Dr.R. Ramnarayan

Expertise

Functional neurosurgery including
1. Deep brain stimulation (DBS) for:

• Movement disorders like Parkinsonism, dystonias, essential tremor
• Some psychiatric problems like depression, OCD, and some other psychiatric illnesses.
• Intractable alcoholism      
• Chronic pain especially the central post stroke pain
• Intractable epilepsy
• Intractable obesity
• some types of autism (aggressive types with self harm).  

2. Intrathecal pumps:           
A). Intrathecal morphine (ITM) pumps are very useful in:

• Cancer pains
• Failed back surgery syndromes
• Other types of noxious pain.          

B)  Intrathecal baclofen (ITB) pumps are good in                     

• All types of spasticity (including cerebral palsy/ multiple sclerosis, traumatic paraplegics etc).
• Patients in persistent vegetative state.
• Cases of spino-cerebellar degeneration     

3). Spinal cord stimulation (SCS) is very useful in:               

• Ischaemic heart disease not controlled with medicines, angioplasty or bypass surgery.
• Intractable heart Failure (Class 3 and 4)
• Patients with failed back surgery syndrome.
• Patients with severe pain in the legs due to diabetes (painful diabetic neuropathy).
• Patients with brachial plexus (nerves going to the hands) injury pain.

4) Sacral nerve stimulation for sphincter disturbances (both bowel and bladder)
5) Epilepsy surgery including temporal lobectomy and vagal nerve stimulation.