Stereotactic thalamotomy and L-dopa induced involuntary movement in Parkinsonism.

Involuntary movement is one of the most disturbing and problematic side effects of L-dopa in the treatment of Parkinsonism. Several attempts have been made to reduce this complication, such as an addition of adjuvant, (4) and use of slow release L-dopa. However, the problem remains unsolved probably because hyperkinesis occurs when the akinesis of Parkinonism is overcorrected by L-dopa and produces hyperkinesis (15). For more than 15 years we have been treating Parkinsonian patients with stereo tactic thalamotomy or pallidotomy or both and began to use L-dopa since 1968. We found that the previous operation reduces the incidence and severity of L-dopa in duced involuntary movements in the treated limbs suggested by several authors (1) (15) (17) (20). This paper is an analysis of L-dopa induced involuntary movements seen in 29 cases in 121 Parkinsonian patients treated with L-dopa, 94 cases with the previous stereotactic procedures and 27 non-surgical cases.