Dystonia Treatment

Dystonia is a diverse set of illnesses that is categorised as a clinical syndrome rather than a single pathology. It is a type of movement disorder where muscles undergo uncontrolled spasms, causing strange and often repeating movements or body postures. These movements are often twisting and shaky. It is often made worse by voluntary effort and results in excess muscular activity. This clinical phenomenon is seen in a wide range of disorders with different causes.

You will need to visit the team of Brain Specialists during your initial evaluation. The procedures included in evaluation appointment are:

• Complete medical history review
• Thorough physical examination
• Comprehensive assessment for movement disorders 
• Computerized balance testing
• Magnetic resonance imaging (MRI) scan of the brain
• Assessment of physical and emotional readiness for surgery 
• CT scan

The team including Neurosurgeons, Neurologists, Neuropsychologists, Movement Disorders specialist, and a DBS program coordinator meets you to review your condition and any potential risk factors associated with the treatment. The neurosurgeon will discuss the surgical possibilities, risks, and response to the treatment if DBS surgery is the best option for you.

Deep Brain Stimulation involves implanting a battery-powered stimulator, effectively a Brain Pacemaker, in the body and delivering electrical stimulation to the parts of the brain responsible for dystonia symptoms. The stimulator is inserted in the chest, and extension wires connect it to brain leads (electrodes). Most of the time, both sides of the brain are treated. The brain stimulation is regulated via remote control to achieve the best settings for each unique patient.

Numerous studies have also demonstrated that this therapeutic procedure provides long-lasting symptom relief even five- or ten-years following surgery. However, current scientific research shows that this procedure is generally safe and is linked to a low and maybe non-existent side effect profile. So, in the treatment of severe and medically refractory Dystonia, Deep Brain Stimulation is the ray of hope to get a better life. However, it can be accompanied by following adverse effects in few cases:

• Worsening in cognition and gait due to the unrelenting advancement of the underlying degenerative disorder
• Sensation of pin and needles
• Double vision
• Abnormal muscle contractions
• Impaired cognition
• Speech abnormalities
• Mood disorders

Patients who have had Deep Brain Stimulation (DBS) surgery must follow precise post-operative recommendations to support optimal healing and the best potential outcomes. These instructions may vary significantly depending on specific circumstances and the advice of the medical team, but here are some broad guidelines:

1. Post-Operative Pain: Mild pain and swelling in the area surrounding the surgery site are usual. If the discomfort becomes unbearable, contact your doctor.

2. Wound Care: Keep the incision area clean and dry. Follow the surgeon's instructions regarding when you can remove any dressings or bandages. Avoid scrubbing the incision area. Gently pat it dry if needed.

3. Activity & Diet: Avoid heavy lifting, strenuous exercise, or activities that could strain the incision site. Gradually resume physical activities under medical guidance. The patient can increase his/her diet as per tolerance.

4. Constipation: Reach out to your doctor if you experience constipation or take over the counter medications for the same under medical supervision.

5. Driving: Do not drive for two weeks following the procedure.

6. Medications: Unless directed, continue to take all of your movement disorder medicines in the same manner you would before surgery.

7. Follow-up appointments: You need to visit your neurosurgeon 7-12 days following each procedure to check on wound healing, remove sutures, and schedule any additional post-operative care visits that may be required.

8. Hair Care: Avoid every kind of hair care including hair colouring and hair cuts 6 weeks following the surgery.

9. Flights: Avoid flights for two weeks after the procedure.

The days and weeks following DBS surgery for dystonia are unique to each patient. However, keep the following in mind:

Rest: When you get home, try to get as much rest as possible. Return to normal activities gradually.

Falls: You are at a higher risk of falling in the weeks following DBS. If you used a walker or cane before surgery, keep using it until you are stronger and more stable.

Symptoms: Your symptoms may improve temporarily following surgery. The symptoms will return to normal after the DBS system is programmed.

Time: It may take a few months of changes until your DBS system functions as effectively as it can.

Deep Brain Stimulation treatment for various forms of dystonia resulted in an improvement in involuntary movements initially, with postural benefits often requiring longer. The symptoms may improve more slowly to stimulation than other movement disorders. Patients may achieve maximum relief after 3-12 months. 

Among the most prominent improvements for patients with dystonia are:

• Genetic Dystonia - 80-99% improvement of symptoms can be seen
• Cervical Dystonia (Torticollis) - 40-60% improvement is often seen but not all patients respond. Pain and the neck movement and posture sometimes respond separately, seldom resulting in improvement in one but not the other.
• Tardive Dyskinesia - 80% improvement can be seen
• Cerebral Palsy - 0-20% response to treatment is seen

The cost of Deep Brain Stimulation significantly depends upon the patient's health status, patient requirements, hospital choice, and the availability of treatment options. This procedure can cost roughly between Rs.7 lakhs to Rs. 15 lakhs in India which is fairly economical when compared to treatment costs in developed countries.

However, the following information can provide you with a broader view of its cost and expense:

The common drivers of overall cost of Deep Brain Stimulation are due to the following factors:

• Hospitalisation: The major cost contributors are associated with the length of Hospital Stay, Medical Staff, Rooms, Laboratory, Pharmacy, Radiology, Blood Bank, and Blood products
• Patient's age and health status
• Type & Severity of dystonia
• Post-surgical complications that are involved
• Choice of City for the treatment

The cost of diagnostics for Deep Brain Stimulation may include various preoperative evaluations and tests that are typically conducted before the surgical procedure. It mainly requires an MRI and CT scan of the brain. 

Brain MRI scans might cost between 12,000-15,000 rupees and Brain CT scan might cost you between 5000-7000 rupees in India. However, the cost of these scans is determined by the scan type and machine quality (1.5 or 3 Tesla). Therefore, the total diagnostic expenses (including facility fees, specialists’ fees, and diagnostic tests) will be roughly around 50,000 INR. 

The price of a diagnostics for this procedure varies significantly depending on the following factors:

• Facility type (public or private) 
• City or patient's location

MedFlick, your trusted healthcare companion, is dedicated to ensuring that your medical journey goes as smoothly and successfully as possible.

• Individualized Guidance: Personalized guidance throughout your medical journey.
• Access to a broad network of prominent hospitals, top doctors, and skilled surgeons.
• Transparent and Competitive Pricing: A full breakdown of treatment costs that eliminates surprises and offers you cost-effective solutions.
• MedFlick provides everything from travel arrangements to hotel and visa help to lodging.
• Multilingual Support: Breaking down language barriers to allow patients and medical professionals to communicate more effectively.
• The road to a successful dystonia treatment like deep brain stimulation is long and winding, full of hope, resilience, and the promise of a brighter future. With MedFlick as your guide, navigating this life-changing adventure becomes simple and liberating.