ABSTRACT
EARLY SURGICAL EXPERIMENTS Early attempts to treat tremor by open resection of motor and premotor cortex resulted in the substitution of disabling extrapyramidal symptoms with disabling hemiparesis (1,2). Amajor advance came about with the publications of Russell Meyers in 1942 and 1951, showing that surgical resection of the head of the caudate nucleus and pallidofugal fibers (3,4) could resolve tremor and rigidity without inducing paresis. This paved the way for the next 20 years of experimental basal ganglia lesion surgery as a treatment for extrapyramidal syndromes. Surgical precision was improved and comorbidity was reduced with the development of the stereotaxic technique (5). Subsequently, stereotaxic chemopallidectomy using procaine oil (6), alcohol (7), and pallidal electrocoagulation (8,9) were reported to effectively improve tremor and rigidity.
