Senior Director & HOD
Neuro Surgery & Neuro Spine
+91-11-30403040The Functional Neurosurgery Unit at the BLK-Max Super Speciality Hospital is a specialised unit that offers high-end surgical treatment for a variety of movement disorders, neuropsychiatric disorders, and intractable pain. Our aim is to provide each patient under our care with an individualised, cutting–edge treatment plan, which is a unique combination of compassion and world-class technical therapy.
Our team of neurosurgeons follows a multidisciplinary approach in order to meet the unmet needs of each patient while providing state-of-the-art surgical treatment facilities and comprehensive care. We help each patient under our care to restore the normal functioning of different body parts by eliminating neurological symptoms and pain to a great extent, thereby enhancing their quality of life. BLK-MAX is the leading hospital of neurosurgery in Delhi.
Functional neurosurgery is a branch of neurosurgery that involves the treatment of neurological conditions and the restoration of functions. It is the surgical alleviation of a wide range of chronic neurological symptom disorders associated with movement disorders and neuropathic pain syndromes.
Functional Neurological Symptom Disorder also known as conversion disorder arises due to a complex condition where a patient experiences physical neurological symptoms. However, these symptoms come with no underlying physical cause and are often associated with a psychological or emotional crisis.
Functional neurosurgery is performed in brain and spinal cord
Invasive Surgical Procedure
Brain and spinal cord
The major indicators that highlight the need for functional neurosurgery involve the conditions in which the patient experiences some of these indicators simultaneously:
Deafness or hearing difficulties
Difficulty swallowing
Difficulty concentrating
Memory problems
Fatigue
Numbness
Loss of balance
Impaired movement
Lack of responsiveness
Loss of the senses, such as smell or touch
Pain in the muscles, skin, or joints
Seizures
Tingling sensations in the skin
Tremors
Twitches
Vision problems
Weakness
Speech problems
Paralysis
Some of the major conditions we treat under Functional Neurosurgery treatment include:
Additional movement disorder Pain
Spinal cord
Nerve Root Pain (Phantom Limb)
Herpetic neuralgia
Cancer pain
Spasticity
A doctor will evaluate the patient for the current medical condition with the help of diagnostic test results and will customise a treatment plan accordingly. However, the chance of a patient undergoing functional neurosurgery increases if a patient:
Experiences more than one symptom that is outside of his conscious control and affects his movement or senses
Is not able to know whether the physical or neurological condition they are suffering from is due to the use of any medication or some other reason
If they suffer from symptoms due to a traumatic or stressful event
However, treatments are beneficial for those with:
Recurrent symptoms
Severe FND symptoms
Other (co-occurring) psychological conditions
Symptoms that are slow to resolve
Some of the diagnostic tests that your doctor might ask you to take for evaluation of your current medical conditions involve:
MRI
Positron emission tomography (PET) or PET-CT scan
Electroencephalography (EEG)
Functional tests (to check for balance issues, normal reflexes, and physical movements)
In the context of functional neurosurgery, the procedure used is based on the use of electrical stimulation in order to correct the function of neural tissue – nerve tissue. The treatment includes areas of the brain, spinal cord and peripheral nerves.
During The Procedure:- The surgeons use an implantable pulse generator, which has a thin insulated wire with four micro-electrodes attached to its tip. The team of highly experienced surgeons implant these micro-electrodes in the area of the brain, spinal cord or occipital nerve and position it with sub-millimetre accuracy using state-of-the-art surgical navigation technology.
Functional neurosurgery is used to treat various conditions of the Central Nervous System such as epilepsy, movement disorders and trigeminal neuralgia. The technique used depends on the condition-
Laser ablation surgery: It is a minimally invasive surgery, unlike craniotomies which require the removal of part of the skull.
Vagus nerve stimulation: It is an outpatient surgery in which mild electrical energy is sent to a nerve in the neck.
Neuropace RNS: It is brain-responsive stimulation in which the electrical activity of a patient's brain is monitored to prevent seizure before it happens.
Deep vein stimulation (DBS): is a type of functional neurosurgery that is used to manage movement disorders such as epilepsy, dystonia and Parkinson’s disease.
Microvascular Decompression: It is a surgery in which a blood vessel that impinges the trigeminal nerve is removed.
Percutaneous rhizotomy: In this procedure, a small needle is used to damage the trigeminal nerve so that the sensation of pain is not conducted to the brain.
Stereotactic radiosurgery (SRS): It is a technique in which radiations are passed to damage the nerve root so that pain conduction stops.
After The Procedure: After recovery, the affected area is stimulated with the help of a surgically implanted stimulator, resembling a heart pacemaker. This is implanted under the skin of the chest. It is used to deliver small pulses of electricity to the target area. The adjustment of the stimulation parameters of the implant are done across a wide range, which helps in relieving symptoms. This implanted system helps in changing the functioning of the brain (the ultimate neural structure), the spinal cord, cranial nerves, and the peripheral nerves.
Some of the common procedures performed using Functional Neurosurgery are:
Deep Brain Stimulation: In this technique, a doctor uses electricity to change the function of the brain.
Spinal Cord Stimulation: In this technique, a doctor uses electricity to alter the function of the spinal cord.
Occipital Nerve Stimulation: In this technique, a doctor uses electricity to change the functioning of the occipital nerve.
Some of the risk factors associated with Functional Neurosurgery include:
Short-term adverse effects of stimulation:
Anxiety and nausea
Difficulty talking
Eyelids closing
Visual flashes
Jerky movements
Limb or face contractions
Numbness or tingling in limbs or face
These risk factors are very mild and usually reversible with adjustments in stimulation or with the help of some medication.
Short term confusion
Blood clot
Infection of the leads
Stroke or other neurological deficit
A weakening of the voice
Seizures
However, if the patient experiences these symptoms for a longer duration then he must see a doctor
Dr. Anil Kumar Kansal
Neuro Surgery & Neuro Spine
Dr. Rohit Bansil
Neuro Surgery & Neuro Spine
Dr. Kaviraj Kaushik
Neuro Surgery & Neuro Spine
Dr. Siddharth Mittal
Neuro Surgery & Neuro Spine
Dr. Bhavuk Kapoor
Neuro Surgery & Neuro Spine
Dr. Abhishek Katyal
Neuro Surgery & Neuro Spine