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Dec 25, 2012  |  Vote 0    0

Sunnybrook pioneers scalpel-free surgery for tremor patients

North York Mirror

For the first time in more than a decade, a nervous Tony Lightfoot held a glass of water and took a drink.

“I’m still scared,” he told neurosurgeon Dr. Andres Lozano at Sunnybrook Health Sciences Centre moments before grasping a styrofoam cup in his right hand and successfully guiding it to his lips.

“That is fantastic. I never thought it would be. I never, never thought this would happen to me. It’s marvelous.”

Only four hours earlier, before undergoing a revolutionary and experimental non-invasive procedure pioneered at Sunnybrook to help people with debilitating tremors, Lightfoot wouldn’t even attempt to hold the cup when Lozano suggested he try it.

“Have you got a raincoat?” he asked.

When Lightfoot held out his arms in front of him, they shook dramatically and uncontrollably from tremors the 68-year-old first began suffering about 15 years ago. For more than a decade, the tremors have been severe.

Holding his shaking right hand in his shaking left hand, Lightfoot could only manage to write a small squiggle when asked to produce his signature.

“It’s different every time,” he said, adding it has been years since he has been able to write out a cheque.

He could only make a few haphazard dots on the page when he was asked to write a spiral.

And he hit himself in the face when Lozano, a neurosurgeon at Toronto Western Hospital, asked him to touch his nose.

That was before Lightfoot had a stereotactic frame screwed on to his head and was taken into an adjoining room for an MRI-guided focused ultrasound on Dec. 18.

The scalpel-free surgery allows medical staff to focus ultrasound waves under MRI guidance through a patient’s skull to reach an area deep in the brain and target troublesome cells.

It is significantly safer than cutting open a patient’s skull and reduces the risk of infection.

Patients require no general anesthetic and, in fact, remain awake during the procedure.

Due to the delicate nature of the brain, the treatment can only now be performed on the part of the brain affecting the patient’s dominant arm rather than on both arms.

The procedure is revolutionizing medicine and can have far-reaching implications for treating brain disorders, said Dr. Michael Schwartz, head of neurosurgery at Sunnybrook and the principal investigator of the clinical trial of the therapy.

At the post-assessment after the procedure, Lightfoot said he was thrilled with the results.

In addition to being able to hold a glass of water, he could touch his nose, sign his name and draw spirals.

“I feel great,” he said, adding he was looking forward to not having to wait until his coffee cools to drink it through a straw and to holding a glass of beer.

The debilitating tremors he has suffered for years robbed the Calgary resident of his ability to properly do his job as a mechanical engineer.

“To write again would be a major step forward because, being an engineer, when I lost my ability to write, it was a huge blow,” Lightfoot said.

“It really knocks your self-esteem down.”

The medical team was also pleased to see such an improvement in Lightfoot’s quality of life.

“We hope you will be able to drink and write and use that hand more than before and improve your activities and do certain things you couldn’t before,” Lozano said.

But the fact that the treatment is in its early days brought a hint of worry.

“How long does it last?” Lightfoot asked.

“We don’t know,” Lozano said.

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