When and where was the deep brain stimulation surgery started in Pakistan?
It was pioneered by Professor Dr. Khalid Mahmood at Lahore General Hospital on 30th November 2014. In one year, we have done 20 patients with results comparable to international standards.
Is there any other centre doing deep brain stimulation surgery inPakistan?
Presently LGH neurosurgery unit II is the only centre doing DBS, thalamotomy and pallidotomy in Pakistan.
When should one consider surgical therapy for Parkinson’s disease?
Drugs are effective for treatment of Parkinson’s disease but the beneficial effect starts diminishing with time and patients develop more side effects (dyskinesias etc). Deep brain stimulation is very good option when the patients starts getting side effects from drugs. Also with time the medicines lose their efficacy (off state), it is when DBS should be considered.
Is there any age limit for surgery?
We do not offer the surgery to patients above age 75.
For what diseases Lahore General Hospital is offering deep brain surgery?
At present, we are offering it for:
Parkinson’s disease
Essential tremors
We are working to start it soon for depression.
Where the surgery will be done?
It will be done at the department of neurosurgery unit-II Lahore General Hospital by Prof. Dr. Khalid Mahmood.
Is there any other neuro surgeon doing deep brain stimulation surgery at Lahore General Hospital?
Is DBS operation done in a single stage or multi stages?
Unlike USA we follow the european trend and operate on the same day as single stage procedure.
What is operation time? and what kind of Anesthesia is used?
On average it takes 6 hours to complete the whole procedure out of which only 1 hour is under general anaesthesia and rest of operation is done in local anaesthesia while patient is awake but pain free.
What is the cost of surgery at Lahore General Hospital?
It is 20,000 us Dollars (approx. 20 lac PKR) which includes surgery, operation theatre, anesthesia and private room for one week.
Is there any package for poor patients?
Yes we have done some patients through zakat, bait-ul-maal and government of Punjab’s aid.
What sort of improvement should I expect after surgery?
Generally there is around 70 percent improvement in patient’s symptoms of PD.
Do I need to take anti-parkinson medicines after surgery?
Yes but there is around 50 percent reduction in medicine.
What are different types of surgeries available for movement disorders at LGH?
We offer;
STN lesioning
What kind of surgery suits me?
For PD, for affording patients deep brain stimulation is the idealsurgery to date.For non-affording patients, if indicated thalamotomy and pallidotomy is offered free of cost for general ward patients. Private patients are charged one lac for these procedures.
Is there any difference between deep brain stimulation surgery done abroad and in Pakistan?
No. We have foreign qualified and foreign trained accredited team doing DBS with all the ideal equipment and resources. That is why our complication rate is comparable to west. We use Medtronics DBS implant made in USA.
There are different types of deep brain stimulation implants available, what kind of implant you use?
We are Medtronics USA designated centre at LGH. Till date Medtronics DBS implants have been used in 150000 patients around the world.
We do not use any Chinese or non-Medtronic implant.
What are the risks of deep brain stimulation surgery?
The risk of DBS surgery is 2 % which includes stroke, infection etc.
How long does it take to get the surgery done if I decide it today?
It usually takes three to four weeks. This time is spent in getting patient assessed by team of neurologists, psychiatrist and neurosurgeon. Patient undergoes brain imaging and all the necessary tests required prior to surgery.
What is the real benefit of getting deep brain stimulation surgery at LGH Pakistan?
It is the cheapest in the world and after the surgery, patients do not have to travel abroad for programming and assessment which is needed time to time.
How long does it take before the full benefit of deep brain stimulation is apparent?
The tremors and rigidity improve/disappear on table during surgery. However in some patients the full effect of deep brain stimulation usually appears after 3 to 4 months.
Prof. Dr. Khalid Mahmood
Intercollegiate Board in Neurosurgery (UK)
Fellowship Neurosurgery The Ohio State University (USA)
Dr. Talha Abbas
MD FCPS Neurosurgery
Assistant Professor Neurosurgery
Professor Dr. Muhammad Naeem Kasuri
Former Professor of Neurology, King Edward Medical University/Mayo Hospital Lahore.
Professor Dr. Athar Javed
Chairman Neurology Department, King Edward Medical University/Mayo Hospital Lahore.
Assistant Professor Dr. Shahid Mukhtar
FCPS Neurology
Head of Department of Neurology, Lahore General Hospital, Lahore.
Professor Dr. Aftab Asif
Chairman, Department of Psychiatary and Behavioural Sciences, King Edward Medical University/Mayo Hospital Lahore.
Professor Dr. Altaf Qadir
FCSP Psychiatry
Head of Psychiatry Department, Lahore General Hospital, Lahore.
Ms. Um-e-Farwa
Neurophysiologist, Department of Neurology
  Lahore General Hospital, Lahore
Hafiz Syed Ijaz Ahmed Burq
Physiotherapist, Department of Physiotherapy
  Lahore General Hospital, Lahore


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Special Thanks
Dr. Shahid Mukhtar
(Head of Department of Neurology, Lahore General Hospital, Lahore)
DR. Talha Abbas, MD
(Assistant Professor Neurosurgery, Lahore General Hospital, Lahore)
© Copyright 2015-2016 Prof Dr Khalid Mahmood