Bengaluru: The doctors from Bhagwan Mahaveer Jain Hospital in Bengaluru have successfully performed an awake brain surgery on a U.S. guitarist. Interestingly, the patient was allowed to play guitar while having brain surgery.
Joseph D’Souza (65), a resident of Los Angeles, suffered the “guitarist’s dystonia”, for which there is no known cure. Joseph lived with this condition for close to 20 long years, struggling to get this small correction done in his nerve.
Dr. Sharan Srinivasan, Stereotactic and Functional Neurosurgeon, PRS Neurosciences, Bhagwan Mahaveer Jain Hospital, popularly known as the “Guitar Surgeon” and Dr. Sanjiv C.C., Senior Neurologist and Movement Disorders Specialist, successfully treated the patient with guitarist dystonia.
Dr. Sharan Srinivasan said that the MRI-guided, stereotactic neurosurgery is performed by specialised surgeons called ‘Functional Neurosurgeons’.
“We performed a Vo Thalamotomy using RF (Radio Frequency) current. This means ablating or ‘burning’ a circuit inside the brain. This live surgery involves the patient being fully awake all through the entire process of 7 hours – it involves fixing a titanium, stereotactic frame to the head, with 2 screws in the front and 2 screws at the back of the head, screwed into his skull and then capturing a special ‘stereotactic MRI’ of the brain,” he stated.
“Then, these MRI images are loaded onto specialized software wherein the probable ‘misbehaving brain circuit’ is identified and mapped. Once this target which is deep inside the brain, in the Vo (Ventralis Oralis) nucleus of the Motor Thalamus has been finalised, and the entry point on the head/ skull is defined, the “X-Y-Z co-ordinates” of both the target and entry point are calculated by the software,” he said.
He added that in Joseph’s case, the distance from the entry point to the target was 100 mm or 10 cms.
“The moment the target spot was stimulated, Joseph experienced a mild numbness/ paresthesia in the left 4th and 5th fingers! And these were his problem fingers! This meant that we were spot-on with our targeting,” he said.
“Then, we made the ‘7 burns’, one after the other, along three different trajectories, each at 70 deg centigrade and 40 seconds, he began experiencing progressive improvements in his guitarist dystonia and by the 5th burn, he said he was ‘near normal’! After the surgery, the patient requires 1-3 months of focused neuro rehabilitation by an Occupational Therapist trained to rehabilitate such patients and re-train their muscle memory,” Dr. Sharan Srinivasan stated.
Joseph D’Souza recounting the experience stated: “Music was life for me. I learnt the guitar as early as six years of age and made it my profession. I played for a renowned band at the age of 20 and life was musical. It took me places and I became a musician and settled down in the USA.”
“I performed with some of the biggest names in the music industry and everything was going well till the year 2004. I started facing difficulty in playing the guitar and that was when the world fell apart for me. I had not known the symptom by name at that point of time,” Joseph stated.
Joseph developed this issue on his left hand – ring and pinky finger. The fingers would curl into his palm uncontrollably. He had no pain, no numbness, no tingling sensation.
The condition worsened and he was found struggling to play simple basic chords and good guitar solos were a huge challenge.
“After 4 years of struggling, without even knowing what was going on, I was first diagnosed by a doctor at UCLA Los Angeles. He told me that I had this condition called Guitarist’s Dystonia, a type of Task Specific Focal Hand Dystonia (TSFHD),” Joseph stated.
“I remember the words of the doctor “There is no known cure for it”. Around six years ago (2017), my friends shared a video of a guitarist undergoing surgery for a condition which was very similar to mine and it gave me hope,” he remembered.
“I hunted for Abhishek’s contact details, managed to get him, spoke to him about my condition and was convinced that it would work for me too. But I was very sceptical of undergoing brain surgery and hence delayed it for seven more years,” said Joseph D’Souza.
