Conventional Parkinson's treatment is based on the use of drugs that try to compensate for the deficiency of nigrostriatal dopamine. However, nowadays we know that pharmacological treatment does not control the clinical manifestations of the disease indefinitely. In fact, at least 50% of conventionally treated patients experience major complications, such as fluctuations in mobility, dyskinesias, psychic disturbances, and autonomic control, which seriously disrupt therapeutic control and lead to functional disability. The clinical picture is aggravated by the deterioration in the pharmacological response: posture, language changes, impeded gait, freezing and falls.
LIMITED PHARMACOLOGICAL PERSPECTIVES
Because of the limited pharmacological perspectives for successful treatment or prevention of these complications in the mid-term, and thanks to advances such as better pathophysiological knowledge of the structures involved in the origin of Parkinsonian syndrome, the notable technological advances in neuroimaging techniques, the development of new surgical software, the possibility of intraoperative monitoring and the improvement in some surgical techniques, interest has been maintained in surgical treatment options for Parkinson's disease.
Surgery would be indicated when pharmacological treatment fails to control the patient's symptoms throughout the day, significantly reducing their quality of life. As Parkinson's disease currently has no cure, the benefits of surgery are truly important. Very significant improvements in movement can be achieved, as well as a decrease in rigidity and tremors. In addition, it makes it possible to reduce the medication, which is beneficial for reducing the side-effects associated with their long-term use.