Table B8.

Therapeutic Breakout 8 GPi pallidotomy

Advantages
Consistent and dramatic improvement in contralateral dyskinesia
Mild improvement in parkinsonian features
Widely available
Disadvantages
Necessitates needle passage(s) through the brain, with risk for hemorrhage
Necessitates making a lesion in the brain with risk for damage to internal capsule and visual pathways
Bilateral lesions associated with additional risks that include cognitive dysfunction, dysphagia, and dysarthria
Optimal target site not precisely defined
Necessity for microelectrode recordings not definitively established
Mechanism responsible for clinical benefit not defined
Lesion may preclude use of more effective therapy in the future