Epilepsy patient treated with pacemaker

Procedure was first in India

In November 2011, an Indian doctor met his American counterpart in South Africa during a conference.

What transpired between the two neurosurgeons was to change the life of Shalini Arora, suffering from intractable epilepsy.

Arora, 33, is the first epileptic patient in India on whom a pacemaker was implanted, relieving her of a condition she suffered since she was 18-month-old.

“Nearly 80 per cent of epilepsy cases can be treated with medication. Some need prolonged treatment. But in some cases conventional treatments are not possible as a wide area in the brain is affected.

That’s when a treatment like Deep Brain Stimulation (DBS) can work,” said Dr Praveen Gupta, head, department of neurology, Artemis Health Institute (AHI).

Intricate procedure

In this highly specialised procedure, a wire as thin as a hair is implanted in anterior thalamus in the brain. The area acts as a gate controlling electrical discharges to and from the brain and the limbs. In this key-hole surgery, impulses to anterior thalamus are supplied and controlled with the help of a pacemaker, implanted below the left collar bone.

Dr Alok Gupta, head, neurosurgery, AHI had met Dr Ashwini Sharan, associate professor at Thomas Jefferson University, Pennsylvania in November and discussed the US experience about DBS.

“Epilepsy affects day-to-day life of a patient since fits can occur any time of the day. The patient cannot go out and perform other tasks. This new line of treatment will relieve such patients. Importantly, this is a reversible and externally controlled treatment. If tomorrow a medicine is created to treat this condition, we can take out the wires and the pacemaker," said Dr Gupta.

Arora developed a bacterial infection as a child which damaged her brain leading to short supply of blood in some areas. This gave her an epileptic condition.

Till the age of 12 medicines helped her could control her fits. After that she started to get seizures every alternate day.

The condition became worse when she failed her 12th standard exams. It took help from her family o complete her graduation.

“I will do a masters now, show to the world I can do it," she said, overcome by emotion. After the surgery and monitoring she has not had any seizures for one-and-a-half month.

Epilepsy facts

*0.5 per cent of India’s general population suffers from epilepsy.
* There are approx 2,00,000 epilepsy patients in Delhi and National Capital Region.
* 15 per cent of all epilepsy cases are refractory or intractable, which means they can not be controlled through medication.