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Surgical Treatment of Parkinson's Disease
In the hands of experienced surgeons operations like thalamotomy and pallidotomy, that excise some areas of the brain related to the persistence of the motor disorder might be indicated. In general, very few selected cases are candidates for surgery, mostly individuals with disabling unilateral movement disorder that is resistant to medication.
Deep brain stimulation with electrodes implanted in the brain is a surgical technique that does not require ablation of the brain and might also be useful in selective cases.
The indications for surgery are limited, and surgery should be done after carefully considering both the benefits and side effects of the surgery.
Transplantation of neurons in the brain to restore the dying cells is an interesting approach; however, this method is still in the experimental phase.
Enhanced Physiologic Tremor
In cases in which the tremor is associated with a specific disease, the tremor improves with the treatment of the condition. When anxiety is the only problem or no other cause is found, then propranolol (Inderal, Inderal LA) or clonazepam (Klonopin) could be effective.
Norberto Alvarez, MD
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