DBS Surgery in Mumbai

Deep Brain Stimulation is an advanced neurosurgical procedure used to manage movement disorders and certain neurological conditions when medications are no longer effective. For patients whose symptoms severely interfere with their everyday lives, we at Gleneagles Hospital advise this course of treatment. Obsessive-compulsive disorder (OCD), essential tremor, dystonia, epilepsy, and Parkinson’s Disease (PD) are among the disorders that are frequently treated using deep brain stimulation.

Deep Brain Stimulation is a neurological procedure in which electrodes are implanted into the brain, and electrical stimulation is provided for treatment. The electricity can directly stimulate the targeted sites in the brain. This form of treatment may also be used for patients who are suffering from severe OCD or depression in case other treatments fail to succeed. However, any other mental disorders can only be treated through this as part of a clinical trial.

Gleneagles Hospital has experienced neurosurgeons and modern equipment to conduct effective DBS surgeries with a high success rate.

DBS surgery in Mumbai is an effective option for people suffering from Parkinson’s disease or other neurological disorders. These disorders cause symptoms such as stiffness, slowness, tremors, and even dyskinesias. Over time, it is possible for medications to become less effective due to their prolonged use. In such cases, this treatment can help manage these symptoms and even reduce the required dosage of medications.

The improvement in the symptoms is not limited to the time period immediately after the surgery. After the deep brain stimulation surgery has taken place, people continue to experience betterment in their health for many years. The procedure gives them the ability to do simple, daily activities such as eating again. It is also possible for people to notice changes in their memory.

However, Parkinson’s disease is not a disorder that can be treated completely through the amount of medical information available right now. Surgery can assist in the management of certain symptoms, such as stiffness and tremors, but there are many symptoms, such as speech impairment and dementia, that can continue.

This surgery requires a lot of preparation prior to the treatment. It is necessary for the doctors to understand which set of symptoms needs to be targeted during the procedure and whether or not the patient’s Parkinson’s disease is responsive to levodopa. Levodopa is a common medication that people take to manage the symptoms of PD. The symptoms of the patient are discussed to understand which of them are most likely to be managed through this.

The neurologist studies the effect that PD medications have on the patient and the scale at which the effect takes place. The patient is observed first without the use of their PD medications and then after. This is done to determine the set of symptoms that need to be targeted during DBS.

The DBS process requires a person to constantly provide feedback to the doctor throughout the procedure. Hence, a cognitive assessment has to be conducted to ensure that the patient is suitable for this treatment. 

1. Lead Insertion

• The first step of brain stimulation therapy requires the doctor to shave the hair on the patient’s scalp. Hair can act as an obstruction as it makes it difficult to place the head into a special frame. The frame is essential to keep the patient’s head still throughout the procedure. The patient will be put under sedation while four pins are inserted into the skull to set the frame. The rest of the procedure will continue once the frame has been set.
• An intraoperative CT scanner will be used by the surgeon to take images of the brain. These images are used to determine the safest and most accurate path through which electrodes can be inserted into the brain. The surgeon will decide on the entry point through the CT scan images and apply a local anaesthetic to the region after cleaning the head.
• The surgeon will make a small incision through which a surgical drill will be used. The surgical drill is used to make an opening in the head where the leads will be inserted.
• In case the surgery is being conducted to treat movement disorders, the patient may be woken up at this stage of the process. They should not feel any pain during this due to the local anaesthetic that has been applied. However, they may feel certain vibrations.
• The neurosurgeon will ask the patient to answer some simple questions or perform some simple movements during the procedure to ensure the leads are being set in the right place. Each case of PD is different, and the level of the deep brain stimulation treatment​, including the number of leads being inserted, would depend on this. After the insertion of the leads, the electrodes will be capped with plastic so they are protected, and the incisions will be closed. Another CT scan would be conducted to ensure the placement of the electrode is correct.

2. Placing the Pulse Generator

• Implanting the pulse generator is the next step of the treatment. However, it does not take place on the same day as the lead insertion. General anaesthesia will be given to the patient before the beginning of the treatment to prevent them from feeling any discomfort while the procedure is taking place.
• The surgeon will create a small cut in the skin just below the collarbone to create an access point for the implant. Then, they will create a small pocket-like structure under the skin. This pocket will be formed so it can securely hold the implantable pulse generator (IPG). The IPG is a device that can send electrical impulses up to the brain. They will then insert a thin insulated wire under the skin that will connect the electrode to the pulse generator. The IPG will be placed into the pocket under the collarbone, and the skin will be cleaned and closed. 

In most cases, the patient is asked to stay in the hospital for one night after surgery. However, this can depend on the complexity of the case and the speed at which recovery is progressing. The period to stay may be longer in some cases.

The patient will need to pay extra care to ensure the incisions are clean and dry. Special instructions will be given by the doctor. Certain MRI procedures will not be compatible with DBS, so it is necessary to check with the patient's healthcare provider before undergoing any such procedures.

The neurostimulator or the area where the neurostimulator has been placed will need to be protected from any force or trauma, along with high heat, high voltage, and strong magnetic fields. 

Certain risks that are associated with the surgical portion of the procedure include incorrect placement of the leads or the wires connecting the leads, along with seizure, stroke, certain infections, internal bleeding within the brain, or heart problems. 
 

Some complications can occur once the surgery has concluded. These are headaches, trouble with concentration, hardware malfunctions, or pain at the site of implantation. 
 

Brain stimulation therapy requires each patient’s device to have settings that are best suited to their functioning. In case the settings are not accurate, the patient may feel certain effects such as numbness, trouble with speech or balance, fatigue, slight vision impairments, or more. 

Gleneagles Hospital is one of the leading healthcare facilities when it comes to performing complex deep brain surgery treatments. Our neurosurgeons are accomplished and have a great amount of expertise in their field.

Gleneagles Hospitals has successfully conducted a great number of DBS surgeries that have led to a safe and quick recovery for our patients. Our doctors are supported by our modern equipment and the latest technologies that are incorporated into surgical procedures. Gleneagles Hospitals has also built a strong reputation across Mumbai due to its holistic approach towards all treatments.