ONE OF THE RARE AND CHALLENGING SURGERY PERFORMED AT SIR GANGA RAM HOSPITAL

Patient, Savitri Devi, 51 years old female came to Department of Neurosurgery, Sir Ganga Ram Hospital about a month back. She was suffering from Parkinson’s disease for last 9 years. It started with tremors and bradykinesia (difficulty in initiating movements) and later she developed rigidity. She was being managed with medicines but her symptoms kept on worsening and she started developing side effects from the medicines she was taking. She was not able to walk, turn, or get up from bed properly without medications. With medications, she was not able to control her hands and legs and they would move without her control. She tried taking treatment at various hospitals but she did not improve and her symptoms kept getting worse. She finally came to us where she was thoroughly evaluated and we gave her an option of Deep Brain Stimulation.

According to Dr. Shrey Jain, Associate Consultant, Neurosurgery Department, Sir Ganga Ram Hospital, “Deep Brain Stimulation is a new surgery where you stimulate particular areas of brain. It acts just like Pacemaker of brain. In this case, we planned to stimulate Subthalamic nucleus of the brain. The purpose of the surgery is to help control the disease and improve patient’s lifestyle. It is particularly useful in diseases like Parkinson’s disease, tremors, dystonia and has been evaluated and successfully shown positive results for psychiatric conditions like depression and mania. The minimally invasive surgery is done while the patient is awake during the whole surgery with support of skilled anesthetist and technicians with a back up of advanced gadgets”.

Dr. Jain added, “It is a minimally invasive surgery wherein electrodes are passed bilaterally in the deep brain through two small holes in the skull. Location was confirmed during surgery by examining the patient continuously and recording brain electric current. Her speech, eye movements, and power of the limbs was being monitored during the surgery and it was being observed how her symptoms are improving so as to make sure the effect of the surgery is maximum with minimal complications. During surgery, she stopped speaking at one point so electrodes were repositioned and her speech came back. CT Scan was also done after the surgery to make sure the electrodes are at the correct position. Later battery was inserted in the chest wall like a pacemaker”.

This patient after the surgery improved quite well and is able to lead a normal life with no side effects from the medications. The dosage of the medications has reduced and their side effects are minimal. Savitri devi is very happy and leading a near normal life again which she thought was near impossible. Her symptoms of shaking hands and legs have improved considerably. She can properly hold the things now.

According to Dr. Ajit K. Sinha, Senior Consultant, Neurosurgery Department, Sir Ganga Ram Hospital, “There are surgeries available now at very few selected places, where the diseases which did not have any cure earlier, can be brought under control with reduced medications. Over 7 million people are suffering from Parkinson’s disease alone in India and this disease can be debilitating. Other diseases which have shown positive results with Deep Brain Stimulation include tremors, dystonia, depression, OCD, epilepsy and chronic pain. With the advancing technology and surgical skills, people should be aware about such options so as to get the best chance to lead a normal life in spite of having these problems”.