Times of India
11, March 2010
By Sumitra Deb Roy
Mumbai, India

After being denied surgery by several doctors back home due to his advanced age, 71–year–old US resident Mohammed Walji’s family was doubly shattered when all they could suggest was to admit him in a shelter for patients. After all, his decadelong Parkinson’s disease was no longer manageable with medication.

Walji, who has been living in Orlando, US, since 12 years, could not read newspapers and had lost his appetite. He was completely dependent on his wife for every little activity like getting off bed or even turning while lying down. To top it, since the past few months, he had started experiencing excruciating body pain as well as severe motor fluctuations.

Increasing dependence on others had made him aggressive and impulsive, said his daughter Siddika. Left with scarce treatment options in the US, the family headed to India where there are no legal restrictions on a doctor to operate upon a Parkinson’s disease patient beyond 65 years of age.

Walji underwent a surgery known as deep brain stimulation (DBS) at the Jaslok Hospital about a fortnight ago. And, says the family, post surgery, a majority of his motor movements have returned to normal. Much to the family’s surprise, last week Walji not only managed to wake up on his own in the morning, but even made his own breakfast. “It was quite an emotional moment for us to see him gain his independence back,” said Siddika. Before surgery, he would pop at least five pills a day, but now the dosage has been reduced to just one.

His treating doctor, neurosurgeon Dr Paresh Doshi, though, cautions that not every Parkinson’s patient may qualify for a DBS surgery. “It is designed for those patients whose quality of life is not adequately managed by medicines,” he told TOI.

Walji’s surgery was strictly done in about three hours as a longer operation could have meant post–operative complications. According to Doshi, DBS involves using electric currents to jam irregular brain signals. “In DBS, we implant a battery–operated neurotransmitter attached to a pacemaker–like wire with an electrode at the tip,” said Doshi. This wire is inserted under the skin and placed through a small hole in the skull. The same wire is used to deliver electrical impulses in the brain, he said.

Patients start showing improvement almost immediately, said Doshi, as in Walji’s case. Although in indistinct speech, Walji managed to convey that he was feeling much better. He plans to fly back to the US in about 10 days.

What is Deep Brain Stimulation?

• The entire process is done under local anaesthesia and the patient is fully awake
• The patient does not experience either pain or discomfort during surgery
• Usually, the surgery lasts three to eight hours
• Patients can soon return to their normal life and activity
• The cost of implants for the surgery can vary between Rs 3 lakh and Rs 4.5 lakh