Forty-Five Years of Stereotactic Surgery for Parkinson’s Disease: A Review

An overview of a large experience of the surgical management of parkinsonism from 1954 to 1999 is outlined--from the original open surgery of Fenelon to the sophisticated, motor-driven electrodes of stereotactic surgery using depth microelectrode recording. The definition of the best target sites for the relief of tremor, rigidity and bradykinesia evolved progressively as accuracy in siting of lesions developed. The significance of these targets in understanding the pathophysiology of the disease and the neurotransmitters involved gradually became clearer and a way forward in future management was suggested.