Parkinson’s disease is a disease characterized by resting tremor, muscle rigidity, reduced movement and vegetative nerve dysfunction. It is commonly used in middle-aged and elderly people and seriously affects the quality of life of patients. Our hospital from March 2001 to May 2004 should stereotactic radiofrequency destruction of intracranial thalamic ventral intermediate nucleus (VIM), the medial part of the globus pallidus (Gpi) to treat 196 cases of Parkinson’s disease (PD), the effect is satisfactory, is summarized as follows: 1, Objects and Methods 1, 1 General information In this group, there were 119 male cases, 77 female cases: age 36-80 years old, the average age of 64.3 years. Duration of the disease was from 2 to 15 years, with an average of 5.6 years. All cases were diagnosed according to the diagnostic criteria established by the 1984 National Symposium on Extrapyramidal Diseases (1), and Parkinson’s syndrome caused by other diseases was excluded. The clinical classification was tremor predominant in 84 cases, rigidity and bradykinesia predominant in 35 cases, and mixed tremor and rigidity in 77 cases. The disease was graded according to the Hoehn and Yahr grading criteria (off state) (Z) grade II in 109 cases, type III in 80 cases, and grade IV in 7 cases. There were 98 cases of thalamic Vim destruction alone, 35 cases of pallidocerebellar Gpi destruction alone, and 63 cases of combined Vim and Gpi destruction. 12 cases were operated bilaterally. All cases were systematically treated with levodopa drugs before surgery. 1,2 Surgical methods Patients stopped using levodopa drugs before surgery. After installing the ASA-602S localization head ring (Anke, Shenzhen) parallel to the AC-PC line under local anesthesia, a 2-mm thin-layer scan of the basal ganglia region was performed on cranial spiral CT. The anterior conjunction (AC), posterior conjunction (PC) and its connecting line (IC) were determined on the computer workstation.The Vim target coordinates were set 5-7 mm before the posterior conjunction at the AC-PC level and 13-15 mm beside the median sagittal line.The Gpi target coordinates were taken as 2 mm before the midpoint of the IC, 4-6 mm below the IC line, and 18-22 mm beside the median sagittal line.CT scanning field coordinates of the target points were calculated and convert them to ASA-602S positioning head frame coordinates. Return to the operating room, local anesthesia, routine cranial drilling, installation of the directional device, and adjustment of target point coordinates. Microelectrodes were fed in the direction of the target point with a micro-propeller in the order of 1 um through the guide needle. The microelectrode started recording from 10 mm above the CT target point, and the computer displayed changes in the electrophysiologic signals of the recorded cells along the way. The target point is confirmed based on the results measured by the microelectrode, and the confirmed target point is called the electrophysiologic target point. Replace the radiofrequency electrode, send the radiofrequency electrode to the electrophysiological target point, and use 2HZ and 100HZ weak current to perform electrical stimulation test respectively. Determine the presence or absence of visual beam and internal capsule response. According to the microelectrode and stimulation results for target point adjustment. After determining the target point, the first 45 ℃, 40S for reversible destruction test, observation of the patient’s consciousness, speech, vision, limb movement and sensory conditions, symptoms have improved without abnormal neurological impairment, and then 70 ~ 75 ℃, duration of 60 ~ 90S radiofrequency thermocoagulation destruction. The volume of destroyed foci was about 4mm×4mm×5mm for Vim and 5mm×5mm×7mm for Gpi. 2.1 Efficacy evaluation The complete disappearance of the symptoms of tremor and rigidity of the limbs was considered as effective; the obvious alleviation of the symptoms but the residual part of the symptoms was considered as effective; and the lack of improvement of the symptoms was considered as ineffective. The evaluation of the efficacy of the treatment was carried out at 7d after the operation. In this group, there were 169 cases (86.2%) with obvious effect, 27 cases (13.8%) with effective effect, and 0 cases with ineffective effect. 2.2 Postoperative adverse reactions and complications In this group of cases, there were 10 cases of drowsiness and haze, 8 cases of dysarthria, 2 cases of numbness of one side of the limb, 5 cases of walking after surgery, but the muscle strength was normal, and CT confirmed that the edema around the target point was obvious. After symptomatic and dehydration treatment, all of them recovered in 2 weeks after surgery.1 case of intracranial puncture tract hemorrhage, hematoma volume of about 30 ml, acute phase of the contralateral limb strength Ⅱ, after active treatment, muscle strength recovered to Ⅳ grade and was discharged from the hospital. There were no fatal cases. 2, 3 Follow-up results Follow-up 6-48 months, 15 cases (7.7%) respectively between 7 months to 20 months after the operation symptoms recurred, of which 10 cases symptoms than the preoperative reduction of about 50%. 3, Discussion The modern view is that if the effect of drug treatment for Parkinson’s disease is unsatisfactory, surgical treatment should be sought. Stereotactic radiofrequency disfigurement reestablishes the balance between dopamine and acetylcholinergic transmitters at low levels in the brain by blocking the pathway from the pallidum to the ventral posterolateral nucleus of the thalamus, or from the cerebellum to the ventral posterolateral nucleus of the thalamus (3). The goal is to alleviate and eliminate clinical symptoms. At present, the surgical methods are basically mature, represented by Vim disfiguration and Gpi disfiguration; Vim disfiguration can significantly improve tremor and muscle rigidity in Parkinson’s patients, but has a poor effect on the symptoms of motor reduction; the latter is incomplete for the elimination of tremor, but has a better effect on the muscle rigidity, and motor reduction (4). We believe that in order to maximize the efficacy of surgery, the following points should be noted: 1) Strict control of the indications is an important factor in improving the efficacy of surgery. We believe that patients with Hoehn and Yahr classification II to IV, good response to levodopa drugs, less than 75 years old, without severe hypertension, heart disease, diabetes can undergo surgical treatment; patients with early onset of levodopa failure syndrome, including anisotropia and “on-off” phenomenon, should be operated as soon as possible. Precise intraoperative positioning is the key to successful surgery. The clinical application of microelectrode recording technology has improved surgical efficacy and reduced the occurrence of complications. ③The loss of cerebrospinal fluid should be avoided as much as possible during the operation, so as not to affect the surgical efficacy by displacement of brain tissues or even cause complications. ④ The choice of target point of destruction. In our opinion, the thalamic ventral intermediate nucleus should be selected for those with tremor; the posterior medial part of the pallidum should be selected for those with muscle rigidity and motor retardation. ⑤ Size of the destructive foci. In general, the size of the disfiguring foci of the pallidum is larger than that of the thalamic Vim; the long axis of the disfiguring foci of the pallidum is controlled to be 9 mm, and the long axis of the disfiguring foci of the thalamic Vim is controlled to be 6 mm. vi) Continue to take medication after the operation. Because disfigurement is only a symptomatic treatment and cannot solve the objective fact of dopamine deficiency in the patient’s body, especially in patients with bilateral symptoms, postoperative medication is still an important part of the treatment. Although DBS surgery has been increasingly favored in recent years for its non-destructive and non-invasive program-controlled regulation outside the body, its expensive price has constrained its widespread implementation. Therefore, stereotactic radiofrequency intracranial disruption for Parkinson’s disease is still a better treatment that is easily accepted by most people.