ABSTRACT
Surgical treatments have been used for decades to treat a variety of movement disorders including tremor disorders, Parkinson’s disease, and dystonia. Beneficial effects of serendipitous lesions in corticospinal, thalamic, and basal ganglia regions resulted in the deliberate use of ablative techniques directed at various components of pyramidal and extrapyramidal pathways. As the pathophysiology underlying movement disorders came to be appreciated, surgical intervention with a rational anatomicophysiological basis emerged. Procedures initially entailed destructive lesioning of nuclei exhibiting aberrant neurophysiological activity-thalamotomy and pallidotomy. More recently, the advent of deep brain stimulation (DBS) has provided a means of reversibly modulating activity in thalamic and basal ganglia nuclei in a manner that is nondestructive, adjustable, and safer for bilateral use using an implantable device.
