Consensus regarding indications for surgical treatment of Parkinson disease

: Renewed interest (also in Poland) in the neurosurgical treatment of Parkinson's Disease is the main cause of referring patients to stereotactic surgery. It is the result of our improved understanding of functional anatomy of basal ganglia and development of neurophysiological, neuroimaging and neurosurgical techniques. Various surgical options and possible targets offer different functional benefits, but due to almost 10 years experience we are aware of limited results and possible complications as well. There is a need of minimal standard of patient's evaluation before selection to surgery. The selection criteria include: good diagnosis of Parkinson's Disease, at least 5 years from the onset of symptoms, good responsiveness to L-dopa or apomorphine, exclusion of severe depression and dementia, neuroimaging (MRI) before surgery and optimal (but ineffective) pharmacological therapy before surgery.