Mr Erlick Pereira, the hospital’s Lead Neurosurgeon completed the 100th surgery nearly six years after he did the first surgery of its kind at The London Clinic.
He said, “The London Clinic offers a complete and comprehensive functional neurosurgery service for movement disorders and pain. For people with severe tremors, Parkinson’s disease and dystonia, deep brain stimulation is a life changing treatment.”
“With a lot of degenerative diseases, there are no treatments available that can profoundly improve someone’s life immediately. The notion that with neurosurgery one’s function and quality of life can improve straight away, is very satisfying, and exciting.”
Deep brain stimulation (DBS) surgery involves the implantation of very small wires (electrodes) to the affected/damaged parts deep in the brain, which deliver high-frequency electrical current to address the abnormal movement patterns. The electrodes are attached to a small electrical device called a pulse generator, in the patient’s chest, that sends out pulses similar to a pacemaker.
While (DBS) is an incredibly innovative and complex treatment, the brain surgery portion of the procedure is minimally invasive for patients, and takes less than an hour, during which the patient is under general anaesthetic. The full procedure takes less than three hours, and international patients who travel for the treatment are usually able to fly home around four days after surgery.
Assessing which patients are suitable for DBS is a team-based multidisciplinary procedure, involving neurologists, neurosurgeons, neuropsychologists, movement disorder nurse specialists and anaesthetists.
Consultant Neurologist Professor Francesca Morgante who programmed the DBS system following the 100th operation said, “We can deliver this neuromodulation treatment using the most advanced technology, which allows for fine tuning of the stimulation. We can personalise it according to patient’s unique clinical features, which is particularly advantageous for those patients with a progressive neurodegenerative disease, such as Parkinson’s.”
Deep brain stimulation first appeared as a mainstream medical treatment in the 1980s, and since then has been a developing area of research.
Looking to the future, Mr Pereira adds, “We now have the opportunity to study a group of people with brain implants, to record those brain signals. This generates exciting opportunities to increase our understanding of this very complex area.”
Successful Deep Brain Stimulation – Patient Case Study:
Benedict Gray is a patient who successfully underwent this surgery six years ago, at The London Clinic, under the care of Mr Pereira.
“I was diagnosed with Cervical Dystonia (CD) at the start of 2018 after my head/neck started continually turning/pulling to my left. I was originally given Botox injections which in many cases is effective in treating CD. However, in my case I received little relief,” said Benedict.
Dystonia is a neurological movement disorder involving uncontrollable and often painful muscle contractions triggered by incorrect signals from the brain.
“DBS is a complex medical procedure. It involves a pacemaker/simulator being embedded into the patient’s chest and this then transmits electrical signals through wires travelling along the neck, to the electrodes placed in the brain. These signals then disrupt the incorrect signals causing the dystonia and alleviate the condition.”
Benedict speaks highly of his experience with The London Clinic and the all-around patient care he received.
“Engaging with the London Clinic was a dream. I was able to speak directly to Mr Pereira, his PA and other members of the team and they were fantastic in organising for my pre-DBS assessment, answering my questions and helping to move things forward with my insurance provider. The staff at the clinic were very patient focused and very responsive.”
After his operation Benedict stayed in the clinic for several days to recover and learn how to maintain his DBS system.
“In the hospital Mr Pereira visited me daily to see how I was and arranged for a Boston Scientific representative to visit me to explain how to maintain my DBS system. Then I had a series of follow-up appointments in which my DBS system was adjusted to ensure optimum performance.”
Now six years on the success of the operation is clear, and Benedict says, “The London Clinic gave me my life back.”
“About a week after the actual operation, I returned to the clinic for an appointment with consultant neurologist Dr Dominic Paviour who switched my system on. Within the space of about 15-30 minutes my symptoms had improved to the extent that my head/neck was no longer pulling to the left and I had full head/neck movement. Within several weeks, I had started driving again and in late 2019 I returned to working overseas.”
Further information:
The team for the 100th Deep Brain Stimulation at The London Clinic included: Mr Pereira, Consultant Neurologists Professor Francesca Morgante and Dr Lucia Ricciardi, Consultant Neurosurgeon Professor Dipankar Nandi, Clinical Neuropsychologist Dr Elena Makovac, Movement Disorders Nurse Specialist Mrs Alison Leake, Consultant Anaesthetist Dr Moein Tavakkoli and Consultant Neuroanaesthetist Dr Audrey Tan.
Boston Scientific who supply the electrodes, said,
“We are delighted to have supported Mr Pereira, Professor Morgante and the team. We hope to continue to work with them and the London Clinic to increase access to and raise awareness of this important and potentially life-changing therapy.”
Brainlab who make the software for the brain surgery, said,
“It’s a privilege to support The London Clinic with software to facilitate the accurate planning of DBS electrodes prior to surgery. We’re grateful that The London Clinic puts their trust in our solutions and will continue to support neurosurgeons to advance this crucial procedure to the betterment of their patients.”