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What are Surgical Options to Treat Parkinson's?

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: April 2025 | Last updated: April 2025

No type of surgery can cure Parkinson's disease (PD). However, surgical methods may relieve symptoms of PD in some people.1,2

Surgical procedures for PD are typically considered after other treatments, like medicines, have been exhausted. Surgery generally only works to improve the motor symptoms of PD that have previously improved on levodopa therapy.1,2

Types of surgeries for Parkinson’s disease

Today, deep brain stimulation (DBS) is the most common surgery for PD. DBS has fewer risks and works by disrupting electrical signals in the brain rather than destroying tissue.1,2

There are other surgical procedures for people with PD. These procedures aim to destroy specific parts of the brain to relieve symptoms. They are less commonly used and have major risks, including the possibility of death. These procedures include:1,2

  • Pallidotomy
  • Thalamotomy
  • Subthalamotomy

Deep brain stimulation

Deep brain stimulation (DBS) is a procedure in which electrodes (thin wires) are implanted in specific areas of a person’s brain. These electrodes are attached to a pulse generator (a pacemaker-like device) that is implanted under the skin.2

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Together, the pulse generator and electrodes deliver precise electrical pulses. The electrical pulses are targeted to specific areas of the brain that contribute to abnormal motor symptoms in people with PD. The electrical pulses disrupt the abnormal signals in these brain areas to reduce motor symptoms like tremor. Specific areas of the brain that may be targeted by the electrodes include the thalamus, subthalamus, and the globus pallidus.2

DBS may be considered for people who have had PD for 4 or more years and:3

  • Have significant times when their medicine is not working well
  • Have dyskinesia

DBS can help relieve motor symptoms like:3

DBS does not work well to treat balance impairments, freezing when walking, or non-motor symptoms of PD. Because DBS can worsen cognition or memory problems, it is not recommended for people with dementia.3

Pallidotomy

Pallidotomies are rarely performed today. However, the surgery may be considered for a person with advanced PD who has developed severe motor fluctuations like dyskinesia (uncontrolled, abnormal movements) from long-term levodopa treatment. Pallidotomy may also be performed for those with severe or disabling motor symptoms (like tremor, rigidity, or bradykinesia) that are no longer controlled with medicine.2

During a pallidotomy, the part of the brain called the globus pallidus is destroyed. In people with PD, there is an abundance of activity in the globus pallidus. Creating a scar in this portion of the brain reduces the activity, which may help relieve motor symptoms like tremor and rigidity. Before surgery, the globus pallidus is located using brain scans like magnetic resonance imaging (MRI).2

Thalamotomy

Thalamotomies are rarely performed today. However, the surgery may be used to treat severe tremors on 1 side of the body that are not relieved by medicine.2

During a thalamotomy, the part of the brain called the thalamus is destroyed. Damaging the thalamus may relieve tremors. Surgery on the right side of the brain affects the left side of the body, and surgery on the left side of the body affects the right side of the body.2

A thalamotomy is performed on the contralateral side of the brain to where the person has the worst motor symptoms. To locate the thalamus, brain scans like MRI or computed tomography (CT) are used before surgery.2

Subthalamotomy

Subthalamotomies are rarely performed today. During a subthalamotomy, the small portion of the brain called the subthalamic nucleus is destroyed. This helps relieve motor symptoms of PD like tremor, rigidity, and bradykinesia.2,4

In most cases, a subthalamotomy is performed only on 1 side of the brain. The risk of speech and cognitive problems is greatly increased when it is performed on both sides of the brain. To locate the subthalamus, brain scans like MRI or CT are used before surgery.2,4

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.