Breakthrough Neurological Treatments in India : A Closer Look at Deep Brain Stimulation for Parkinson's, Tremor, Dystonia, and OCD at India's Premier Hospital

 In the realm of neurological disorders, advancements in medical science have paved the way for innovative treatments that have transformed the lives of countless individuals. Deep Brain Stimulation (DBS) has emerged as a beacon of hope for patients grappling with conditions such as Parkinson's disease, essential tremor, dystonia, and obsessive-compulsive disorder (OCD). At the forefront of these groundbreaking treatments lies India's world-renowned hospital, where medical excellence converges with cutting-edge technology to offer a new lease on life to patients from around the globe.

Unraveling Deep Brain Stimulation (DBS)

Deep Brain Stimulation is a revolutionary surgical procedure that involves implanting electrodes within specific regions of the brain. These electrodes deliver electrical impulses, modulating abnormal brain activity and offering relief from debilitating symptoms. DBS has emerged as a game-changer for a range of neurological conditions, including Parkinson's disease, essential tremor, dystonia, and OCD.

Parkinson's Disease: A New Dawn in Treatment

Parkinson's disease, characterized by motor symptoms such as tremors, rigidity, and bradykinesia, can significantly impact an individual's quality of life. DBS has emerged as a transformative approach, offering symptom relief and improved mobility for patients who have not responded adequately to medication. By targeting specific brain regions responsible for motor control, DBS has provided renewed hope and enhanced daily functioning for Parkinson's patients.

Empowering Lives Amidst Tremors

Essential tremor, often mistaken for Parkinson's disease, leads to involuntary shaking of the hands, head, and voice. DBS has emerged as a beacon of light for those affected by this condition, offering a remarkable reduction in tremor severity and allowing individuals to regain control over their movements.

Dystonia: Unshackling Muscular Contractions

Dystonia, characterized by involuntary muscle contractions leading to repetitive movements and abnormal postures, can be extremely debilitating. DBS has emerged as a lifeline, targeting specific brain circuits to alleviate the distressing symptoms of dystonia, enabling patients to reclaim their lives with improved motor control.

Breaking Free from Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder, a mental health condition characterized by intrusive thoughts and repetitive behaviors, can profoundly affect an individual's well-being. For those who find limited relief through traditional therapies, DBS has emerged as a promising avenue. By influencing neural circuits associated with OCD, DBS has offered newfound hope and relief from the grips of this relentless disorder.

India's Premier Hospital: Pioneering Excellence in Neurological Care

The world's best hospital in India stands as a testament to medical ingenuity and compassionate care. Renowned for its multidisciplinary approach, cutting-edge technology, and a team of distinguished neurologists and neurosurgeons, the hospital has become a beacon of hope for patients seeking advanced treatments. With a commitment to improving lives and pushing the boundaries of medical science, the hospital has cemented its position as a global leader in neurological care.

Conclusion

In the landscape of neurological treatments, Deep Brain Stimulation has emerged as a transformative breakthrough, offering renewed hope and improved quality of life for patients battling conditions such as Parkinson's disease, essential tremor, dystonia, and OCD. India's premier hospital stands as a testament to medical innovation, providing a ray of light to individuals seeking advanced care. As the journey of medical discovery continues, the intersection of expertise, technology, and compassion promises a brighter future for those in need.

'Alarming Rise' In Strokes Among Younger Men !

A warning over the risk of strokes among young people following a study that suggests more and more working age people is suffering strokes. A study shows among men aged 40-54 between 2000 and 2015. In 2015, 6,221 men in this age range in England were admitted to hospital due to a stroke. This represents an increase of 1,961 cases compared to 2,000.

Experts believe that lifestyle factors play a major role, however there may be additional causes, including population growth and changes to the way hospitals work.

Strokes are often considered to be an illness of old people, but experts are stressing that younger people are at risk of strokes and there should be a shift in the way strokes are viewed and they should no longer be seen as an old person’s health risk. Although the majority of people who suffer strokes in England are aged over 65, there are clear trends that indicate younger people are at risk.

Strokes are caused by blood clots that block oxygen flow to the brain and they often have devastating consequences. They often contribute to long-term disability and they can be fatal. Lifestyle factors tend to play a part and living a sedentary life, smoking, eating unhealthily and being overweight can all increase the risk of a stroke.

A patient was just 34 years old when he suffered a stroke four years ago on New Year’s Day. Fortunately, he survived and he has recovered well, but his case is a stark reminder that strokes can affect much younger people.

The findings underline the importance of making healthy lifestyle choices and keeping an eye on blood pressure and cholesterol levels. Public to attend regular health checks in middle age and to see a doctor if they notice any symptoms that may be indicative of cardiovascular disease.

Tips for Fast Stroke Recovery : Rehabilitation is a crucial component of care following a stroke

Survivors have an increased risk for long-term disability and face challenges completing daily activities.

Rehabilitation is a crucial component of care following a stroke. At top stroke centers some form of rehabilitation begins virtually immediately after a patient is admitted to the hospital — to get them on the right path to the best possible outcomes.

However, there are several things patients can do to ensure they are maximizing their recovery starting the second they suspect a stroke. Here are 10 tips:

1. Seek urgent care immediately.

It is absolutely critical to seek emergent care when a stroke is suspected. Patients who arrive at the emergency department within 3 hours of their first symptoms tend to have less disability months after a stroke than those who received delayed care.  A stroke alert prompts a team of experts from our center to come to a patient’s bedside within minutes to confirm or rule out a stroke, allowing treatment and rehabilitation to begin as soon as possible.

If you’re worried about clogging the emergency room or just want to wait things out, you could be delaying life-saving care.

2. Keep your medical information handy.

A stroke can affect parts of the brain responsible for cognition and communication, leaving a patient unable to tell a doctor their medical history. That can be worrisome, because some stroke treatments can’t’ be given with other medications.

I urge people to carry with them a patient health profile that lists their medical conditions and any medications they’re taking. This piece of paper carried in your wallet might contain vital information that doctors can use to ensure you’re on your way to an optimal recovery.

3. Choose a top care center for your rehabilitation.

Whenever possible, you want a patient to be involved in acute inpatient rehabilitation following a stroke. Data suggest the more acute, intensive rehabilitation you get after a stroke, the better the outcomes.

4. Eat well.

A healthy and consistent diet is crucial when recovering from a stroke, from the hospital bed to your outpatient care at home.

One reason food choice is important is because patients in early stages of recovery may experience weakness or incoordination of the swallowing muscles. A care team might recommend soft foods or thicker liquids, because swallowing problems can lead to fluid aspiration which might lead to pneumonia.

Also, certain medications may interact with certain foods, so a rehabilitation specialist can direct you to the best choices.

5. Compliance is key.

I tell my patients if you don’t remember anything in the weeks you’ve been here as an inpatient, the one thing I want you to remember is to see your primary care doctor for regular follow-ups and checkups. Your primary care doctor is essential to your recovery from a stroke, and can make sure your medication needs and health issues are being attended to properly.

Some people may be in denial after a stroke and instead avoid their doctors. But poor compliance with physicians and medications may have got them into these health problems in the first place.

6. Exercise, but within your limits.

Safe levels of physical activity as prescribed by a physical or occupational therapist can go a long way when rehabilitating from a stroke.

What’s important though is you don’t overdo it. People may be excited by improvements in their ability to exercise, but falls are a very real risk following a stroke. That’s why it’s important to stick to your prescribed routine.

7. Limit stress.

I urge patients to keep their lives as stress-free as possible after a stroke. This is not meant to imply that leading a stressed life in some way contributed to their stroke in the first place, but keeping your life more balanced without undue psychological pressures is associated with better outcomes.

8. Stay positive.

It’s very common to have a negative attitude after a serious illness, and some patients experience depression after a stroke — sometimes weeks or months later. However, it is absolutely critical to keep a realistic or positive attitude during rehabilitation to maximize results. Psychologists, psychiatrists and other therapists, who are part of your care team, may recommend therapy and/or medication.

9. Do your homework.

For every stroke patient, treatment at a rehabilitation center eventually comes to an end. When you continue onto the outpatient setting, it is essential you do any homework — otherwise known as a home exercise program — assigned to you by one of your rehabilitation care specialists.

I can’t tell you how many times a patient comes back with a family member or partner to report they’re not getting better, only for a loved one to point out they’re not following their assignments.

It’s never fun to have a stroke or disabling illness, but even if it feels like it’s a grind, do whatever you can to stay up-to-date with your homework.

10. Stay vigilant.

Patients following a stroke face an increased risk of second stroke compared with the general population. Your brain helps you recover from a stroke by asking the unaffected brain regions to do double duty, which means a second stroke can cause far more dangerous effects.

If heaven forbid something gets worse again or you suspect you’re having another stroke, seek out medical attention immediately.

Most Advanced Treatment of Brain and Neurological Disorders

The main line of treatment is with antiepileptic drugs, which are effective in controlling seizures in 70%-80% of patients with epilepsy. There are several antiepileptic medications. Since certain medications are much better for some seizures, the choice of the medication should be made by a physician who is familiar with these medications. If possible, the child should be evaluated in a center specializing in epilepsy. If this is not feasible, usually pediatric neurologists have training in epileptic disorders and are a good source for a referral.

When antiepileptic drugs fail to control the seizures, the patients may improve with surgical procedures.

Who is a candidate for epilepsy surgery?

Surgery is indicated in a small group of children.

It usually takes the failure of two or three antiepileptic medications before a child would be considered as a potential candidate for surgery. In general, this happens at least after two or three years of continuous treatment with medications. The failure might be due:

1.   to a resistance to the antiepileptic medications that are available,

2.   to the presence of intolerable side effects to the antiepileptic medication,

3.   or to a combination of both.

Since surgical procedures might be very effective in some children, once it is clear that the child's epileptic disorder is not responding to treatment with antiepileptic medications, surgery should be considered. Young age is not a contraindication for surgery, and there is no benefit in waiting for the child to be older. In fact, there is considerable evidence that the younger a child is at the time of surgery, the better his/her potential will be for good function after the surgery. There is a certain degree of plasticity in the brain that helps with the recovery of functions that can be damaged at the time of surgery. This plasticity is higher in younger than in older children.

Advanced Epilepsy Treatment Options Available at World Best Hospital in India

Best Neurosurgery Hospital in India | Neurosurgeon India : Stroke Patient from Nigeria

Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.

Vagus Nerve Stimulation (VNS) :

VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.

Ketogenic Diet :  This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.

Advanced Surgical Procedures for Management of Epilepsy

Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.

• Anteromedial Temporal Lobectomy
• Selective Amygdalohippocampectomy
• Electrocorticography guided Resections
• Multiple Subpial transections
• Quadrantic Resections
• Multilobar Resections
• Functional Hemispherotomy
• Vagal Nerve stimulation
• Radiosurgery (selected cases)

  Services offered at our Network Hospitals for the treatment of various types of Brain and Neurological Disorders

  • Highly advanced surgeries for the patients with Vascular Malformations, Cerebral Aneurysms, Complex Craniofacial Malignancies andAcoustic Tumours
  • Diagnosis and Treatment of Cancerous Brain Tumours with complete range of treatment options that include surgery, radiosurgery , radiation therapy, chemotherapy and other cancer treatments
  • Deep Brain Stimulation ( DBS) for patients with Parkinson's Disease and tremors from other neurological conditions
  • Paediatric neurologists and neurosurgeons who specialize in the surgical management of a wide range of paediatric diseases including brain tumours, epilepsy, spinal bifida and hydrocephalus
  • Minimally Invasive Brian Surgeriesusing the most sophisticated 3-D image-guided technology

The main line of treatment is with antiepileptic drugs, which are effective in controlling seizures in 70%-80% of patients with epilepsy. There are several antiepileptic medications. Since certain medications are much better for some seizures, the choice of the medication should be made by a physician who is familiar with these medications. If possible, the child should be evaluated in a center specializing in epilepsy. If this is not feasible, usually pediatric neurologists have training in epileptic disorders and are a good source for a referral.

When antiepileptic drugs fail to control the seizures, the patients may improve with surgical procedures.

Who is a candidate for epilepsy surgery?

Surgery is indicated in a small group of children.

It usually takes the failure of two or three antiepileptic medications before a child would be considered as a potential candidate for surgery. In general, this happens at least after two or three years of continuous treatment with medications. The failure might be due:

1.   to a resistance to the antiepileptic medications that are available,

2.   to the presence of intolerable side effects to the antiepileptic medication,

3.   or to a combination of both.

Since surgical procedures might be very effective in some children, once it is clear that the child's epileptic disorder is not responding to treatment with antiepileptic medications, surgery should be considered. Young age is not a contraindication for surgery, and there is no benefit in waiting for the child to be older. In fact, there is considerable evidence that the younger a child is at the time of surgery, the better his/her potential will be for good function after the surgery. There is a certain degree of plasticity in the brain that helps with the recovery of functions that can be damaged at the time of surgery. This plasticity is higher in younger than in older children.

Advanced Epilepsy Treatment Options Available at World Best Hospital in India

Best Neurosurgery Hospital in India | Neurosurgeon India : Stroke Patient from Nigeria

Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.

Vagus Nerve Stimulation (VNS) :

VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.

Ketogenic Diet :  This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.

Advanced Surgical Procedures for Management of Epilepsy

Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.

• Anteromedial Temporal Lobectomy
• Selective Amygdalohippocampectomy
• Electrocorticography guided Resections
• Multiple Subpial transections
• Quadrantic Resections
• Multilobar Resections
• Functional Hemispherotomy
• Vagal Nerve stimulation
• Radiosurgery (selected cases)

  Services offered at our Network Hospitals for the treatment of various types of Brain and Neurological Disorders

  • Highly advanced surgeries for the patients with Vascular Malformations, Cerebral Aneurysms, Complex Craniofacial Malignancies andAcoustic Tumours
  • Diagnosis and Treatment of Cancerous Brain Tumours with complete range of treatment options that include surgery, radiosurgery , radiation therapy, chemotherapy and other cancer treatments
  • Deep Brain Stimulation ( DBS) for patients with Parkinson's Disease and tremors from other neurological conditions
  • Paediatric neurologists and neurosurgeons who specialize in the surgical management of a wide range of paediatric diseases including brain tumours, epilepsy, spinal bifida and hydrocephalus
  • Minimally Invasive Brian Surgeriesusing the most sophisticated 3-D image-guided technology

Most Advanced Stroke Recovery Treatment in India

What is Stroke?

Stroke refers to a brain disease caused by either blockage of blood supply or rupture of a blood vessel to a particular part of the brain. This results in reduction of blood and oxygen supply to the affected part of brain resulting in loss of function

A Stroke can be categorized into two types:

• Hemorrhagic Strokes: This type of stroke occurs when a blood vessel bleeds and burst within the brain. This accumulated blood compresses the nearby tissues of the brain. This could be due to:
  • A blood vessel on the brain surface starts bleeding in between the area of the skull and the brain.
  • A blood vessel bleeding or bursting inside the brain
  • Hemorrhagic strokes has two main types:
    • Subarachnoid hemorrhage: In this, there is bleeding in between the area of the brain and the thin tissues covering the brain.
    • Intracerebral hemorrhage: This is considered as the most common type of hemorrhagic strokes. This occurs when an artery bursts inside the brain and resulting in the flooding of the nearby blood tissues.
• Ischemic Stroke: This occurs when something is causing blockage in an artery which is carrying blood to the brain. The potential causes are:
  • When there is a blockage in the small blood vessels within the brain
  • When a blood clot develops in the main artery to the brain
  • When an air bubble, a blood clot or fat globule develops in a blood vessel which is carried to the brain.
  • There are two common types of Ischemic stroke:
    • Embolic Stroke: This stroke occurs when other debris or a blood clot develops away from the brain. This mostly happens in the heart and is swept from the bloodstream into the narrow brain arteries. This kind of blood clot is known as an embolus.
    • Thrombotic Stroke: This occurs when thrombus (a blood clot) develops in one of the arteries which supply blood to the brain. This clot may be due to the accumulation of plague (fatty deposits) in the arteries that causes decreased blood flow.

When there is temporary blockage in the blood supply to the brain and there is a feeling of stroke for a little time. This entire process is termed as mini stroke or a transient ischaemic attack (TIA). A mini stroke is an indication that a part of the brain is not getting sufficient blood and this can result into a severe stroke in the future.

Causes

Some of the causes that can lead to a stroke are as follows:

• Ageing
• High blood pressure
• Diabetes
• Cardiovascular diseases
• High cholesterol
• Obesity
• Vitamin B12 deficiency
• Excessive alcohol and drug abuse

Symptoms

Symptoms of a stroke occur suddenly. Symptoms vary depending on the location of the stroke. Each area of the brain is supplied by specific arteries. If an artery supplying the area of the brain that controls the left arm movements is blocked, that arm becomes weak or paralyzed.

The five most common signs and symptoms of stroke are:

• Sudden numbness or weakness of the face, arm, or leg - like weakness of half of the body called as hemiplegia.
• Sudden confusion or trouble speaking or understanding others called aphasia in medical terms.
• Sudden trouble seeing in one or both eyes called as mono or binocular vision disturbance. This could be due a stroke anywhere in the visual pathway.
• Sudden dizziness, trouble walking, or loss of balance or coordination, this is commonly due to posterior circulation strokes.
• Sudden severe headache with no known cause is due to hemorrhage or sometimes infarction.

Diagnosis

The diagnosis is based on the symptoms and a good history given by the patient or an observer. Usually any neurologic symptom occurring suddenly in a neurovascular territory is attributed to a stroke. CT scan done immediately after a stroke is almost always normal in ischemic strokes. MRI with diffusion images is sensitive to diagnose acute infarction.

Treatment of a Stroke

The treatment for both hemorrhagic and ischemic stroke is different.

The purpose of treating ischemic stroke is to restore the flow of the blood in the brain. Medications are given in the first four and a half hours of the stroke for destroying the clots in the blood vessels. An injection of tissue plasminogen (TPA) can also be given to a patient for improving the probability of a full recovery.

The main purpose of treating a hemorrhagic stroke is to stop bleeding and decrease the pressure on the brain. Instead of blood thinners, clotting drugs can be given. After the area has been healed and the bleeding is controlled, the damaged and leaky blood vessels are then repaired.

The first stroke device approved by FDA is Merci retriever. The aim of this device is to restore the flow of the blood in the neurovasculature by removing thrombus in those patients who have ischemic stroke.

The penumbra system (endovascular thromboaspiration) is the last FDA approved device that has been primarily developed for removing a clot in the case of acute ischemic stroke. In order to eliminate or reduce the clot burden, this system uses dual approaches to clot extraction by using debulking and aspiration of the thrombus. Clot retrieval is then used where a ring device holds the thrombus by capturing it in clasps with a cylinder. This is then withdrawn at the time of flow arrest. This new aspiration device (the penumbra system) has an excellent safety profile and a high rate of ‘target vessel’ recanalization. 

 

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