Winning the fight vs Parkinson’s disease

The success of the first-ever surgery to help patients suffering from Parkinson’s disease was not only a milestone in Philippine medical history; it is likewise a proud moment in the careers of the medical team who conducted the operation.

"You can’t put a price on the life of the patient," says Dr. Dominic Jamora, movement disorder neurologist of the Philippine Movement Disorder Surgery Center (PhilMove) team which conducted the implantation of the deep-brain stimulation (DBS) device that helps control the symptoms of Parkinson’s disease.

Called the Activa Therapy, the world-renowned procedure has been proven to significantly suppress the symptoms of the debilitating disease. It involves the surgical implantation of a lead, a thin insulated wire with four electrodes at the tip, deep within the brain’s structures.

"The first procedure is always the hardest," says neurosurgeon Dr. Theodor Vesagas. "But we were confident with the skills of the members of our team."

The other members of the PhilMove team were neurosurgeon Dr. Jose Aguilar; movement disorder neurologist Dr. Rosalia Teleg; neuroanesthesiologists Dr. Jose Antonio Evidente and Dr. Monserrat Velasquez; neuropsychiatrist Dr. Joseph Anlacan; neuropsychologist Dr. Lourdes Ledesma; and neurosurgical nurses Mel-Ross Caleda and Mario Louis Bumatay.

Strict screening

Teleg says that while many people have inquired and expressed desire to undergo the procedure, not all of them were eligible candidates for the treatment.

"First of all, we really have to establish that what they are suffering from is Parkinson’s disease," she emphasizes. "That it is idiopathic and that what the patient perceives to be Parkinson’s are not just symptoms of other diseases."

She adds that the patient should also be under medication for Parkinson’s disease for at least five years.

"The medication should be maximized first. It is when the medicine starts to fail as the disease progresses and the symptoms worsen, that’s when we suggest that the patient undergo the DBS procedure," Vesagas says.

Age is also a major consideration. Aguilar explains that while there is no specific age limit for DBS candidates, it would be best if they are under 80 years old.

"Our first patient was a good candidate for the treatment. He was 68 years old," he says. "But those who are younger are the best candidates since they would reap the most benefits from it and will incur lesser complications and risks."

Follow-up visits

Follow-up visits are required after the operation. "We need to see if the patient is receiving proper stimulation," Teleg explains.

This is because the therapy involves the delivery of mild electrical stimulation to the brain. Electrodes (neurostimulator) are connected to a pulse generator that is embedded underneath the skin of the chest and generates electrical currents that are delivered to the targeted area in the brain.

Turning on the pulse generator alleviates a patient’s symptoms such as muscle stiffness or slowness of movement, tremor or other unnecessary movements.

While no cure has been found for Parkinson’s disease, Activa Therapy safely and noticeably suppresses many of the primary symptoms of the disease.

Follow-up visits are also necessary to check on the battery life of the DBS device.

"In fact, PhilMove has already received a patient who had her DBS done abroad, but needed to replace the pulse generator here," Teleg says.

Marked improvement

The doctors, meanwhile, report that after the DBS surgery, their first patient has now gone back to his busy lifestyle.

"He has regained his ability to walk. He no longer needs the assistance of a caregiver. He has also gone back to his business," Jamora says.

Prior to the surgery, the patient had been experiencing severe physical disability and motor complications for 15 years. He had to rely on other people to run his business.

"The patient first suffered an uncontrollable trembling of his left hand followed by a slowness and then rigidity of movement. Later on, he developed complications such as freezing, excessive movements, and occasional falls," Jamora says.

Activa Therapy has helped thousands of patients from Europe, Canada, Australia and the United States. Prior to its introduction in the Philippines last year, Filipinos had to go to abroad to undergo a more expensive procedure.

(For more information on the Activa Therapy, call PhilMove at 726-0776 or 723-7575 or e-mail [email protected].)