A monumental event took place this week in the Tel Aviv Sourasky Medical Center operating room. Naomi Elishuv, a professional violinist, formerly with the Lithuanian National Symphony Orchestra, the Israel Chamber Orchestra and the Givatayim Conservatorium of Music (in greater Tel Aviv), granted the surgical team a private performance while undergoing deep brain stimulation (DBS) surgery to suppress her essential tremor symptoms, a condition that she suffered from for 20 years.
“My greatest love was playing the violin, but unfortunately, until today, I have had to make do with teaching. My tremor prevented me from playing professionally, and this was very difficult for a woman such as myself, who was used to playing her entire life,” Elishuv explained before she entered the operating room.
Professor Yitzhak Fried, the Director of Functional Neurosurgery, who operated on Elishuv this morning, explained the procedure.
“We implanted and positioned a brain pacemaker with electrodes in the area of the brain disturbance, which emits impulses to suppress the tremor that was disturbing Elishuv’s daily functioning. The operation was performed under local anesthesia. In order to place the electrode in the optimal location, we wanted her active participation in real-time, so we asked Elishuv to play the violin during the surgery. During the procedure, she did not feel pain because these areas of the brain do not feel pain.
Fried continued, “In the first phase, before the operation, I did stereotactic planning, which enabled me to identify the exact optimal brain location, within millimeters. That is where I implanted the electrode.
“The surgery was performed via a minute hole in the skull, through which the 1.3-millimeter electrode was inserted. The electrode was implanted precisely in the thalamus region of the brain, and more specifically, in the ventralis intermedius nucleus – or VIM – which is one of the brain’s movement centers. In the second phase of the procedure, we did an electrophysiological mapping of the cells in the area of the disturbance, which gave us an indication of the precise problem location. I performed electrical stimulation in the center of the disturbed area and asked Elishuv to report any side effects caused by the stimulation. And, indeed, when we activated the stimulation in the exact location, we found that the tremor disappeared and Elishuv continued to play Mozart—with great emotion, but without the tremor or side effects,” Fried remarked enthusiastically.
“I could not continue any longer in my 20-year tremor state; I can’t wait to return to normal life,” Elishuv said excitedly. “I want to play, sign my name, and drink tea without spilling it, and I am only sorry that I just now discovered this surgery,” Elishuv summed up.
Prof. Fried adds, “This is the first time that I have operated on a patient who played an instrument during surgery, and I am so pleased that we had the opportunity to enjoy a private concert from a most talented and honorable musician. I hope that Elishuv will return to performing and that many more people will delight in her talents.”