How An Advanced Surgery Helped A 53-Year-Old Patient Get Relief From Focal Hand Dystonia

The patient, a banker by profession, was not able to do even the most basic chores. But then, a minimally-invasive surgery gave him a new lease of life. Read on to find out more.

Many patients suffer from debilitating health conditions that cause tremors and dystonia, and prevent them from performing basic regular activities like eating, holding a glass, using a cup or a spoon, brushing teeth, buttoning and ironing clothes, shaving, writing, or even using their mobile phone. Focal hand dystonia is one such neurological health problem, in which there are involuntary muscle contractions in the hand, wrist, or the entire arm. It is also known as 'writer's cramp' or 'musician's cramp'. Recently, a 53-year-old patient battling dystonia was successfully treated with advanced 'lesioning surgery', which has been improving the quality of life for people suffering from tremors, dystonia, and Parkinson's disease. It is considered to be an alternative to deep brain stimulation (DBS), allowing patients to reclaim their lives with a minimally-invasive surgery and fast recovery. Read on to find out more about the case.

The patient, a Mumbai resident and banker by profession, suffered from severe focal right-hand dystonia that caused abnormal involuntary movements for the past seven years. He struggled to do basic chores like writing, eating, dressing, and shaving, and even experienced continuous pain in his right hand. In fact, his hand would move 'inward' while walking or using small objects, leading to significant clumsiness.

While the patient was on several dystonia medications, he was only able to recover partially, with temporary improvement. But, he did find substantial relief through lesioning surgery, which provided immediate pain relief and almost complete resolution of the involuntary movements.

Dr Pankaj Agarwal, head of the department of neurology at Gleneagles Hospital in Parel, Mumbai said in a statement shared by the hospital that lesioning surgery is an 'excellent option' for many patients with severe tremor and dystonia, either isolated or as part of diseases such as Parkinson's or essential tremor and other neurological diseases.

"Unlike deep brain stimulation, which requires the implantation of a pacemaker and is often expensive, lesioning surgery uses a heated metal tip -- that uses radiofrequency waves -- to 'silence' abnormal circuits in certain nuclei or targets in the deep part of the brain. This technique delivers immediate and lasting relief, significantly improving patients' quality of life. Many of our patients, who have been suffering for years, can now perform simple tasks like eating or writing without difficulty. The results are life-changing, and the procedure itself is highly specialised yet cost-effective," the doctor explained.

Dr Agarwal further stated that the procedure is an excellent option for many patients struggling with movement disorders due to its 'immediate efficacy, affordability, and relative longevity'. "For patients who have struggled with chronic symptoms for many years, the results are almost miraculous and on-table, seen within minutes of the lesion being created. The reduced cost and shorter recovery time make it an accessible option for those who cannot afford DBS."

Dr Naren Nayak, functional neurosurgeon at Gleneagles Hospital, meanwhile, said that lesioning surgery requires immense precision and represents a highly specialised form of functional neurosurgery. While these surgeries are rarely performed, they have great scope and potential.