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Neurological problems are on the rise in India. Early detection can reduce the risk and halt the progression of such diseases.  Professor Dr. K Sridhar is the Head of the Department of Neuro Surgery and the Director of the Institute of Neurological Sciences and Spinal Disorders of Gleneagles Global Health City. He is also associated with the Dr. MGR Medical University in Tamil Nadu. In an exclusive interview with BE’s Saptarshi Deb, Dr. Sridhar explained the nuances of neurological disorders and their treatment. 

Q. How far can early detection mitigate the risks of neurological diseases like Parkinson’s, dementia, and epilepsy?

A. As far as all these three conditions go and in the case of any other neurological illness, the earlier you detect the problem, the chances of halting the progression and to a certain extent, reversing the symptoms can be ensured.

For epilepsy, the option of surgery is available now and it is curable. For Parkinson’s, it is a progressive disorder. Surgery can stop the symptoms and halt the progression of the disease. Dementia is not so easy. Medicines can be given but the disease will progress. However, mental exercises can help a patient to cope with dementia better.

Q. Which should be the early symptoms that can be looked out for the detection of epilepsy, dementia, Alzheimer’s, and Parkinson’s?

A. Epilepsy is the hyper functioning of the brain. In case of normal epilepsy, the patient becomes unconscious and there is jerking of hands and legs. But in other types of epilepsy, the symptoms may not be so obvious. You may have a staring look and that could be an epileptic attack. People must be made aware that any abnormal movement or activity of a person can be related to epilepsy. Dementia is characterised by easy forgetfulness. If a person has a progressive memory problem, then he must be examined for dementia. Alzheimer’s is a type of dementia.

The first symptom associated with Parkinson’s is associated with slowness of physical movement. The patient may find difficulty in buttoning his shirt or may find that it is taking him longer to walk a particular distance. Trembling of hands or tremor  can be another symptom.

Q. What kind of medical research is being pursued in case of epilepsy and dementia?

A. In the case of epilepsy, there is a wide range of medicines available. These medicines are becoming increasingly
precise in regard to a certain type of epilepsy and are causing fewer side effects. At the same time, there are certain percentages of patients who do not respond to medicines and surgery is needed in those cases. The micro-surgery entails removing the part of brain that is causing the abnormal electrical activity. Cutting or interrupting the transmitting path is another option.

For dementia, there are drugs coming in which can help the patients to halt its progression but more research is needed.

Q. Is there any evidence to suggest that diseases like epilepsy, Alzheimer’s, dementia, and Parkinson’s have a genetic correlation?

A. There are certain genetic syndromes where epilepsy can be correlated genetically. But I would not say ‘in general’. In general it is only a sporadic occurrence which means one generation may have the disease and following generations may not have it. I would not say that epilepsy can be passed on genetically. There are certain syndromic epilepsies (which are relatively uncommon) that can be correlated genetically. 

Q. How far has the Deep Brain Stimulation (DBS)
been successful in tackling advanced Parkinson’s and other diseases?

A. For well-chosen patients, the success rate is around 80%. However in the case of advanced Parkinson’s with memory issues, DBS do not do very well. But with early detection, DBS has a high success rate. It is also being used to treat psychological problems like Obsessive Compulsive Neurosis.

I would also like to inform that in the 1960s and 70s, a large number of similar stereotactic procedures were performed for all treating these neurological problems in India. However, the procedures were ablative in nature. Small portions of the brain (where the disease had originated) were destroyed. But now, DBS is a simulative procedure. However, these ablative procedures can still be opted by patients who cannot
afford DBS. 

Q. What other research is on in regard to treating Parkinson’s? Can dopamine patches be a viable alternative in near future?

A. Presently there is a lot of research involving stem cells and tissue modulators. However, presently DBS seems the only alternative to medicine in the case of Parkinson’s.

Q. Please suggest dietary practices that can ensure neurological wellness?

A. Eat and live sensibly. The normal Indian diet is probably the best balanced diet that you can have. Excess of anything is bad.

Q. How can yoga and meditative techniques help neurological patients?

A. Yoga and other meditative techniques have shown to be of help. There is a lot of research going on to incorporate ancient Indian medical practices into the realm of modern medicine. Recently, I read an article on how a Parkinson’s patient was helped by ball room dancing. Dance therapy is a
great rehabilitative therapy. There is a lot that goes on in the brain. Much of it is still unknown to us. Research should explore all these avenues and see what can help. Yoga and other practices should be looked at seriously and used to help neurological patients.