Manipal Institute for Neurological Disorders (MIND) has set up a Parkinson's Disease and Movement Disorders Clinic. The exclusive clinic helps to evaluate movement disorders, diagnose, adjust medical treatment and offer Deep Brain Stimulation (DBS) for advanced Parkinson's disease cases.

Dr N. K. Venkataramana, director, Manipal Institute for Neurological Disorders, Manipal Hospital said, "We have come a long way in evaluating and treating patients afflicted with Parkinson's disease. We have treated such cases for the last nine years and performed 73 stereotactic lesioning surgeries. Two years ago, the DBS was introduced and workshops were conducted on Micro Electrode Recording (MER)." This is perhaps the first time in the private sector that such a structured programme is being offered.

This state-of-the-art clinic offers comprehensive treatment - clinical evaluation, diagnosis, drug management, follow-up, evaluation for surgery, programming, speech therapy, physiotherapy, cognitive retraining, gait therapy and other supports. Patients are evaluated and programmed every Tuesday, said Dr. Venkataramana.

DBS is a novel technique of providing high frequency stimulation to selected target nuclei in the brain. Post-operatively programming will be done by adjusting stimulation parameters to provide maximum benefit with lowest stimulation intensity. Patients are able to switch stimulation on/off by means of a hand held programmer/magnet.

DBS is under evaluation for the treatment of essential tremor, dystonia, intractable pain and epilepsy. It is the only surgery that improves symptoms like tremor, rigidity, akinesia, postural instability and gait virtually in all patients.

Patients with severe Parkinson's disease with inadequate benefit from medical therapy and those with fluctuations and dyskinesia are ideal candidates for DBS surgery, he said.

Age is not a contra-indication although the patient has to be medically fit with no signs of depression or dementia.

"For us evaluating patients is extremely crucial. Initial therapy consisting of drugs is important and standard protocols are used in evaluation and assessment. We do not take them straight away for surgery," Dr Venkataramana pointed out.

Prohibitive costs and replacement of battery every five to seven years are the only disadvantages. The complications are similar to any stereotactic procedure like intracerebral hematoma (swelling), infection and seizures. The other affects are related to the position of the electrode, which is adjustable and rarely result in permanent problems.

Parkinson's disease is a progressive, degenerative movement disorder affecting an average of 1 in every 10,000 people. Though it usually affects people over the age of 50, younger individuals also get affected.