April 11 is observed as World Parkinson’s Day annually to raise awareness and understanding about this progressive neurodegenerative disorder. By educating the public about the disorder, symptoms and the impact on individuals, the day seeks to support the community and reduce the stigma around it.
THE WEEK organised a podcast with Dr. Paresh Doshi, a pioneer in functional neurosurgery, a specialised branch of neurosurgery. He has performed more than 700 brain surgeries on Parkinson’s patients. Here are some important insights from the conversation.
Q/What exactly is Parkinson’s disease?
A/Parkinson's disease is a neurodegenerative disease which happens when brain cells are exhausted. This is an age related ailment. As you grow old, people would be required to go through a knee replacement. Similarly, for some patients due to the degeneration of brain cells and the decrease in dopamine cause Parkinson's disease. This is most commonly found in the elderly, but now also found among the youth as well. We have treated some patients who are less than 20 years of age. This is called Juvenile Parkinson's.
People assume Parkinson's to be an old age disease and they miss the symptoms of the young onset Parkinson's disease which affects some people before the age of 40. Of the surgeries that I have performed, approximately 25 per cent of the patients belonged to the young onset Parkinson's category because their disability aggravates and they are unable to lead a productive life ahead. But generally it is an old age disease.
Q/ What is the first line of treatment for a patient who has been diagnosed with Parkinson's disease?
A/ Initially, patients who are diagnosed with Parkinson’s disease can go through a medical treatment that can give them a good quality of life for four or year years. If you are in the initial stages then through the intake of medicines you should not be facing issues for five to six years. This is the primary form of treatment.
Q/ Are there any side effects of these medications?
A/ On prolonged use of these medications for Parkinson's disease, there will be side effects. We know that the process of degeneration will continue in the brain, there are no medications to slow down the degeneration. As the degeneration continues, symptoms will advance. Medicines are like batteries in a toy. The moment the patient takes it, they feel better and the moment the power of the medicine wears off, the patient also shuts down. With prolonged use, the patient would become clueless about when the power of the medicine will be effective or wear off. Another side effect is dancing moments. The power is too much for the patient and they start shaking. The third important side effect is hallucinations.
Q/ What is deep brain stimulation surgery?
A/ It is technically simple. We make a small hole of about one centimeter hole and through that we put a wire inside the brain. This wire goes into the brain, to a particular spot in the brain where the cells of Parkinson's disability are present. We need to control these cells through electrical current. This is done through a programmable pacemaker similar to the heart pacemaker. It gives current to the brain wire. The whole surgery is performed by keeping the patient in awake condition.