Parkinson’s Tremor Treatment in India: Surgery vs Non-Surgical Options Explained

Parkinson’s Tremor Treatment in India: Surgery vs Non-Surgical Options Explained

When patients have Parkinson’s disease, they experience involuntary shaking known as a tremor. Tremors often begin with the hands but can progress to involve the whole body. For Parkinson’s disease patients, everyday tasks—like writing, eating, and even gripping objects—can become extremely difficult.

Patients in India have access to a wide variety of treatment options to manage their Parkinson’s disease symptoms. Treatment options include both non-surgical and surgical options. It is important for patients to understand the differences between the options so they can make the best choices for their treatment.

Basics of Parkinson’s Disease

The disease is the result of the deterioration of neurotransmitters in the brain. The neurons of concern generate dopamine, which is a neurotransmitter that is crucial for smooth and balanced movement.

As we age, our brains develop the ability to control our bodies. But what happens when your brain can’t control your body anymore? Parkinson’s disease is the slow progression of your brain’s ability to control your muscles, resulting in stiffness, tremors, and slow/non-existent movements. Patients usually develop symptoms anywhere from 10 to 30 years prior to the age-specific symptoms described below, but typically, they develop symptoms closer to age 60. However, some patients develop symptoms at a much younger age and develop what is known as early-onset Parkinson’s disease.

Symptoms of Parkinson’s Disease

Symptoms vary among patients and depend on the progression of the disease.

The primary symptoms include, but are not limited to, tremors, slow movements, stiffness of the muscles, and balance problems.

• Tremors: Tremors are typically the first symptoms to develop. Patients typically develop tremors in 1 of their 2 hands in the form of shakes, and usually only develop these symptoms when they are at rest.

• Bradykinesia: Bradykinesia is the result of slow movements in almost all day-to-day activities that patients are supposed to perform. Overall, including the time it takes for patients to perform the activities involved, and the time taken for patients to perform the activities, in total, those activities are supposed to take much less time to perform compared to the total time taken to perform them.

• Muscle stiffening: The muscles of patients who develop the disease tend to become rigid, and it becomes harder to freely perform movements.

• Balance and posture problems: The patients develop problems maintaining their balance; some develop a posture that is slightly curved forward.

• Changes in writing and talking: Talking may get quieter, and writing may get smaller and tighter.

With these motor symptoms, Parkinson’s disease may also present non-motor symptoms such as problems sleeping, feeling more tired, changes in mood, constipation, and a decreased ability to smell.

How is Parkinson’s Disease Identified?

A neurologist needs to perform a thorough clinical assessment. It is unlikely to be a laboratory test to confirm the diagnosis.

Doctors rely mostly on:

• A thorough medical history
• Symptoms and the way their body moves
• Neurological assessment to check their body control, how fast and in what order body parts move, and the coordination of body parts
• Sometimes, other brain imaging is recommended to eliminate other disease processes in the nervous system that cause symptoms that mimic Parkinson’s disease.

It is essential to get treated early so the disease process can be controlled and the person can improve their well-being.

Uncontrolled disease process

Most patients start with an uncontrolled disease process. These medicines help raise dopamine levels in the brain or mimic its effects. These medicines lower the uncontrolled disease process tremors and speed up the controlled disease process symptoms.

With the uncontrolled disease process, it is common to improve their flexibility, balance, and muscle strength.

Patients can experience changes in their communication and voice and can benefit from speech therapy.

Therapy can also help patients learn how to manage daily activities so that they can continue to sustain their level of self-sufficiency.

MR-guided Focused Ultrasound

A novel method that has the potential to address the symptoms of Parkinson’s Disease is called MR-guided Focused Ultrasound.

This type of therapy targets specific areas of the brain that are responsible for the tremors using focused ultrasound waves. The ultrasound waves are directed at the area of the brain that is involved through the use of an MRI scan. There is no need for surgical or invasive treatment, so the recovery process is faster when compared to surgery.

Surgical Treatment: Deep Brain Stimulation

DBS or Deep Brain Stimulation is one of the last treatment options for patients suffering from Parkinson’s Disease. When the tremors of a patient become intolerable and are not responsive to medication, then the patient will be recommended for surgery.

During DBS surgery, tiny electrodes are inserted into certain areas of the patient’s brain. These electrodes are responsible for producing controlled electrical impulses for the purpose of normalizing the functioning of a brain region that is causing involuntary movements and tremors.

The electrodes are linked to a device that is implanted under the skin of the patient’s chest, similar to a pacemaker. This device is responsible for providing continuous electrical impulses in order to manage the patient’s symptoms.

DBS has improved life quality for numerous patients with advanced Parkinson’s disease.

Surgery vs Non-Surgical Treatment: What are the Considerations?

Multiple factors determine the choice of surgical vs non-surgical treatment. This includes the symptom complexity, the overall condition of the patient, and the level of medication control of the tremors.

Patients may opt for non-surgical techniques such as medication, therapy, or Focused Ultrasound, especially when surgery may not be an option.

Surgical techniques such as Deep Brain Stimulation are warranted when medication does not provide tremor control, and the tremors are a major disruption to the patient’s day-to-day activities.

Rapid Medical technology is enabling more refinement and safety to these techniques. Support from Advanced Medical Technology Innovations to Focused and Robotic Vattikuti Technologies’ minimally invasive techniques is also helpful in improving the range of modern neurological interventions.

The Future

In recent years, treatment of Parkinson’s disease has remained challenging. However, with increasing awareness, evolving techniques for accurate diagnosis and advanced machinery techniques, the available options have tremendously broadened for patients.

An early appointment with a neurologist and a quick start to treatment can help people control symptoms and improve their quality of life.

Frequently Asked Questions

1. What causes tremors in people with Parkinson’s disease?
Tremors happen when the brain cells that produce dopamine are damaged. Dopamine is the brain chemical that helps control movement. When there is less dopamine, there is shaking that cannot be controlled.

2. Do all people with Parkinson’s tremors need to have surgery?
No. Surgery is not needed for most people. Many people are able to control their symptoms with medications and therapy. Surgery is only done when medications fail to provide enough control.

3. What is Focused Ultrasound for Parkinson’s tremors?
Focused Ultrasound is a non-invasive technique that uses ultrasound waves guided by MRI to treat certain areas of the brain to stop tremors. Improvements in the precision and the range of these types of treatment are a result of the Vattikuti Technologies partnership.