Parkinson’s disease and Ghana’s untold medical feat

By George Sydney Abugri

The perplexing medical condition known as Parkinson’s disease, has come to fairly wide public attention in Ghana in recent weeks for three reasons: First, Africawatch magazine alleged that former President Jerry John Rawlings had been diagnoses with the disease. The rumour died in its infancy when the former president staunchly denied the report and threatened to sue the magazine over the publication.

Next, came the revelation around the same time, that boxing legend Mohammed Ali who has been an idol of most Ghanaians for decades, had suffered from Parkinson’s disease for 30 agonizing years.

Then this week, an organization called the “Parkinson’s Disease Support Group”, which draws its membership from people suffering from the disease, doctors, pharmacists, physiotherapists, speech therapists, nutritionists and other health professionals, was launched in Ghana.

At the launch in Accra, the group explained that it intends to create public awareness of Parkinson’s disease and educate people suffering from the condition and their caregivers on the nature, progression and management of the disease.

What many outside medical circles in Ghana may not know, is that Ghana made medical history and recorded a major breakthrough in brain surgery in November 2007, when a team of brain surgeons at the Tema International Neuro-Center successfully performed a seven-hour operation to treat a patient suffering from Parkinson's disease.

For the first time in sub-Saharan Africa, a patient with Parkinson's disease had a brain pacemaker placed within the sensitive structure of his brain, in order to stop the disabling, abnormal movements associated with the disease. The procedure is called Deep Brain Stimulation (DBS).

The head of the surgical team, Ghanaian neurosurgeon, Dr. Nii Bonney Andrews led colleague surgeons, Dr. Van den Mencken and Dr. Rick Shuurman, both of the Academic Medical Centre in Amsterdam and Dr Philip Batiade of Germany to successfully perform a marathon surgical operation to treat the patient.

They were assisted by neurosurgical theatre technologist, Grace Fiagbe, radiology technologists, Theodore Ntiri and Thomas Kweku Aperko, Dr L. John, a specialist in deep brain surgery anaesthesia and Steve Bati a nurse anaesthetist of the Narh-Bita Hospital.

The 63-year old patient had been suffering from Parkinson's disease for 20 years and had not been able to walk steadily. He fell frequently and had multiple shoulder dislocations as a result. He also shook uncontrollably and had great difficulty rising from a chair. The epoch-making medical drama began that memorable morning in the Scan Suite of the Medlab Building located at Roman Ridge in Accra at 8 o’clock in the morning:

The surgeons first placed a specialized metal frame called a “Leksell frame” round the patient's head. A special scan of the patient's head was next performed in order to obtain a detailed map of his brain, to pin point the exact location of the brain abnormality, where an electrode/wire was to be placed. With the metal frame still attached to the patient's head, the patient was transported by ambulance to the Narh-Bita Hospital in Tema. The main surgical operation began at 9 am and lasted seven hours.

Parkinson's disease is a disorder of the nervous system characterised by violent trembling of the hands, arms, legs, jaw, and face as well as stiffness of the limbs and trunk. Victims of Parkinson's disease have great difficulty walking and only manage to shuffle along.

Other symptoms of the disease include difficulty in swallowing, chewing, speaking; urinary problems, constipation, skin problems, and sleep disruptions.?

Dr Andrews said, Parkinson's disease patients also had great difficulty getting up, after sitting for a while. “They literally get stuck in chairs after sitting for some time”, he said.

The list of world famous sportsmen, politicians, clergymen, actors, musicians and heads of state who have suffered from Parkinson’s disease is a very long one.

The 63-year old Parkinson’s disease patient who underwent deep brain surgery made significant progress within hours of the operation.

The patient was able to walk better, his tremors decreased considerably and 48 hours after the surgery, he was able to sit for more than an hour, playing an exciting game of chess which is his favourite pastime.

There are currently no blood or laboratory tests that have been proven to help in diagnosing the Parkinson's disease, which tends to afflict people in their 50s and older.

Dr Andrews said a diagnosis of the disease is mainly based on the medical history and a neurological examination of persons suspected to be suffering from early stages of the disease.?

He said Deep Brain Stimulation (DBS) was performed for the first time ever in 1994, in Grenoble, France. 'Since then, numerous clinical reports from all over the world have confirmed major improvements for all Parkinson's disease symptoms in patients who have undergone DBS surgery”, the Ghanaian surgeon said.

He described DBS as “a very complex and delicate operation requiring highly specialised skills and technology” and said its successful performance in Ghana “is a fine example of Ghanaian expertise linking up with international know-how, to improve medical outcomes in patients and expand medical knowledge.”

“There was an air of great excitement among the surgeons, as the first electrode was passed deep into the brain of the patient.” Dr Andrews reported. He said this was because for the first time in surgical intervention in Ghana, “the electrical charge from living and functioning cells deep within the human brain, could be heard by surgeons as specific rhythmic sounds!”

The work of Tema International NeuroCenter at the Narh-Bita Hospital is funded by the medical NGO NeuroGHANA. Dr Andrews revealed that since its inception in 1996, the medical NGO has promoted and pioneered the use of modern techniques in brain surgery, key-hole video surgery, as well as Gamma Knife (GK) or “incisionless” surgery in Ghana.

NeuroGHANA which is an indigenous NGO, dependent on its own resources for its activities, is willing to link up with medical professionals and institutions dedicated to helping people fight serious diseases such as brain tumours, strokes, neck pain, back pain and paralysis.

Following the successful DBS surgical operation Dr Andrews said, a special center was being set up to manage Parkinson's disease in Ghana.

The brain surgeon told me that many patients suffering from Parkinson's disease confuse their condition with stroke: “When we administer drugs to Parkinson's disease patients at the Neuro-Centre and their condition improves, they spread the news that there is a doctor at the Narh-Bita Hospital who cures stroke.”

The brain surgeon attributed the success of the Neuro-Centre to the support it received from the Narh-Bita Hospital administration. He said Dr Edward Narh, the Medical Director of the hospital, had been outlining productive medical service concepts and inviting suitable partners to develop them for an expansion in the range of specialised medical services at one of Ghana’s leading private medical facilities.

“Dr Narh does not interfere in the work of specialists working at the hospital. He allows them to employ their creativity and skills to achieve results. That accounts for the numerous medical service innovations and successes chalked by the hospital”, the brain surgeon told me at the time.

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