Tipu Zahed Aziz: resurrected functional neurosurgery in the UK in the face of a sceptical medical establishment

Abstract

As a young physiology student Tipu Aziz was inspired by watching grainy videos from the 1970s showing patients undergoing brain surgery for movement disorders such as Parkinson’s disease. The films depicted medical miracles: before surgery patients had debilitating tremors, making the performance of everyday tasks almost impossible; afterwards, the tremors had disappeared. In the UK neurosurgery to treat movement disorders had fallen out of fashion, largely because of the introduction of levodopa. While the medication can be transformational, its long term use can lead to crippling side effects. Aziz realised functional neurosurgery still had a place and, in the face of a largely sceptical and indifferent surgical establishment, managed to resurrect it single handedly in the UK. Aziz’s quest began soon after he qualified and completed house jobs. He sought out Alan Crossman, a neuro-anatomist, with whom he worked as a research fellow, and obtained his doctorate in medicine. His work on monkeys demonstrated the subthalamic nucleus as a new surgical target for Parkinson’s disease—two decades later this would become the main target for deep brain stimulation (DBS). This discovery was soon translated into clinical practice and doctors in France were the first to report the efficacy of surgery in this part of the brain.1 In the UK, Aziz’s breakthrough was largely ignored. His …