Surgery for movement disorders.

Since Laitinen’s report of pallidotomy for the treatment of advanced Parkinson’s disease less than a decade ago, there has been a resurgence of interest in functional neurosurgery for movement disorders. The convergence of several paths, including the clinical problem of levodopa induced dyskinesias and motor fluctuations, increased understanding of cellular pathophysiology, improved brain imaging and microelectrode recording techniques, and the development of deep brain stimulation (DBS), have paved the way for novel therapeutic strategies and major advances in the field. The neurologist must work in partnership with the neurosurgeon in a multidisciplinary team, helping to optimise patient selection, assess patients interoperatively, and supervise drug treatment and stimulation parameters postoperatively.