Neurosurgical procedures are indispensable in management of various types of 
movement disorders (MD). Stereotactic operations that have been well established 
include deep brain stimulation for tremor, dystonia, and Parkinsonian symptoms. 
Recently the actual role of stereotactic ablative procedures such as thalamotomy 
and pallidotomy has been re-explored, and Vo thalamotomy shows long-term 
improvement of task specific focal dystonia like writer's cramp and musician's 
dystonia. A new less invasive treatment of tremor using MR guided focused 
ultrasound has started and is promising. Intrathecal administration of baclofen 
is also an established treatment for severe spasticity, but other ablative 
procedures such as peripheral neurotomy and dorsal rhizotomy are also important 
in spasticity treatment. It seems that most neurologists are unfamiliar, at 
least in Japan, with such neurosurgical procedures. However, neurologists 
involved in management of MD should understand the important roles of 
neurosurgical management of intractable MD and should refer such patients to 
appropriate neurosurgeons before permanent contracture and deformity develop.