The Hindu : Andhra Pradesh News : Deep brain stimulation gives relief to Parkinson’s patients

Online edition of India's National Newspaper
Monday, Dec 10, 2007
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Andhra Pradesh

Andhra Pradesh

Deep brain stimulation gives relief to Parkinson’s patients

Y.Mallikarjun

HYDERABAD: “Earlier, we had to feed him. He also was not able to button up his shirt. But, I rarely help him now. There is 60 to 70 per cent improvement in his condition,” exclaimed Veni Ravi, wife of 58-year-old K.Ravindran from Chennai, who recovered remarkably from symptoms of Parkinson’s disease after undergoing ‘deep brain stimulation’ (DBS) surgery at the Nizam’s Institute of Medical Sciences (NIMS) here, one of the few centres in the country offering the complex procedure.

It was 10 years ago that Mr. Ravindran was diagnosed and developed symptoms like tremors and rigidity, making him almost an invalid although he was put on medication.

Referred to NIMS

“Once he reached a stage where giving medicines proved futile, then we were asked go to the NIMS,” said Ms. Veni. Subsequently, he underwent DBS at NIMS in May last year.

In the DBS procedure, a pace-maker is placed under the skin near the chest for generating electrical stimuli. The wires are connected to an electrode placed either in sub-thalamus nucleus (STN) or pallidum. After the patient’s head is held by a ‘stereotactic frame’, two holes are bored through the skull of the brain even as the patient is kept awake by administering local anaesthesia.

“After reaching the right place in STN, which is only 4 mm in size, we ask the patient whether the stiffness and tremors have come down. If yes, we place the electrode at that spot. However, the pace-maker is implanted under the chest after giving general anaesthesia and the whole procedure takes about six to seven hours,” explained Manas Panigrahi, neuro-surgeon, who along with his colleague, Rupam Borgohain, neurologist, who had performed 54 DBS surgeries at the NIMS.

While DBS was used to arrest further deterioration in advanced cases among 53 patients, in the other case it was done to control tremors. “There was 70 to 80 per cent improvement in most patients. It is almost like a miracle. Before the surgery, they had to be in bed for six to eight hours during the waking period,” added Dr. Rupam. In view of good results obtained in controlling Parkinson’s symptoms, it is proposed to use the technique for dystonia, epilepsy and psychiatric conditions.

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