This specialised procedure is used to treat several movement disorders, ranging from dystonia to Parkinson’s disease.

Surgical Technique of Pallidotomy

After a patient gets evaluated on outpatient basis; he / she gets admitted and is thoroughly evaluated by our team comprising of well trained doctors and nurses.

Each individual patient is put through rigorous tests and evaluation parameters which help us to further narrow down the patient’s problems and offer optimum treatment. Routine blood and radiological required for surgery are performed.

The patient is also assessed by anaesthesiologist to determine surgical fitness.

The next day patient undergoes a MRI which may or may not require anaesthesia.

On the day of the surgery the patient is taken to the operation theatre. A frame is fixed to the patients head under local anaesthesia.

Patient is taken for CT scan after frame fixation. After the patient returns from the CT scan his/her head is fixed with the help of the frame to the table. The head is cleaned thoroughly with antiseptic solution.

The appropriate surgical trajectory is identified to target the GPi. Incision is taken based on the coordinates under local anaesthesia.

A microelectrode is inserted after creating a small hole in the skull. The electrical recordings are sequentially noted followed by which macro electrode stimulation of target is done during which the patient is assessed for symptom improvement.

A lesion is then created using thermal energy at appropriate level/s. The wound is closed and patient is shifted to CT scan. Patient is subsequently shifted to his/her room.


The surgical precision and meticulousness along with proper patient selection has meant that our complications are on the lower side. Complications related to surgical techniques like hemorrhage or infarct are reported in literature with an incidence of around 4%.

Transient encephalopathy which is reversible occurs in 10% of patients in various studies.

Speech disturbances in the form of dysarthria, hypophonia and dysphasia are common in literature but not so frequent in our series of patients.

Bilateral Pallidotomies result in severe dysphagia, apathy, loss of initiative, loss of motivation and motor drive and persistent levodopa resistant gait freezing.

Benefits of Pallidotomy

Pallidotomy greatly helps in sustained amelioration of contralateral dyskinesias.

This leads to improved tolerance of Levodopa and more dyskinesia free On phase. Rigidity Bradykinesia and tremors of the opposite side also improve to a great extent. Speech symptoms do not respond to pallidotomy and may even worsen. Painfull dystonia greatly decreases.

With the advent and technological advances made in the field of DBS have made Pallidotomy less opted treatment modality. Though it still remains a viable option for many patients.