Surgical methods are remarkably useful in cases with medically intractable Parkinson’s disease. These procedures have high efficiency and low morbidity, when they are performed in the experienced centers. There are two surgical basic stereotactic methods in the management of the disease:
(1) lesioning (unilateral thalamotomy or pallidotomy with radiofrequency);
(2) neurostimulation. These procedures are performed on the several deep brain structures: the subthalamic nucleus (STN), the pallidum (internal-posterior part) and thalamus (nucleus ventrointermedius).
Thalamotomy and pallidotomy are usually performed unilaterally. Thalamotomy is indicated in cases mainly suffering from tremor; on the other hand, pallidotomy in cases with drug induced diskinesias dominantly. Bilateral STN neurostimulation has recently become the most prominent surgical method in the control of the cardinal parkinsonian symptoms, e.g., bradikinesia. In this article, we summarize the surgical techniques and our results of 552 cases with movement disorders including Parkinson’s disease, who underwent surgical procedures in the last 45 years.