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Thalamotomy
First introduced in the 1950s, thalamotomy is a procedure, primarily effective for tremors such as those associated with Parkinson's disease (PD), where a selected portion of the thalamus is surgically destroyed (ablated). Neurosurgeons use specialized equipment to precisely locate an area of the thalamus, usually choosing to work on only one side (the side opposite that of the worst tremors). Bilateral procedures are poorly tolerated because of increased complication and risk, including vision and speech problems. The positive effects on tremors are immediate. Other less destructive procedures are sometimes preferred, such as subthalamic deep brain stimulation (DBS), since this procedure can also improve tremors and other symptoms of PD.〔Julie A. Fields, Alexander I. Tröster, Cognitive Outcomes after Deep Brain Stimulation for Parkinson's Disease: A Review of Initial Studies and Recommendations for Future Research, Brain and Cognition, Volume 42, Issue 2, March 2000, Pages 268-293, ISSN 0278-2626, 10.1006/brcg.1999.1104.〕〔Bruce BB, Foote KD, Rosenbek J, Sapienza C, Romrell J, Crucian G, Okun MS:
Aphasia and Thalamotomy: Important Issues.
Stereotact Funct Neurosurg 2004;82:186-190 〕〔Justin S. Cetas, Targol Saedi, and Kim J. Burchiel. Destructive procedures for the treatment of nonmalignant {}pain: a structured literature review. J Neurosurg 109:000–000, 2008〕
==Subthalamotomy==
Subthalamotomy is a type of brain surgery in which the subthalamic nucleus is destroyed in attempt to help alleviate movement disorders often associated with Parkinson’s disease.〔Subthalamotomy. ''National Parkinson Foundation''. Retrieved from http://www.parkinson.org/Parkinson-s-Disease/Treatment/Surgical-Treatment-Options/Subthalamotomy.aspx〕 This surgery has been most widely researched at Havana’s International Center for Neurological Restoration (CIREN) located in Cuba. This center has assumed a leading role in developing a surgical procedure that provides significant relief for patients experiencing the slowness of movement, tremor and muscle rigidity in middle to late stages of PD. Similar to the thalamotomy, this procedure can be repeated on both sides of the brain bilaterally, but is not recommended due to a large increase in the risk of speech and cognitive problems post-surgery.〔Stix, Gary. (2003). Sustainable Surgery. ''Scientific American.'' Retrieved from http://www.scientificamerican.com/article.cfm?id=sustainable-surgery〕 The aim of subthalamotomies is to reduce symptoms of PD and the uncontrolled movements that can happen to someone who has been taking the drug levodopa for a long period of time.〔Subthalamotomy. ''BootsWebMD''. Retrieved from http://www.webmd.boots.com/a-to-z-guides/parkinsons-disease-subthalamotomy〕
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