Dr. Rajiv Nair

Dr. Rajiv Nair is a leading functional neurosurgeon at Toronto Western Hospital (TWH) — part of the University Health Network (UHN) — in Toronto, Ontario. Toronto Western Hospital is home to one of Canada's premier neuroscience programs and is internationally recognized for its expertise in movement disorder surgery and epilepsy surgery. Dr. Nair has been a central figure in this program for over 20 years, performing hundreds of deep brain stimulation (DBS) procedures and complex epilepsy surgeries.

Dr. Nair's primary clinical focus is functional neurosurgery — a subspecialty that uses surgical intervention to modulate dysfunctional neural circuits in the brain and spine. His work encompasses deep brain stimulation for Parkinson's disease, essential tremor, and dystonia, as well as surgical treatment of drug-resistant epilepsy using stereoelectroencephalography (SEEG) and resective surgery. He is also a pioneer in the clinical application of focused ultrasound thalamotomy — a non-invasive, incision-free treatment for essential tremor and tremor-dominant Parkinson's disease.

As a Professor in the Division of Neurosurgery at the University of Toronto, Dr. Nair is deeply committed to advancing the science and practice of functional neurosurgery. His laboratory at the Krembil Brain Institute at TWH investigates the neurophysiological basis of movement disorders and develops novel neuromodulation paradigms. He collaborates extensively with neurologists, neurophysiologists, neuropsychologists, and psychiatrists as part of the Toronto Western multidisciplinary movement disorder and epilepsy programs.

Patients from across Canada and internationally travel to Toronto Western to consult with Dr. Nair, particularly those with advanced Parkinson's disease or medically refractory epilepsy who have not responded adequately to pharmacological management. He is known for his careful patient selection process and his meticulous surgical technique.

Dr. Nair completed his undergraduate studies at the University of Toronto before earning his Medical Degree (MD) at the University of Toronto Faculty of Medicine. He pursued his Royal College residency in Neurosurgery at the University of Toronto — one of the largest and most comprehensive neurosurgery training programs in North America, encompassing training across Toronto Western Hospital, Toronto General Hospital, Sunnybrook Health Sciences Centre, and The Hospital for Sick Children.

Paralleling his surgical training, Dr. Nair completed a PhD in Neuroscience at the University of Toronto's Institute of Medical Science, where his research explored the role of the subthalamic nucleus in motor and non-motor processing — foundational work that directly informed his clinical career in DBS surgery.

He subsequently completed a two-year Fellowship in Functional Neurosurgery at the Toronto Western Hospital under the mentorship of internationally renowned functional neurosurgeons, gaining advanced expertise in DBS programming, intraoperative microelectrode recording, and epilepsy surgery. Dr. Nair is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC) in Neurosurgery, the definitive credential for specialist surgeons in Canada.

Dr. Nair's functional neurosurgery expertise is centered on deep brain stimulation (DBS) — a procedure in which electrodes are implanted in specific brain targets to deliver therapeutic electrical stimulation. He implants DBS systems for Parkinson's disease (targeting the subthalamic nucleus and globus pallidus internus), essential tremor (ventral intermediate nucleus of the thalamus), dystonia, and selected cases of refractory OCD.

For essential tremor patients who are not DBS candidates, Dr. Nair offers focused ultrasound thalamotomy — a truly non-invasive procedure performed using MRI guidance without any incisions or implants, which provides immediate tremor relief in appropriately selected patients.

In epilepsy surgery, Dr. Nair performs stereoelectroencephalography (SEEG) for precise seizure focus localization in complex cases, followed by resective surgery (anterior temporal lobectomy, selective amygdalohippocampectomy, or lesionectomy) or neuromodulatory approaches (vagus nerve stimulation, responsive neurostimulation). He works within a comprehensive epilepsy program that includes dedicated presurgical evaluation, neuropsychological testing, and post-surgical rehabilitation.

Dr. Nair has published over 110 peer-reviewed articles in high-impact neuroscience and neurosurgery journals including Brain, Annals of Neurology, Journal of Neuroscience, Journal of Neurosurgery, and Movement Disorders. His research spans DBS mechanisms of action, focused ultrasound neuromodulation, and biomarkers of epilepsy surgical outcomes.

He leads a research program at the Krembil Brain Institute focused on closed-loop adaptive DBS — next-generation stimulation systems that automatically adjust stimulation parameters in real time based on detected brain signals, representing the forefront of neuromodulation technology. This work is funded through grants from the Canadian Institutes of Health Research (CIHR), the Michael J. Fox Foundation for Parkinson's Research, and the Ontario Brain Institute.

Dr. Nair has been a principal investigator on multiple clinical trials examining novel DBS targets, programming strategies, and patient selection criteria for focused ultrasound. He is a regular presenter at the Movement Disorder Society World Congress, the International Stereotactic and Functional Neurosurgery Congress, and the American Epilepsy Society Annual Meeting. He is also a peer reviewer for the journals Brain, Movement Disorders, and the Journal of Neurosurgery.

Toronto Western Hospital's international reputation in functional neurosurgery attracts patients from the United States, United Kingdom, India, the Middle East, and other regions who seek DBS surgery or advanced epilepsy surgery unavailable or difficult to access in their home countries. The UHN International Patient Program coordinates all aspects of care for international visitors, from initial inquiry through post-operative discharge planning.

Dr. Nair offers telemedicine consultations for international patients to review existing imaging, neurological records, and prior treatment history as part of the DBS candidacy assessment process. The evaluation process typically also requires an in-person visit to Toronto for neurological examination, neuropsychological testing, and imaging before surgery is scheduled.

All consultations are conducted in English. Dr. Nair's team coordinates with UHN's interpretation services for patients who require translation support. Post-operatively, Dr. Nair provides detailed surgical and DBS programming reports to the patient's home neurologist to facilitate ongoing DBS programming and neurological follow-up in their home country.

Dr. Nair has received the University of Toronto Department of Surgery Distinguished Researcher Award and the Canadian Neurosurgical Society Innovation Award for his contributions to focused ultrasound thalamotomy and adaptive DBS research. He has been recognized by the Michael J. Fox Foundation for Parkinson's Research as an outstanding contributor to translational Parkinson's research.

He is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC) in Neurosurgery and holds membership in the Movement Disorder Society and the International League Against Epilepsy. Dr. Nair appears annually in the Best Doctors in Canada directory and has been recognized by the Parkinson's Society Canada and Epilepsy Canada for his commitment to advancing surgical treatment options for patients with these conditions.