Neurology Specialised Procedures

Specific diagnostic procedures are used to determine the cause and treat neurological conditions accurately. At Aster Hospitals, we provide the best possible treatment modalities for our patients. Several specialized procedures have been developed to deal with neurological conditions. These procedures are not readily available in several hospitals. However, we have equipped ourselves with the latest procedures to diagnose and treat these conditions at Aster Hospitals. Some specialized tests can detect and treat diseases like Parkinsonism, tremors, dystonia, cerebral palsy, and many others.

Deep brain stimulation is one such advanced neurosurgical procedure that uses electrodes implanted and electrical stimulation to treat conditions like Parkinson's disease, essential tremors, dystonia, and other neurological conditions.

Production of abnormal signals in parts of the brain that control body movements leads to movement-related symptoms in patients. Deep brain stimulation disrupts the abnormal signals that cause tremors and other movement-related symptoms.

After performing a series of tests to determine the accurate location of the placement of the leads, a neurosurgeon implants them in the brain. The leads are connected with a wire to a neurostimulator placed under the patient's collarbone; continuous pulses of electric current pass through the leads and into the brain. A few weeks after the neurostimulator is implemented, the doctor programmes it to deliver a signal.

Three types of Parkinson’s disease patients benefit from this procedure:

• Patients with symptoms who respond well to medicines but experience severe motor fluctuations once the effect of the drugs wears off
• Patients whose symptoms may respond to higher or more frequent doses of medicines but cannot take them due to the dyskinesias

Essential tremor is one of the most common disorders, and deep brain stimulation is an effective therapy, particularly in severe cases where even shaking hands can be disabling. Since tremor is the only symptom experienced by these people, deep brain stimulation can improve the life of those with the condition. Similarly, dystonia is a relatively uncommon movement disorder that can respond well to deep brain stimulation when the medications fail to provide relief. Recent studies have confirmed that certain psychiatric conditions, such as depression, obsessive-compulsive disorder, or Tourette's disorder, can benefit from deep brain stimulation.

Botulinum toxin therapy is another specialized procedure that involves neurotoxins, which affect the nerves and cause their weakening. This toxin may be given for cosmetic and medical reasons. Small amounts of toxin are injected to smoothen the wrinkles, prevent migraine headaches, and treat various health conditions.

Botulinum toxin blocks the nerve signals to the muscles, as a result of which, the muscles cannot contract. Although these effects are temporary, they can last for several months. Several medical conditions can be treated with botulinum toxin. These include:

• Strabismus
• Dystonia
• Excessive sweating
• Eyelid twitching
• Chronic migraines
• Cervical dystonia
• Blepharospasm
• Sciatica pain
• Neuropathy
• The side effects of botulinum toxin injections vary depending on the area receiving treatment. Possible side effects include:
• Pain, swelling, and redness at the site of injection
• Flu-like symptoms
• Headache
• Neck pain
• Indigestion
• Ptosis
• Irritation in the eyes or redness

Some neurological conditions mimic the symptoms of Parkinson's disease. These disorders are called Parkinsonism plus syndromes or atypical Parkinsonian syndromes. These conditions usually do not have a definitive cure. However, your doctor can help you plan your treatment of specific symptoms. Treatment options include:

• Physical and occupational therapy to help you keep moving.
• Assisting swallowing and speech: A speech therapist helps you train your muscles so that you do not have difficulty performing tasks like swallowing and speech.
• Medications for difficulty in movement.
• Medications to improve the mood of the person.

Although there are no treatment modalities that can stop the progression of Parkinsonism plus syndrome, there are specific treatments that can help you manage your symptoms well.

Conditions such as dystonia, tics, writer's cramps, and chorea can be associated with an underlying disease. The various treatment options available to treat dystonia are:

• Botulinum injections to stop contractions of the muscles in focal dystonia and to treat writer's cramps
• Medications that block the different chemicals in the brain
• Surgery to implant electrodes in the brain so that the movements can be controlled
• Speech therap
• Physical therapy to improve the posture of the person
• Mechanical devices to hold the person's limbs in position
• Antipsychotic medications as the primary modality for the treatment of tics

Health Conditions Treated

• Parkinson's disease
• Essential tremors
• Dystonia
• Strabismus
• Excessive sweating
• Eyelid twitching
• Chronic migraines
• Cervical dystonia
• Blepharospasm
• Sciatica pain
• Neuropathy