Q. Is the Deep Brain Stimulation procedure: a cure for Parkinson disease ?

Answer. Deep Brain Stimulation is not a cure for Parkinson disease. It improves the quality of life, improves tremor, stiffness, freezing and drug-induced dyskinesia associated with the disease. After Deep Brain Surgery the requirement of medications reduces by 40-50%. We expect 60-70% improvement in his quality of life. This therapy is reversible, programmable and does not preclude new therapies in future.



Q. What is the cost of the Deep Brain Stimulation Surgery and duration of the hospital stay ?

Answer. In our hospital the cost of this therapy is 7.5 - 9 Lac Rupees (18-20,000 US$). This includes the cost of implant(Non rechargeable), operation charges and hospital stay charges. Patient has to remain in the hospital for 7 days.



Q. At what time in the stage of the disease parkinson surgery is indicated ?

Answer. In advanced stage of Parkinson disease when patient has developed drug induced side effects like dyskinesia, hallucinations and when despite adequate medications a person is incapacitated for performing his day to day activity, parkinson disease surgery is indicated.



Q. Is there any risk in this surgery and how long the effect of Deep brain stimulation will last ?

Answer. As such the risk of Deep Brain Stimulation surgery is less than 1%. There can be possible risk of Mechanical malfunction, infection or bleeding. We have one patient who had infection in our series of 350 procudure perform. Normally the life of I.P.G. (battery) is five years and after that new battery replaces it. The brain electrodes will remain in position for life long.



Q. How many surgeries have been performed by you for movement disorder ?

Answer. We have performed 350 Deep Brain Stimulation and 55 Brain Lesioning procedures( Pallidotomies) for Parkinson disease Essential tremor and various indication.



Q. What are the cheaper alternatives to Deep Brain Stimulation surgery for movement disorder ?

Answer. Patients with advanced Parkinson disease and Essential tremor can be subjected to Pallidotomy/Thalamotomy. The cost of this therapy is around 2.5-3 Lac (4000-5000$). Brain Lesioning in anterior capsulotary can be perform for OCD Patient. But as compared to DBS this procedure is irreversible, effects do not last for more than 2-4 years. However Pallidotomy has long lasting effect on dyskinesia.



Q. What are the other diseases where Deep Brain Stimulation therapy is effective ?

Answer. Other than Parkinson disease and Essential tremor this therapy is effective in hemidystonia, idiopathic congenital dystonia and for lower limb pain and bladder dysfunction where spinal cord stimulation and sacral nerve root stimulation is performed. Future use of this therapy will be for Epilepsy and various other neurological disorders.



Q. After deep brain Stimulation how frequently one has to come for programming ?

Answer. After surgery initial programming is done by the neurologist and with latest kinetra, LibraXP "Non Rechargeable" and brio "Rechargeable" implant patient himself can change the stimulation parameters under the guidance of local neurologist. Programming at distant places can be arranged by local Medtronic representative anywhere in the world.