14 April 2010
By Jinal Shah
Born with multiple complications in Shakar near Karachi 47 years ago, Saleem Abdul Rashid Mohammad was the weakest of six children. He started walking at the age of 12, had little control of his neck, and struggled with his speech.
Later diagnosed with dystonia, Saleem was operated at Jaslok Hospital last week. He now says he has had a rebirth in India.
Dystonia is a neurological movement disorder characterised by involuntary muscle contractions, which force certain parts of the body into abnormal postures. Saleem was diagnosed with the condition in 1996 and put on medication ever since. He managed with the help of physiotherapy for over 30 years, and would sit at his general store in Karachi, till he lost control of both his legs. “Till 1996 he used to walk up to our general store and sit there for six hours at a stretch. Suddenly he complained of weakness and was bedridden.
We had to bathe him, feed him, he was completely dependent,” says younger brother Naser, 32.
“Medication worked but only for a few years. We consulted doctors at Aga Khan University, they advised surgery,” Naser said. They considered surgery in the United Kingdom but the cost would have been high and they opted for India. “The British doctors recommended we get in touch with surgeons at Jaslok Hospital,” he said. “The family wrote to us a year ago. The patient had generalised dystonia that affects most or all parts of the body, in his case the neck and speech. He had continuous movement of hands, legs and neck, arching of the back, and abnormal postures. He was wheelchair-bound,” said Dr Paresh Doshi, in charge of the department of stereotactic and functional neurosurgery at Jaslok Hospital and Research Centre.
“Although there is no total cure for dystonia, we use a surgical implant in the brain, a battery-operated medical device that includes deep brain stimulation (DBS) surgery (widely done for Parkinson’s disease) to alter certain brain signals that trigger such involuntary move ments,” said Doshi. The concept is similar to that of a cardiac pacemaker.
Doshi said the device delivers carefully controlled electrical stimulation to targeted areas in the brain. “Stimulation appears to block the brain signals that cause the motor symptoms associated with dystonia,” Doshi said.
Saleem was operated on March 31 and is currently recuperating at the hospital. “After surgery his speech improved, he slowly gained neck control, the upper limbs are relaxed and he is in less pain. It will take at least six months for any visible improvement,” Doshi said.
“If he is able to walk and resume work at our store, it will be his rebirth and this time in India,” said Naser.