Relief at fingertips: UK man suffering from occipital neuralgia gets unique pacemaker-of-sorts fitted
Picture this: The moment you experience a debilitating headache, you toggle controls on a remote hand-held device, and the shooting pain in your head disappears. Medical science makes this miraculous possibility real, but only for a particular condition — occipital neuralgia — as of now.
UK national George Johnston, 32, recently underwent a brain surgery in Mumbai to get a pacemaker with connections that travel from the right side of his chest to the back of his neck fitted. Johnston, who works as an accountant in a bank, has to spend long hours number-crunching in office. A year ago, he started getting chronic headaches, which were diagnosed as occipital neuralgia, often confused with migraine. While he bore them earlier, now, all he has to do is fit a coin-sized sensor pad, which is connected to the remote control, on to his chest.
“When I feel the pain coming, I hold the sensor pad over my chest and adjust the current, which is calibrated in milliamperes. It passes on from the pacemaker to the back of my neck and controls the headache,” said an excited Johnston. “I used to get continuous headaches when I was younger. They disappeared, but returned a year ago. I decided to get operated in Mumbai as it was expensive and time-consuming to do it in the UK. Moreover, the National Health Services (NHS) in the UK don’t cover the procedure under medical insurance. And even if I were to appeal for its inclusion in NHS, I would have had to wait for six years for a tribunal’s response.”
Johnston got operated under neurosurgeon Dr Paresh Doshi at Jaslok Hospital. In the UK, the surgery would have cost him over Rs22 lakh; here, the cost was Rs11 lakh. A neuro-stimulating pacemaker was tunnelled underneath his skin at the back of his neck. The surgery was minimally invasive and no muscles or nerves were cut. “The brain is made up of large and small fibers. The small fibers are responsible for the sensation of pain. The passing current stimulates the large fibers, which block the small fibers from carrying the sensation,” explained Doshi.
Occipital neuralgia is widespread in India, but, doctors say, many are wary of going under the scalpel and, hence, continue to put up with the headaches.
How it works
Two electric leads were implanted under the skin in the chest and were connected with wires passing from under the neck to the back of the head George Johnston was wide awake and conscious during the surgery, so that he could give real-time feedback about his pain sensation The remote control can conduct a current from 1 milliampere to 10 milliampere to stimulate long fibers of the brain to block the small fibers, which transport the sensation of pain.
The technology is based on an experiment conducted by Ronald Melzack, a Canadian researcher who proposed the gate control theory with Patrick David Wall in 1965. The gate control theory of pain asserts that non-painful input closes the ‘gates’ to painful input, which prevents the pain sensation. It was invented after the scientists self-experimented with the device.