The surgical interruption of the parapyramidal pathways at the cervical level in cases of adventitious movement due to disease of the basal ganglia has not been uniformly successful, partly, it is thought, because the level of section has not been sufficiently high to interrupt the more cephalic neuromuscular innervations. To test this hypothesis it, was decided to make an effort to secure interruption of the parapyramidal complex at a point in the brain stem where it might be reasonably superficial. It was felt that section of the rubrospinal tract cephalad to the pyramidal decussation would offer less chance of coincident injury to the corticospinal pathway. The actual course of the various parapyramidal pathways in the human brain stem is as yet imperfectly understood. Opinion, however, tends to favor the reticular formation in the medulla as including the rubrospinal, tectospinal and vestibulospinal bundles. The first of these occupies a position between
SIRIS JH. PARAPYRAMIDAL FASCICULOTOMY IN THE BRAIN STEM. Arch NeurPsych. 1942;47(5):808–812. doi:10.1001/archneurpsyc.1942.02290050110009
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