Posteroventral pallidotomy in Parkinson's disease

Harstall C, Hailey D
Record ID 31997008260
English
Authors' objectives: A short overview of the effectiveness and status of a neurosurgical procedure, posteroventral pallidotomy (PVP), which is used in the treatment of some people with Parkinson's Disease.
Authors' results and conclusions: 1) PVP is symptomatic treatment and does not halt progression of the disease or replace the need for medication. 2) technical aspects of the procedure continue to evolve, notably in relation to location of the target site and determination of the volume of tissue to be ablated. There is no consensus on whether microelectrode recording techniques should be used as part of the location process. 3) Several trials have shown that PVP can be effective in relieving symptoms. The quality of the available evidence is fair to poor and there are few data on long-term outcomes. 4) Alternative procedures, including radiosurgical pallidotomy and chronic high-frequency stimulation, have been used in small numbers of cases. 5) There are strong anecdotal reports of individuals who have experienced a dramatic improvement to their quality of life following the procedure. 6) PVP is associated with complications, though these should be regarded in the context of the severity of the disease in those who are candidates for the procedure. 7) Economic data for the procedure in Alberta are not available. However, hospital stays for PVP are expected to be brief, and alternative medical treatments may be costly.
Authors' recomendations: 1) The procedure should be regarded as an evolving technology, with uncertain outcomes, until further data are available. 2) PVP should be performed only in specialized centres which have combined neurological and neurosurgical expertise. 3) Systematic collection of data on PVP cases in the province should be obtained, and include results of long-term follow-up. 4) Close contact should be maintained with other centres undertaking PVP. 5) The comparative advantage of PVP should be kept under review, both in regard to conventional methods of management and to chronic high-frequency brain stimulation techniques, which may offer effective alternatives without ablation of brain tissue.
Authors' methods: Systematic review
Details
Project Status: Completed
Year Published: 1997
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Humans
  • Globus Pallidus
  • Pallidotomy
  • Parkinson Disease
Contact
Organisation Name: Institute of Health Economics
Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;
Contact Name: djuzwishin@ihe.ca
Contact Email: djuzwishin@ihe.ca
Copyright:

Alberta Heritage Foundation for Medical Research, 1997

This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.