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European Journal of Neurology 1 and in Movement Disorders. 2 The authors meticulously documented and summarized the literature on device-aided invasive therapies (deep brain stimulation [DBS], apomorphine pump, and levodopa/carbidopa intrajejunal pump) and are to be praised on this Herculean work. The authors, however, inadequately documented and summarized the literature on lesional surgery, especially posterovental pallidotomy. This resulted in an erroneous appreciation of the utility of this procedure and in guidelines that contradicted the repeated endorsements of pallidotomy by the International Parkinson and Movement Disorder Society in 2011 and 2018, 3, 4 as well as contradicted previous evaluations of pallidotomy by some of the very same authors of the European Guidelines. 5, 6 The authors started by describing “the revival of unilateral pallidotomy, particularly in North America at the turn of the century,” 1, 2 then, immediately after, they stated,“However, the evidence for this treatment is weak.” 1, 2 To illustrate the “weakness” of that evidence, they wrote,“Two unblinded RCTs [randomized controlled trials] with 36 and 37 patients were included,” and they referred to references 77 and 78. 1, 2 Reference 77 is an article by Vitek et al 7 from the Atlanta group, and reference 78 is an article by de Bie et al 8 from the Amsterdam group. These two RCTs were not, in fact, unblinded; they were single-blinded (ie, evaluator-blinded), which is the accepted standard for class I evidence. Furthermore, there are at least five additional randomized studies on pallidotomy, 9 some with blinded evaluations, that were not taken into …