This report concerns the authors' findings on the effect of thalamic surgery (particularly cryothalamectomy) in bilateral parkinsonism, not only from the viewpoint of neurosurgery but from that of several other disciplines, e.g., physical therapy, speech therapy, psychology, and vocational rehabilitation-in both the immediate postoperative and long-range situations. The purpose of the investigation was to gain more knowledge concerning the treatment of parkinsonism and the pathophysiological mechanisms of the disease, and also the relationship between behavioral disturbances and alterations in the subcortical regions of the brain.Details are given in five chapters entitled respectively: Background, Patients and Procedures, Results, Discussion and Impllcations, and Significant Findings for the Rehabilitation Worker. The conclusions, outlined in the fifth chapter, are:Bilateral tremor and rigidity can be relieved by bilateral cryothalamectomy in most parkinsonian patients who are properly selected for surgery.Symptomatic relief is significantly related to improvement in self-care ability, functional status and return to gainful employment.

Electromyographic studies of the monosynaptic reflex in 70 Parkinsonian patients and 12 normal subjects show four types of abnormal facilitation and recovery curves in the Parkinsonian group, types that correspond to variations in the clinical syndrome; Cryosurgical lesions in the, ventro-lateral and ventro-postero-lateral nuclei of the thalamus restore essentially normal curves.

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