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Home News News Year 2013 16-yr-old undergoes brain surgery while awake and humming songs

16-yr-old undergoes brain surgery while awake and humming songs

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The challenge with epileptic Arvind was to remove focal point of seizures, while retaining part of brain that gives him musical cognition

While doctors wielded the scalpel and manoeuvered through parts of his brain, 16–year–old Arvind Mohan Kumar was singing away in the operation theatre. In a rather unusual method to rid the teenager of epilepsy while simultaneously saving his exceptional musical abilities, a team of doctors at Nimhans used a first–of–its–kind technique to operate on the boy while awake, using only local anaesthesia.

Even as doctors were drilling into his brain, Arvind was asked to sing, listen to music, and recognise melodies and rhythms to assess the part of his brain that actively perceived music. Six hours of the delicate surgery later, doctors had succeeded in removing the focal point of seizures, but retainined the part of his brain that gave him musical cognition.

Arvind was diagnosed with drugresistant epilepsy at five, about the same time he took his first steps in the world of music. While the boy battled the recurring convulsions and refused to let them become a hurdle in his musical journey, there was no wishing them away. His father Mohan Kumar, also a musician, has an institute in Sharjah where he trains budding artistes. "One of Mohan’s students suggested we take Arvind to Nimhans," said mum Binila. It was a ray of hope for the family.

While Nimhans doctors said surgery could offer a permanent solution, the bad news was that the focal point of seizures was also the core where his musical abilities stemmed from.

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Coming from a family of musicians, the Std X student from Kerala had nurtured only one dream — to be a musician, primarily a violinist and a vocalist. He had already made a name at several district and state–level competitions. "In 2012, when I was singing for a competition at the Kerala Youth Festival, I had convulsions on stage. I took 10 minutes off and the judges asked me to come back. I went on to bag first prize in that competition," said a proud Arvind.

Doctors decided to go the extra mile to save Arvind’s music. A complete musical assessment was done to see which brain parts were active when he perceived music, analysed by neuro physicians, neuro surgeons, a neuro radiologist and clinical psychologists.

"Arvind had localised epilepsy, which meant his seizures started only in one part of the brain. Removal of that part would free him of the problem without damaging any other part. But, in his case, the seizures originated from the right temporal bone on the side of the skull that is instrumental for hearing and music functions," said Dr Malla Bhaskhar Rao, professor and head of the department of neurosurgery, Nimhans.

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Towards the end of the surgery, Dr Shanthala came into the room with a laptop and placed two speakers close to me. She played five songs and asked me to identify them. I got three right ARVIND MOHAN KUMAR

Dr Shanthala Hegde, assistant professor in Clinical Psychology at Nimhans, and a trained musician, said they first conducted a test to judge his musical abilities and assess which side of the brain was more active. "Years of dedicated practice had made both sides of the temporal bones equally strong, which is why he scored very high in the music assessment test," she said. A functional MRI was then conducted, in which, "the patient was asked to imagine himself singing and recognise the pitch, melody etc to understand which side of the brain was active at what time," explained Dr Shanthala.

"We decided to operate under local anaesthesia. A question mark incision was made on his head close to the right ear and it penetrated four to five layers. He was made to listen to songs and identify the pitch, melodies and sing while the surgical procedure was taking place. Parts active during musical activity were preserved, the focal point of the seizure removed. The incision was then stitched back," said Dr Rao.

More than 10 days since the surgery on September 25, seizures have stopped, and Arvind can sing better than before. "Whenever I had a seizure, I felt someone was whispering in my ears. Now, I am free of hallucinations," said Arvind.

During the surgery, Arvind says the doctor told him not to worry about anything. "The next thing I was conscious of was doctors drilling into my head to open the skull. I was irritated and tense. But then I knew they were doing it for me to get well. But every now and then when the pain would become unbearable, I would tell the doctor and he would stop the process for five minutes before resuming again. The drilling continued for around 20 minutes."

He realised he had "no option but to go through it as there is nothing more than my music to me," as he heard a sound like that of a nail gun and realised they were opening his skull. "Sometime toward the end, Dr Shanthala came into the room with a laptop, and placed two speakers close to me. She played five songs and asked me to identify them. Of the five songs, I got three right. Then there was a beat test when I was asked to name the beats and I cleared that too. After the music test I fell asleep. I remember waking up in the lift and asking my father how the operation went. I felt it had lasted for almost 10 hours. He said everything was fine," he said.


Surgery is a very good option for patients with medically refractory epilepsy. With proper, pre–surgical preparation, the area responsible for this type of epilepsy can be identified, and removed. While removing the particular portion, one needs to be extremely careful. In this case, as the boy excelled at music, functional studies were done to isolate this area and he underwent awake surgery. This means the patient is awake during surgery, and the surgeon and the team tested his musical ability before extricating the part. The boy is doing very well now and he demonstrated his skills with the violin, percussion instruments and vocals while we were on the rounds the other day. Dr P Satishchandra,
Director, Vice–Chancellor & Senior
Professor of Neurology, Nimhans

Times Of India
07 October 2013

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