'Oman girl youngest to undergo DBS surgery in India'

Oman girl youngest patient to undergo deep brain stimulation surgery in India, says Bengaluru hospital

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A five-and-a-half year old girl from Oman who was operated upon in December last year became the youngest to undergo Deep Brain Stimulation (DBS) surgery in the country, doctors at Vikram Hospital, Bengaluru, said at a press conference here on Wednesday. The girl is doing well and is recovering. Normally, it takes six months for a patient who has undergone DBS to show full results.

In patients suffering from Parkinson's disease, DBS is usually performed on patients who have suffered from the disease for at least four years. But in this case, the girl was suffering from DYT16, a Dystonia-Parkinsonism disorder. DBS is a neurosurgical procedure involving the placement of a neurostimulator, which sends electrical impulses, through implanted electrodes, to specific targets in the brain for the treatment of movement disorders.

Dr Prashanth LK, Consultant Parkinson's disease and Movement Disorders Specialist, Vikram Hospital, said, "For the past two years, she was completely bedridden and dependent on her parents. Her limbs had an abnormal posture. World over, only 10 to 15 patients have been documented to have suffered from this rare genetic abnormality. In medical literature abroad, DBS is said to have been done in a two-year-old patient but not in India. Here, we do DBS in adults for various conditions apart from Parkinson's like Dystonia and tremors. We did the surgery for seven hours last December and in one-and-a-half months, she has shown good improvement."   

DBS for DYT16 has been done only for four other individuals worldwide till date. However, there were challenges in doing the surgery for such a young patient. First, the battery that is normally fixed under the collar bone in adult patients couldn't be fixed there as her supple skin could not accommodate such a large device in that area. Hence, the doctors fit the device in her abdomen. "In view of her low weight and subcutaneous fat, we placed the DBS battery in the abdominal wall," said Dr Kiran Khanapure, Functional Neurosurgeon, Vikram Hospital. 

Asked if a smaller battery was used in the patient, Dr Prashanth said, "The company that manufactures the battery only does it in sizes meant for adults so we had to make do with its original size."

The patient will be going back to Oman later this week and doctors will schedule a follow-up after a few days. The patient and her parents only spoke Arabic. Fortunately, the cost of the surgery, Rs 11 lakh, was covered by insurance in Oman. 

DYT16 is usually transmitted in an autosomal recessive manner like consanguineous parentage or both parents having one abnormal gene. There is no specific curative treatment for DYT16 yet.

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