World-class neuro care.
By a team revered around the world.
Our Neurosciences Centre offers highly advanced diagnosis and treatment for disorders of the nervous system.
The centre is officiated by a team of distinguished and dedicated Neurosurgeons, Neurologists, Neuro-anesthetists, Neuro Imaging specialist Neuro-oncologists and Neuro-interventionists (supported by a team of highly skilled nurses and paramedics) who carry international credentials and lend their vast experience in the treatment of complex neurological diseases to ensure that you receive the finest care available.
Our consistent achievement of desired clinical outcomes is made possible by our world-class facilities, cutting edge technology, the latest surgical techniques and a variety of surgical and non-surgical approaches designed to restore the patient's health along with help of personalised care by our team of dedicated rehabilitation specialists.
Our precedence lies in a senior faculty with vast collective clinical, academic & research experience, who are committed to an unwavering focus on compassionate and quality patient care delivered with a human touch.
Over the years, patients from India as well as the Middle East, Europe, GCC and other SAARC nations (Afghanistan, Bangladesh, Maldives, Sri Lanka etc.) have shown great belief in the expertise of our illustrious Neuro Team and have become our ambassadors in their respective countries
Facilities
Well equipped with the latest medical equipment, modern technology & infrastructure, Aster Hospital is one of the best hospitals in India.
Flat panel bi-plane vascular hybrid cathlab
Fourth generation Time of Flight 16 Slide PET CT
True Beam Linear Accelerator for high-precision radiotherapy
Low radiation CLARITY cath lab
256 slice Philips iCT scanner
3 Tesla Wide Bore Digital MRI
GE SPECT-CT OPTIMA NM 640 Gamma Camera EPIQ
Image fusion for guided biopsies
OR 1 Karlstroz fusion integrated, Green OT certified Operation Theatres with autopilot anaesthesia
Stealth Station Navigation
C- Arm for surgical imaging
Dedicated ICCA (IntelliSpace Critical Care and Anaesthesia) Neuro ICUs
Level 3 Paediatric ICU
A single-photon emission computerized tomography (SPECT) scan lets your doctor analyze the function of some of your internal organs. A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures.
Positron emission tomography (PET) scans detect early signs of cancer, heart disease and brain disorders. An injectable radioactive tracer detects diseased cells. A combination PET-CT scan produces 3D images for a more accurate diagnosis.
MRI protocol for epilepsy is a group of MRI sequences put together to improve sensitivity and specificity in identifying possible structural abnormalities that underlie seizure disorders.
This is a procedure used intraoperatively to confirm the location and extent of epileptic tissue by recording electrical activity directly from the surface of the cerebral cortex.
Invasive EEG recordings are those recordings that are made with electrodes that have been surgically implanted on the surface or within the depth of the brain.
A video EEG records what is happening when you have a seizure or event and compare the picture to what the EEG records at the same time.
An EEG records the electrical activity of your brain via electrodes affixed to your scalp. EEG results show changes in brain activity that may be useful in diagnosing brain conditions, especially epilepsy and other seizure disorders.
- Deep Brain Stimulation (DBS) surgery: For Parkinson’s Disease, Essential Tremor, Dystonia ( primary and selected secondary dystonias), intractable Tourettes Syndrome)
- Focused ultrasound therapy: for Essential Tremor (if FUS is set up in COE Neurosciences under brain tumour centre)
Evaluation and treatment of acute and chronic movement disorders
We trained in nervous system conditions , brain and nervous system surgery, and other areas work together to determine the most appropriate treatment for your condition.
We run a number of Specialty Clinics at Aster Medcity. Each clinic runs on a particular day of the week and offers a gamut of services to the needy patients. Our services include, but not limited to:
- Clinical evaluation ,diagnosis and medical treatment of Adult and pediatric Movement Disorders
- Selection of cases of Movement Disorders for DBS treatment
- Selection for Apomorphine pump treatment for advanced Parkinson’s disease (OP assessement of eligibility and IP for initial titration). Indicated for those who opt for non surgical treatment or in whom surgery is contraindicated
- Cognitive and Neuropsychological evaluation
- Neuropsychiatric assessment
- Physiatry assessment and physiotherapy
- Autonomic function tests
- Sleep studies
- TRODAC studies, MRI through Radiology and nuclear medicine dept
- Speech, swallowing and gait rehabilitation
- Pain and palliation in advanced movement disorders
- Selection of patients for clinical trial and research
- Movement Disorder Clinic
- Deep Brain Stimulation (DBS) Programming Clinic
- Botulinum Toxin Clinic
- Pediatric Movement Disorder Clinic
- Memory Clinic
24/7 neuro trauma & critical care
Dedicated Neuro ICUs
Carotid ultrasound and transcranial doppler
Diagnostic cerebral angiography
Thrombolysis and mechanical thrombectomy for stroke
Angioplasty and stent for stroke management
Inpatient electrophysiological procedures including: Long-term video EEG Invasive intracranial monitoring Sleep lab Nerve conduction and evoked potential studies (somatosensory, motor, visual & auditory) Intraoperative electrophysiology
Consultation
Outpatient electrophysiological diagnosis including: Nerve conduction studies Somatosensory, visual and auditory evoked potential studies EEG, Video EEG Carotid ultrasound and transcranial doppler
Speciality clinics for neurological problems
ORI Fusion Digital Integrated Operation Theatres With 22 Operating Rooms that are on par with some of the largest in the world, Aster Medcity, for the first time South India, introduces ORI Fusion Digital Integrated Operation Theatres using Karlstorz OR1 Fusion - Asia Pacific’s first complete digital integration system.
The integration enables real-time sharing of images, videos and medical reports, which not only facilitates virtual participation from any location in the world, but also helps the rest of the surgical team to monitor the patient closely during the operative procedure, much to the benefit and safety of the patient undergoing the surgery.
Aster Medcity is also the first surgical facility in the state to offer Robotic Surgery using high-precision da Vinci Surgery Robot.
An electroencephalogram (EEG) is a test used to find problems related to electrical activity of the brain.
An EEG tracks and records brain wave patterns. Small metal discs with thin wires (electrodes) are placed on the scalp, and then send signals to a computer to record the results. Normal electrical activity in the brain makes a recognizable pattern. Through an EEG, doctors can look for abnormal patterns that indicate seizures and other problems.
Physical therapy
Occupational therapy and rehabilitation for patients with neurological/ physical disabilities
Speech therapy for patients with language disabilities
Immunohistochemistry
Molecular diagnosis and genetic mutation analysis
Neuropsychology is the systematic evaluation of higher cognitive abilities including intelligence, memory, academic skills, cognitive and language, attention span, sensory motor, problem solving abilities, executive abilities, visual motor skills and personality/emotional functioning. The Neuropsychology Clinic at the Aster Centre of Excellence in Neurosciences offers:
Cognitive evaluation/ rehabilitation/ remediation in patients with neurological conditions like epilepsy, stroke, Alzheimer’s disease, Parkinson’s disease and tumours
Study of functional aspect of brain through pre & post-operative evaluation
Study of decline of cognitive skills in the elderly
Evaluation of changes in thinking/ behavior pattern with people with serious illnesses
Evaluation/ management of behavioural problems
Counselling/ management of depression and anxiety
Counselling and management of depression and anxiety
Family counselling
Brain perfusion imaging
Ictal SPECT imaging
Technetium TRODAT imaging
I - 131 MIBG therapy for malignant neuroendocrine tumours
This comprehensive rehabilitation regimen can help the patient to maximise and regain normal muscle movement and function after a stroke or for neurological conditions such as:
Parkinson’s disease
Multiple sclerosis
Spinal cord injury
Head injury
Balance dysfunction
Bell’s palsy
Routine 32 channel digital video EEG
Round-the-clock, long-term 128 channel video EEG monitoring
Functional MRI and WADA study to assess eloquent cortex regions.
3T MRI and an exclusive intraoperative MRI
PET (positron emission tomography)
SPECT (single-photon emission computerized tomography)
ECOG (ElectroCorticography)
Cortical Mapping
SSEP (Somatosensory Evoked Potential)
MEP (Motor Evoked Potential)
Different surgeries available:
Respective Surgery
Lesionectomy
Amygdalohippocampectomy
Corticectomy
Lobectomy (e.g. temporal lobectomy)
Multilobar resection
Disconnective/Palliative Surgery:
Hemispherectomy
Corpus Callosotomy
Multiple Subpial Transections
Conditions treated:
Mesial temporal sclerosis
Focal cortical dysplasia
Lesions like ganglioglioma, DNET
Hemimegalencephaly
Rasmussen’s Encephalitis
The Neuro ICU at the department combines the service of ICU staff with advanced critical care training together with technological expertise. It facilitates round-the-clock close monitoring and personalised care for the patients.
Continuous assessment of Intracranial Pressure is necessary to evaluate the efficacy of therapeutic measures and for evaluating the evolution of brain injury. This is being carried out using ICP monitoring system, ensuring an optimal level of Cerebral Perfusion Pressure.
Neuronavigation systems facilitate image-guided neurosurgery ensuring accurate resection of brain tumours or biopsies of brain lesions and detailed brain surgery. Basic principles of navigated surgery are to see the tip of a pointer in an image space.
Outpatient (6 days in a week), Inpatient, follow-up clinic
24 hours emergency services
Neurocritical care
Comprehensive Neuro rehabilitation services
Cerebral angiography
Electroencephalogram (EEG)
Nerve conduction studies (NCS)
Electromyography (EMG)
Evoked potential (VDP, SSEP, BERA)
Nerve and muscle biopsies
Polysomnography
Video EEG monitoring
Imaging tests:
- CT
- MRI
CT cisternography
Cerebral arteriogram
Neurosonography
Myelogram
Electromyography
Intracranial pressure monitoring
Electroencephalography
Electromyography
Transcranial doppler
Faqs
Want to find out more about the treatment? The answer to your questions can be found below.
When should you see a neurologist?
If the patient has
Headache
Vomiting
Tingling
Numbness
Burning or pricking sensation or loss of sensation
Weakness of limbs
Facial deviation
Speech and swallowing disturbances
Memory disturbances
Sleep disturbances
Seizures
Abnormal movements
Back and neck pain, etc.
What does a neurologist check for?
Diagnosis and treatment of neurological diseases by complete neurological examination and investigations.
Is Neurological disorder curable?
Most of the neurological disorders are curable.
What is epilepsy?
Patients having two or more seizures or a tendency to have recurrent seizures, are termed to be having epilepsy.
What are the major types of seizures?
Sometimes it is difficult to determine when a person is having a seizure. A person with a seizure may look confused or as if they are staring at something that is not there. Other seizures can cause a person to fall, shake, and become unaware of what’s going on around them.
Seizures are classified into two groups.
Generalized seizures affect both sides of the brain.
Focal seizures affect just one area of the brain. These seizures are also called partial seizures.
What causes epilepsy?
Epilepsy can be caused due to various conditions that affect a person’s brain. Some known causes include:
Stroke
Brain tumor
Traumatic brain injury or head injury
The cause of epilepsy is unknown for 2 in 3 people. This kind of epilepsy is termed as cryptogenic or idiopathic.
Developmental anomalies of the brain
Hereditary causes
Loss of oxygen to your brain. Example: Birth time
What is pre-surgical evaluation for epilepsy surgery?
The pre-surgical evaluation consists of various domains. Most important is video EEG followed by investigations like MRI, PET scan, SPECT scan. This MRI scan performed here is not the regular MRI but a customized scan which will depend on recordings of your video EEG. A neuropsychological assessment is also a vital part of presurgical evaluation which gives important insight into the localization and potential problems you will be having after surgery. Once all these investigations are ready, it is generally discussed in meetings to reach a consensus about the plan.
What is SUDOSCAN?
SUDOSCAN is an approved device used to test the sudomotor function and test for Small fiber neuropathies. The test is non-invasive, accurate and fast. No patient preparation or fasting is needed and outcome of the test is available within 3 minutes.
Who should get tested with a SUDOSCAN?
A SUDOSCAN test is very useful if you have burning feet, an undiagnosed neuropathy or for periodic assessment of patients with a known neuropathy. It is effective in identifying autonomic neuropathy caused by diabetes and other diseases.
What is a stroke?
Stroke is sudden onset weakness in one half of the body due to the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
What is Seizure?
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behaviour, movements, or feelings, and in levels of consciousness.
Is There a Cure for Parkinson's Disease?
There is currently no cure for Parkinson's disease, but treatments are available to help relieve the symptoms and maintain your quality of life.
Why choose Aster MIMS for Neurosurgery?
Aster MIMS offers highly qualified and dedicated neurosurgeons. Our facility put forward advanced guidance and the latest technology, as well as a warm, family-like atmosphere, we are well known for the quality of care we provide.
Aster Mims neurosurgeon Dr. Jacob P. Alappat is nationally recognised as well. Our certified doctors and nurses monitor the progress of our patients round the clock.
What is the current scene in the country for Epilepsy in terms of patients and advances in treatment?
At the global level, it is estimated that nearly 70 million people suffer from epilepsy and the prevalence of epilepsy across the globe is estimated to be 5-9 per 1,000 population. There are 12 million people with epilepsy in India, contributing to 1/6th of global burden.
In majority of the people with epilepsy ie 70-80%, the seizures can be well-controlled by giving anti-epileptic drugs. The rest 20-30% have medically refractory epilepsy, in these patients advanced modalities of treatment such as dietary therapy, epilepsy surgery and neuromodulation are the emerging therapeutic options.
Are there any new clinical trials going on for epilepsy?
There are several medical and surgical trials going on for epilepsy treatment in the Western countries. Few of them are enlisted here:
- XEN1101 As Adjunctive Therapy In Focal-Onset Epilepsy
- Stereotactic Laser Ablation For Temporal Lobe Epilepsy
- Perampanel Study For Infants With Epilepsy
- Cannabidiol As An Add-On Therapy In Tuberous Sclerosis Complex
- Focused Ultrasound For Treatment Of Epilepsy
What Constitutes A Healthy Back?
Our spine is nature’s extraordinary miracle. Several complex structures come together to provide the human body with a fine balance of protection, support, strength and movement. A healthy spine is not just the bony segments but a combination of several ‘supporting structures’ - protective discs, strong muscles and attached ligaments and tendons. The 24 bony segments or vertebral bodies or vertebrae in the spine are interspersed with a tough, yet soft gel-like cushion or shock-absorber, called intervertebral disc. The muscles surrounding the spine or ‘para-spinal muscles’ are attached to the bones through ligaments. Together these structures, called the ‘natural tension band’ provide mobility, strength and protection to the back. The core of our spine’s movement, structure and flexibility comes from complex biomechanics of the bony vertebrae and supporting structures. Often compared to a ‘crane’, it is said that for the spine to be stable, all elements must be intact and function in unison.
What is minimally invasive spine surgery (MISS) or keyhole spine surgery?
Minimally invasive spine surgery is a highly advanced spine surgery technique using very small incisions, using cutting-edge intra-operative technology.
Can elderly patients or very obese patients undergo spine surgery?
The advantages of minimally invasive spine surgery enable us to safely perform spine surgery in elderly patients with multiple medical problems and also obese /overweight patients, with the best possible medical outcomes.
What is Endoscopic Spine Surgery?
Endoscopic Spine Surgery is a minimally invasive spine surgery procedure that helps to relieve pain caused by herniated discs pressing on nerve roots.
What is Awake spine surgery?
These are surgeries done under local or regional anaesthesia without using general anaesthesia. Certain Minimally invasive spine surgery can be done in this manner.
What is scoliosis?
Scoliosis is a condition wherein a person’s spine or back is curved like an “S” or “C”
Scoliosis can be a by birth, acquired or age-related condition
Early detection and correction (in the adolescent age itself) is the key to effective treatment of scoliosis
Severe or visible scoliosis, if left untreated, can lead to complications including disfigurement, pain, breathing difficulties or nerve damage
Who can undergo scoliosis / spinal deformity surgery?
Children, adolescents with scoliosis
Patients with kyphosis (hunchback / forward curving of the spine)
Adults and elderly patients with spinal deformities
How long does it take to recover from scoliosis surgery?
If the recovery is as expected, the patient can be discharged within a week
Children can get back to school about a month after the surgery
What conditions do neurologists treat?
Stroke, seizures, headache, backache, neck, pain in any part of the body, Parkinson's disease, Alzheimer's disease, dementia, movement disorders, neuromuscular diseases, sleep disorders, neuropathy, myopathy, etc.
What is a common neurological disorder?
Most common neurological disorders are migraine, stroke, epilepsy, backache.
What is a seizure?
A Seizure is a condition in which sudden, uncontrolled electrical irregularity occurs in our brain. It may cause changes in behavior, movements or feelings, and levels of consciousness.
How long do seizures usually last?
Usually, a seizure may last from a few seconds to a few minutes, based on the type of seizure.
If I have a seizure, then does it mean that I have epilepsy?
Not always. Seizures can also happen because of other medical problems. These problems include:
A high fever.
Alcohol or drug withdrawal.
Low blood sugar.
What are the steps for epilepsy surgery?
Once you are being considered for epilepsy surgery, you will have to undergo three major steps
Pre-surgical evaluation
consensus decision and
finally surgery
In pre-surgical evaluation, we decide the specific portions of your brain which are responsible for this epilepsy with different tests, clinical evaluations, etc. And a team of doctor specialists from various related fields meet together to discuss and reach a consensus about the type of surgery you will need. A final plan is decided in the multidisciplinary meeting.
Why test sudomotor function?
A sudomotor function test is a quick and reliable way of identifying certain types of neuropathies. The presently available tests detect only 50-60% of neuropathies. This test helps the clinician to identify small fiber neuropathies and improve diagnostic accuracy.
What information does SUDOSCAN provide?
SUDOSCAN gives you the information about the small fiber nerve functions. In a SUDOSCAN test, electrical conductance of the hands and feet are measured. Test results with high conductance means normal sweat function whereas low conductance indicates peripheral or autonomic neuropathy.
When to consult a Neurologist?
Neurologist opinion is required when the patient has signs and symptoms of disorders related to the brain, spinal cord, peripheral nerves, and muscles<
How to identify stroke?
Unexpected numbness or weakness in the face, arm, or leg, especially on one side of the body. sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden in trouble walking, dizziness, loss of balance, or lack of coordination.
What is Epilepsy?
Epilepsy is defined as having two or more unprovoked seizures.
What is the average age for dementia to begin?
The risk rises as age increases, especially after age 65. However, dementia is not a normal part of ageing, and dementia can occur in younger people. Family history. Having a family history of dementia puts you at greater risk of developing the condition.
How important is Epilepsy from a neurology department perspective?
Epilepsy, the fourth most common neurological disorder, affects people of all ages and can cause unpredictable seizures.
Could you specify the new drugs and therapy options accessible in the country?
The pharmacological armamentarium against epilepsy has expanded considerably over the last three decades, and currently includes over 30 different antiseizure medications. The new medications which have been added over the past decade by the FDA include Brivaracetam (Levetiracetam derivative), Perampanel (AMPA antagonist), Cenobamate (Carbamate derivative), Everolimus (Rapamycin derivative), Fenfluramine (Amphetamine derivative) and Cannabidiol (Cannabinoid). Among these Brivaracetam and Perampanel are available in India.
How easy is it to get the right qualified medical expertise and the related support staff to treat and manage the patients?
The treatment gap in epilepsy in India ranges from 22% in the urban setting to as high as 90% in villages. The treatment gap has 2 components- People unable to access healthcare services and People who do not adhere to appropriate medical therapy.
One million Indians have medically refractory seizures. Approximately 5 -6 lakh people are candidates for epilepsy surgery in India. Still... Just about 500-600 epilepsy surgeries per year are performed.
What Can I Do To Maintain My Spinal Health?
A healthy back is a combination of healthy bones, mobile joints, and strong muscles. Unfortunately, a complex system like our back or spine is prone to issues arising from one or more malfunctioning elements. Any disturbance to the spine and it’s supporting structures due to aging, trauma, lifestyle stresses or other pathologies can lead to spinal complications, most commonly appearing as back or neck pain. Maintaining a healthy spine is almost non-negotiable to ensure a healthy, pain-free and active life. Simple activities such as maintaining healthy posture, regular exercise, good nutrition and regular exposure to the sun, go a long way in maintaining a healthy spine.
What are the advantages of minimally invasive spine surgery over open surgery?
Very small surgical incisions and scars (approximately 18mm)
Minimal muscle damage
Minimal blood loss
Lesser pain, which reduces the need for pain killers
Fewer post-surgical complications
Minimal hospital stay
Quicker recovery
Faster return to normal life
Lower incidence of surgery related back pain
What is spinal stenosis decompression
The narrowing of the spaces within the spine is known as spinal stenosis. The minimally invasive spine surgery procedure helps decompress the nerves in the narrow spaces between the vertebral bones and spinal joints.
What is the purpose of Lumbar fusion?
Lumbar fusion is done to correct issues with the vertebrae such as painful motion and stability of the spine.
What are the advantages of awake spine surgery?
Many patients with multiple risk factors (cardiac/liver/kidney disorders) or those who are elderly may not be good candidates for general anesthesia. Awake spine surgery can be performed in such patients. Another advantage would be shorter recovery times and same day discharge from hospital
What is scoliosis spine surgery?
Scoliosis spine surgery is a specialised surgery for correction of spine deformity
Are spinal deformity surgeries safe?
Yes, these surgeries are safe. The centre for spine care at Aster Medcity has the latest medical technology for ensuring maximum patient safety and are performed with the help of intra-operative nerve monitoring for unmatched accuracy.
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