Laitinen (57) and Iacono et al. (70) reported early good outcomes in 12 and 10 bilaterally operated patients, respectively. There are, however, concerns regarding permanent cognitive and bulbar side effects of bilateral pallidotomy, which have been confirmed in a study of four patients in whom bilateral pallidotomy was performed (71). Despite a 40% improvement in motor UPDRS scores and resolution of dyski-nesia, one patient developed dysarthria, dysphagia, and eyelid opening apraxia,
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