Pune (P&V News Service): The department of stereotactic and functional neurosurgery at Sahyadri Super Specialty Hospital Hadapsar successfully recently carried out a rare surgery of Image guided and image verified deep brain stimulation on a 58 year old suffering from Parkinsons disease.
A 58 year old gentleman suffered from Parkinson’s disease for last 8-9 years. He had uncontrolled tremors at rest, severe rigidity in all four limbs and needed hourly medications for reduce his symptoms. There was only partial relief with medication and he could not do his basic day to day activities like eating, drinking water, dressing himself, walking etc. without an assistant. He consulted senior neurologists in Pune and was advised surgical treatment for Parkinsons Disease. The patient was first seen at Nagar road Sahyadri Hospital by brain and spine specialist Dr Sachin Mahajan and senior neurologist Dr. Nasli Icchaporia and was advised surgical treatment for Parkinson’s Disease. He was further evaluated by Dr. Manish Sabnis, Neurosurgeon at Sahyadri Speciality Hospital Hadapsar for feasibility of placement of brain pacemakers. The surgery was performed by a team consisting of neurosurgeons Dr Manish Sabnis, Dr Josna Sabnis,Anesthetist Dr Aparna Kaje, Neurologist Dr Sadiq Pathan and Neurologist Dr Aradhana Chauhan.
Giving details about the case, Neurosurgeon Dr. Manish Sabnis said that after the patient was considered eligible for Deep Brain Stimulation (DBS) he was subjected to the actual surgery which was performed keeping him awake, under local anaesthesia. DBS (Deep brain Stimulation) means implantation of 1.27mm thick electrodes in deep and delicate parts of brain and connecting it to high frequency pacemaker which modulates brain activities. Accuracy of placement of electrodes is essential as the tip lies in the mid brain and any discrepancy might result in devastating mishaps as well as failure of this therapeutical option.
Deep brain stimulation has been performed in world for last 20 years, there are few centres in india which are performing it with the help of protocol called micro electrode recording(MER). The one operated at our centre as purely performed under guidance of special CT scan and MRI images.
The protocols of obtaining high resolution images and targeting it with ultra fin accuracy was developed at Sahyadri hospital in association with The national hospital for neurology and neurosurgery Quee Square London where Dr Manish Sabnis got trained for this unique technique of PURE IMAGE BASED DBS.
Neurosurgeon Dr. Josna Sabnis said that the surgery was performed under local anesthesia (scalp block ) and through 12mm holes drilled into the skull. Throughout the placement of electrodes in brain, the patient was awake and carefully monitored. There was immediate relief from all the mentioned symptoms and patient became tremor free with complete relief from rigidity /stiffness in all four limbs. Patients activities became completely normal and his medication requirement reduced by 80%. earlier he was on hourly doses of medicines without control of symptoms but now he takes medicines only two times a day which we plan to reduce further over next few weeks.
Disease which can benefit with Deep Brain Stimulation are Parkinsons disease, essential tremors , Dystonia. It has also been used in treatment of Resistant Depression and Obsessive Compulsive Disease. The role of DBS is also being tested in case of Alzheimers disease.
Abrarali Dalal, CEO Sahyadri Hospitals said that, this achievement demonstrates that advancements in medical procedures and techniques can deliver amazing outcomes. As a leading chain of hospitals, we continue to make efforts to be at the forefront of technology to deliver best outcomes to our patients.
