgery is not widely used to complement pharmacological treatment of Parkinsons disease. Pallidotomy, a procedure involving heating of malfunctioning brain tissue with an electrode, is the method which has received greatest attention during the 1990s. Several uncontrolled studies have shown that pallidotomy reduces symptoms such as hyperkinesia (involuntary movement), rigidity (stiffness), dystonia (painful muscle cramps), tremors (shakiness), and akinesia (poverty of movement), in that order.
Based on the studies reviewed, SBU Alert has found moderate* evidence to support the short-term effects of the method on patient symptoms. However, poor* evidence has been presented yet regarding the duration of these effects and their importance on the patients quality of life.
Pallidotomy should be performed only in conjunction with scientific studies until more knowledge is acquired on patient benefits and reliable data demonstrates the relationship between costs and benefits.
*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.
This summary is based on a report prepared at SBU in collaboration with Assoc Prof Marwan Hariz, MD PhD, Norrland’s University Hospital in Umeå. It has been reviewed by Olof Corneliusson, MD, Sahlgrenska University Hospital.
Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.
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