Dystonia Musculorum Deformans Alleviated by Chemopallidectomy and Chemopallidothalamectomy

Of the many neurologic diseases which have failed to respond to medical or surgical therapeutic measures, the extrapyramidal disorders of childhood have, by and large, been considered as the most intractable, and have generally been regarded as hopeless. In 1951 Percival Bailey stated that on the whole surgery has little application in the vast field of the extrapyramidal hyperkinesias. However, in the brief six years since this statement was made, considerable progress has been made as regards the possibilities for the surgical therapy of tremor and rigidity in the adult Parkinsonian patient. Our own series (St. Barnabas Hospital) of 800 cases of Parkinsonism treated by anterior choroidal artery occlusion (50 cases) and chemopallidectomy (750 cases) demonstrates that both tremor and rigidity can be alleviated without any neurologic sacrifice by the infliction of well-localized but sufficient-sized lesions in the globus pallidus and/or the ventrolateral nucleus of the thalamus. Similar progress has