ABSTRACT
Surgical treatments for Parkinson’s disease (PD) reemerged in the 1990s after essentially two decades of relative obscurity. Prior to the late 1960s, treatment of PD consisted of the use of marginally beneficial pharmacological therapy and lesioning operations. Lesioning operations, including thalamotomy, were employed mainly in attempts to treat severe tremor. Major limitations encountered with surgical treatments in the first half of the 20th century included inconsistent targeting and side effects from lesioning. Inconsistent targeting occurred because of the lack of reliable radiological assistance for stereotactic procedures. Retrospective review of historic surgical records suggests that attempted thalamotomies, especially those deemed as particularly clinically successful for parkinsonism, were probably often subthalamotomies judging from notation of immediate, transient, postoperative chorea.* Lesioning side effects, even in instances with accurate targeting, such as dysphonia or dysarthria in bilateral lesioning operations, also limited enthusiasm for surgical treatment of PD.
