Alzheimer patients: Issues to deal with Alzheimer
How to take care of Alzheimer patients at home?
Alzheimer vs. Dementia
Dementia refers to a decline in mental and cognitive abilities that impair one’s daily life. Alzheimer’s disease is the most common type (60-80%) of dementia. It is a progressive nervous system disorder in which the neurons (the cells of the brain cells) are gradually destroyed, and thus, a person’s behavior, thoughts, and emotions are affected. Once damaged, Neurons cannot be repaired, or damaged neurons cannot be replaced, as neurons do not divide. Thus, there is a progressive worsening of memory, ability to concentrate, among others. Care of patients with Alzheimer’s by family members, friends, and medical support staff can be challenging. Since there is no definitive treatment for dementia, palliative care remains the mainstay of therapy along with some drugs (rivastigmine, galantamine, and donepezil), which act by increasing some other neurotransmitters in the brain. Thus, caring for patients with Alzheimer’s makes a huge difference in their lives. Many of the caregivers feel overwhelmed over a while as they see the person deteriorating further in cognitive, behavioral, physical, and functional abilities. It may lead to neglect of one’s health in place of patient care and put one at an increased risk of stress, burnout, anxiety, loneliness, and depression. Several strategies help the caregiver cope with dementia care while making the caregiving journey meaningful and less challenging.Alzheimer Stages: Understanding the disease
As mentioned above, Alzheimer’s is a progressive disease. There are 3 broad stages in the course of the disease: mild, moderate, and severe. The care required thus varies upon the stage in which the person is. Mild Alzheimer’s: Patients with mild or early-stage Alzheimer’s disease can still have independent functioning in their daily life. Difficulty in remembering recent events, concentrating, and problem-solving are some of the earliest signs of neurocognitive decline in Alzheimer’s disease. Moderate Alzheimer’s: It is associated with significant loss of memory, a state of confusion, and the following physical symptoms: Difficulty in recognizing family members, close friends, and relatives; impaired co-ordination while performing daily tasks; restlessness and insomnia; urinary and fecal incontinence; and some personality changes. Severe Alzheimer’s: It is the last stage of Alzheimer’s. People cannot carry out independent daily living activities such as dressing up, walking from one point to another, and having a meal. They lose their awareness of the environment and cannot converse, recognize close family members, and lose time, place, and personal orientation.Common do’s and don’t
Creating a Routine: A daily routine with a plan of activities to help patients with Alzheimer’s to feel comfortable and adapt to their surroundings. Thus, maintaining a routine gives a sense of continuity to the patients and the caregiver as well. Any changes, such as the change of caregiver or change of setting, should gradually adjust to the new environment and at his own pace.Planning Activities:
The person with Alzheimer’s must be kept engaged in some work to slow the cognitive decline. Activities help to reinforce the neuronal circuitry in the brain and thus, promote memory retention. These include:- Listening to music and watching light-hearted movies/shows,
- regular exercising, such as walking, stretching exercises, playing board games,
- engaging in hobbies like gardening, cooking, stitching, etc.
- Maintaining eye contact while speaking.
- Addressing the patient by his name
- Assuming a welcoming and relaxed posture
- Trying to be calm and not frustrated while conversing.
- Avoiding a breakdown in front of the patient
Boosting Self- Image in Alzheimer’s Disease
Persons with Alzheimer’s should not lose touch with their selves. Thus, being comfortable with themselves is one of the first steps towards their self-confidence. Caregivers can promote that by encouraging them, supporting them, and helping them with their hygiene and grooming activities. Some activities include:- Eating together at the same time.
- Helping them comb on their hair while making your hair
- Allowing them extra time for dressing up and makeup (if they use one)
- Buying accessories with velcro’s or zippers instead of buttons.
- Blunting or padding sharp corners
- Giving them soft yet sturdy shoes
- Putting markers across the floor, in the form of fluorescent tapes, if they venture out at night.
- Sticking “hot” and “cold” signs near taps
- Ensuring timely medications through reminders or apps
- Preventing burn injuries by installing safety locks on stoves
- Keeping matches and lighters out of reach. If the person with dementia smokes, one must always supervise smoking and ensure that fire extinguisher are accessible in worst-case scenarios.
- Avoiding activities like driving in moderate disease as it poses a health risk to the patient and society, or ensuring that they have someone to help them out.
Caring for self in Alzheimer
Taking care of a loved one with Alzheimer’s is both a humbling and noble experience, which may, at times, be overwhelming. It may affect the ability of the person to socialize and work out his commitments. Besides, it is important to take care of one’s physical and mental social wellbeing while caring for others at the same time. Also, one cannot take care of others if they are unfit or in a disturbed state of mind.Some of the following tips may help in reducing the stress the burnout while at the same time promoting self-love and compassion.Sharing one’s feelings: It is natural to avoid talking about a loved one’s illness to one’s friends or family. However, talking your heart-out about fears, apprehensions, and frustrations helps relieve the tension and provides an outlet. One may also join a support group or ask for a counselor’s support if feeling worse. Getting enough sleep: A sound sleep of 7-9 hours each night goes a long way in promoting freshness and enthusiasm every day one wakes up. Being active: A good 30 minutes of moderate-intensity exercise daily (150 minutes a week) promotes endorphins release (the feel happy substances). It promotes overall wellbeing and helps improve sleep as well. Being gentle to oneself: Often the caregivers are hard on themselves and blame themselves, whether for feeling miserable or the misplaced idea that they are not doing enough for their loved ones. It may lead to a vicious cycle of anger, frustration, and helplessness. But it is important to remain calm in the face of adversity. Well, one can’t change the circumstances, but one can surely change one’s response to one’s circumstances! Deciding upon professional help: Alzheimer’s patients may require professional help if they need full-time assistance with daily and personal activities such as bathing, moving, or feeding. Any injury which makes the patient bed-ridden or any cerebral accidents which make the person perpetually agitated or make him wander also warrants professional help. Eventually, it is up to the family members and the caregiver to decide upon the timing of asking for professional help.
Conclusion:
In conclusion, the care of people with Alzheimer’s is both science and art. The caregivers may experience a gamut of positive and, at times, negative emotions. It is important to focus on the positive aspects while coping up with the negative stressors. Besides the ways mentioned above, caregivers should take the help of both family members and professional personnel to monitor the patient’s progress. Self-love and self-care for caregivers are essential. It goes a long way in preventing adverse health outcomes. Exercise, self-compassion, meditation, and controlling one’s emotional impulses are some of the ways by which they can help themselves.Read other articles
List of Top 20 Neurosurgeons
List of Top 20 Neurosurgeons/Top 20 Neurosurgeons Here is the list of top 20 Neurosurgeons. 1.Dr. Sandeep Vaishya Qualification: MBBS (G R Medical College, Gwalior)
Alzeimer’s Disease: Signs & Symptoms
Alzheimer’s is a disease associated with loss of memory. The patient suffers from dementia or loss of memory along with changes in behavior and thinking.
Alzeimer’s Disease Lifestyle modifications
Lifestyle modifications in Alzheimer’s Disease Alzheimer’s is a disease associated with loss of memory. The patient suffers from dementia or loss of memory along with
List of Top 20 Neurosurgeons
List of Top 20 Neurosurgeons/Top 20 Neurosurgeons
Here is the list of top 20 Neurosurgeons.
1.Dr. Sandeep Vaishya
Qualification:
- MBBS (G R Medical College, Gwalior)
- MS (G R Medical College, Gwalior)
- MCh (AIIMS, Delhi Top 10 best hospitals in Delhi)
- Fellowship
Brief Profile:
Dr. Sandeep Vaishya is one of the finest & famous neurosurgeons in India and has an experience of more than 22 years. He has been worked with some famous hospitals in India. He is one of the famous surgeons for brachial plexus Injuries and for Gamma Knife Surgery in South Asia. He is worked as one of the best brain and spine surgeons in our country.
His specializations are:
- Intracranial Brain Tumour Surgery
- Deep Brain Stimulation Surgery
- Minimally Invasive brain and
- Spine surgery
- Image-Guided Neurosurgery
- Brachial Plexus surgery
- Spine Surgery in India.
Hospital Website: https://www.fortishealthcare.com/
2. Dr. V. P. Singh
Qualification:
- MBBS
- DNB
- MCh
Brief Qualification:
Dr. V. P. Singh is a famous neurosurgeon with experience of more than 30 years. He is starting the epilepsy surgery program and Gama Knife Unit and at AIIMS, New Delhi. He has also operated more than 400 intracranial aneurysm cases.
Highlights:
- Dr. V. P. Singh got various awards:
- The prize for the best student in Anatomy.
- B.Sc.; Best paper award at many conferences.
- He has published moreover 70+ papers and chapters in books and has also invited for a speech at many national and international conferences.
- He is a member of Journal of following:
- Pediatric Neurosurgery
- Neurological Society of India
- Secretary of Indian Society of Cerebrovascular Surgery
- He has President of Indian Society for Stereotactic and Functional Neurosurgery and Executive Committee of Indian Society of Pediatric Neurosurgery.
Hospital Website: https://www.medanta.org/
3.Dr. Aditya Gupta
Qualification:
- MBBS (AIIMS, New Delhi)
- MCh (AIIMS, New Delhi)
- Fellowship ( CJW Medical Centre Richmond, US)
Brief Profile:
- Dr. Aditya Gupta is one of the famous surgeons in the field of Neurosurgery in India with an experience of more than 21 years. He has used excellent surgical techniques for a wide variety of brain tumors & spine diseases.
- Dr. Gupta has special and unique skills in
- Managing Movement Disorders with Deep Brain Stimulation.
- Surgery for Epilepsy, Nerve and Brachial Plexus Surgery
- Radiosurgery
- Cerebrovascular Surgery
- Dr. Gupta completed his advanced training from the University of Amsterdam, Paris -University of Marseilles, Wake Forest University -US, University of Kiel – Germany.
Highlights:
- Dr. Gupta has published more than 41 publications, chapters in the book.
- He is invited as a speaker at national and international conferences.
- He is an active member of the following organizations:
- Congress of Neurological Surgeons (US)
- Neurological Society of India
- International Gamma Knife Society Treasurer
- Indian Society for Stereotactic and Functional Neurosurgery
- Skull Base Surgery Society
- Dr. Gupta has seen in many noteworthy news media such as The Hindu.
Hospital Website: https://www.artemishospitals.com/
4. Dr. Atul Prasad
Qualification:
- MBBS
- DM
Brief Profile:
Dr. Atul Prasad is a famous neurologist with experience of more than 26 years. Now he is working as the Director & HOD at Neurology Department at BLK Super Speciality Hospital, New Delhi. He is well specialized in Parkinson’s disease and Botulinum Toxin Injection, Stroke: Acute Stroke Unit.
Highlights:
- Dr. Atul Prasad is an author of 17 chapters and has 38 publications in many Indian and International journals.
- He is an active member of prestigious organizations like
- Indian Academy of Neurology
- Neurologist Society of India
- Indian Epilepsy Association
- Malaysian Society of Neuro Sciences.
Hospital Website: https://www.blkhospital.com/
5. Dr. A.K. Banerji
Qualification:
- MBBS
- MS
Brief Profile:
Dr. A.K. Banerji is a famous Neurosurgeon in New Delhi and has an experience of more than 50 years. He has established Microneuro Surgery in India and Standardized neurosurgical training in India. Now he played a major role in the form of all the neurosurgical subspecialties.
His expertises in
- Brain Tumors (neoplasms)
- Spinal Tumors
- Epilepsy Surgery
- Disc Prolapses
- Head Injuries
- Spine Injuries
- Aneurysms
- Vascular malformations
- Hydrocephalus.
Highlights:
- Dr. A.K. Banerji is a member of the medical education of neurosurgeons of India.
Hospital Website: https://www.medanta.org/
know more about Neurology hospitals in India.
6. Dr. Rajiv Anand
Qualification:
- MBBS
- MD
- DM
Brief Profile:
- Dr. Rajiv Anand is a famous neurologist in Delhi and has experience of more than 35 years; he has done his studies from some of the famous institutes in India. He has done his MD in Neurology.
Highlights:
- Dr. Rajiv Anand is an active member of various famous organizations like
- Delhi Medical Association (DMA)
- Indian Academy of Neurology
- Indian Epilepsy Association (IEA),
- Delhi Neurological Association (DNA)
- Association of Physicians of India (API).
Hospital Website: https://www.blkhospital.com/
7. Dr. Chandran Gnanamuthu
Qualification:
- MBBS
- MD
- DM
- FRCP
Brief Profile:
Dr. Gnanamuthu is a famous Neurologist in Bangalore Best Hospitals from Bangalore and has an experience of more than 38 years in Neurology and Clinical Medicine field. He specializes in building teams to give an Advanced Specialized Medical Care to his patients. He has made Clinical Departments & Teams for highly specialized Neurological Care. His special interests are in
- Neurological infections,
- Nervous system inflammation,
- Para-infectious syndromes a
- Tracing the link between genetic and epigenetic factors.
Highlights:
- Dr. Chandran is India’s most famous clinical neurologists and he has got Global recognition for Clinical Excellence by service, research, and education.
- He has published more than 70 publications in peer-reviewed journals and paper presentations at national & international conferences.
Hospital Website: https://www.fortishealthcare.com/
8. Dr. Soundappan V
Qualification:
- MBBS
- MS
- MCh
Brief Profile:
Dr. Soundappan V is a famous neurosurgeon and has more than 28 years of experience in which 16 years in managing the disease which affects the nervous system like the spinal cord, brain, and extra-cranial cerebro-vascular system.
His special interest in:
- Minimally Invasive Brain surgeries
- Spine surgeries (Spine disc replacement)
- Micro Neuro surgeries
- Trauma.
Highlights:
- In 1977, Dr. Soundappan V is achieved by Gold Medal in Micro-biology.
- Dr. Soundappan is a member of the following Organizations
- Neurological Society of India (NSI)
- Neuro Spinal Surgeons Association (NSSA).
Hospital Website: https://www.fortismalar.com/
9. Dr. Rajan Shah
Qualification:
- MBBS
- MS
- MCh
Brief Profile:
Dr. Rajan Shah is a famous neurosurgeon with an experience of more than 30+ years. He has also handled over 8000+ brain tumors with less than 1 percent of the mortality rate. He has also managed moreover 450 a cerebral aneurysm and more than 100Arterio Venous malformations.
His special interest in:
- Trigeminal neuralgia
- Spinal tumors
- Brain injuries
- Brain strokes.
Highlights:
- Dr. Rajan Shah has trained in newer technology at Mount Sinia Hospital, New York & Fujita University Hospital, Japan.
Hospital Website: https://www.nanavatihospital.org/
10. Dr. Rana Patir
Qualification:
- MBBS (All India Institute of Medical Sciences)
- MS (All India Institute of Medical Sciences)
- MCh (All India Institute of Medical Sciences)
- Fellowship (Frenchay hospital, Bristol, UK.)
Brief Profile:
Dr. Rana Patir is one of the famous neurosurgeons having experience of more than 26 years. He is one of the best surgeons for brain tumour surgery in India. His keen interests in complex brain tumours surgeries
Highlights:
- Dr. Rana Patir has various noteworthy articles in print media such as The Hindus, ABC News.
Hospital Website: https://www.fortishealthcare.com/
know more about Neurology hospitals in India.
11. Dr. Rakesh Kumar Jain
Qualification:
- MBBS (PGIMS, Rohtak.)
- DCH (PGIMS, Rohtak.)
- FRCPCH
- CCT (Oxford University Hospital, UK).
Brief Profile:
- Dr. Rakesh Jain is a famous Paediatric Neurologist in Gurgaon with an experience of more than 18 years, he has worked with some of the famous hospitals in the UK. Dr. Jain’s expertise lies in: Paediatric Neurology,
- Paediatrics
- Paediatric Neuro Rehabilitation.
Highlights:
- Dr. Rakesh Jain has published various publications in some of the famous journals nationally and internationally conferences.
- Dr. R K Jain has presented many papers & posters at the British paediatric neurology conference, the European paediatric neurology conference, and the royal college of paediatric & child health conference
Hospital Website: https://www.fmri.in/
12.Dr. Mayank Chawla
Qualification:
- MBBS (Banaras Hindu University)
- MD (Banaras Hindu University)
- DM (Banaras Hindu University)
Brief Profile:
Dr. Mayank Chawla is one of the famous neurosurgeon in India and has experience of more than 30 years. Dr. Chawla is well specialized in the treatment of :
- Stroke,
- Epilepsy
- Paralysis
- Spine disorders
- Muscular weakness
- Low Back Pain.
Highlights:
- Dr. Mayank Chawla has published many publications in some of the famous journals both national & international conferences.
Hospital Website: https://www.fmri.in/
13.Dr. Balamurugan M
Qualification:
- MBBS
- DNB
Brief Profile:
Dr. Balamurugan M is a famous neurosurgeon and has more than 20 years of experience.
He provided the following services are:
Brain Aneurysm Treatment,
- Brain Dural Arteriovenous
- Fistula Embolization
- CSF Rhinorrhoea Repair Surgery
- Carotid Body Tumour Embolization
- Brain Aneurysm Treatment and Foot Drop.
Highlights:
- Dr. Balamurugan M has published various papers and articles in several journals.
- He is a member of the following organizations:
- Neurological Society of India
- Indian Medical Association
- American Academy of Neurological Surgeons.
Hospital Website: https://www.askapollo.com/
14. Dr. Arun Saroha
Qualification:
- MBBS
- MS (RNT Medical College, Udaipur)
- MCh (PGI Chandigarh)
Brief Profile:
Dr. Arun Saroha is a famous brain & spine surgeons in India. And has an experience of more than14 years. He is one of the first and finest few to perform Scoliosis surgery in India. He has done over 8000+ brain and spine surgeries.
His expertise lies in:
- Brain Tumour Surgery
- Brain Aneurysms
- Spine Surgeries
- Spine Instrumentation surgeries
- Management of head injury patients.
Highlights:
Dr. Arun Saroha is a member of various famous organizations like
- Ferdinand Church University
- Nigeria, Baghdad University, Baghdad.
Hospital Website: https://www.maxhealthcare.in/
15. Dr. Veena Kalra
Qualification:
- MBBS (Delhi University)
- MD (AIIMS, Delhi)
Brief Profile:
Dr. Veena Kalra is one of the famous Paediatric Neurologist in Delhi having an experience of more than 37 years. She has guided more than 50 theses. Dr. Veena Kalra did leadership in paediatrics and she has developed paediatric neurology in India and the 1st DM Paediatric Neurology program in India.
Highlights:
Dr. Kalra has awarded by the Honourable President of India. Dr. Kalra has got many medals at UG and PG medical education levels such as;
- President of India’s Medal
- WHO Research Training Grant Award.
- Cambridge University, U.K
- WHO Laboratory, Geneva
- Pfizer Scroll of Honour
- Sorell Katherine Award of AIIMS, New Delhi
- ST Achar Endowment Award for Best Clinical Research of the Indian Academy of Paediatrics
- Kanishka Award for Medical Education.
Hospital Website: https://delhi.apollohospitals.com/
know more about Neurology hospitals in India.
16. Dr. K. Sridhar
Qualification:
- MBBS
- DNB
Brief Profile:
Dr. K. Sridhar is a famous neurosurgeon with the experience of more than 30 years.
His special interests are:
- Vascular
- Skull Base
- Cervical Spine surgery
He established centers of excellence in Neurosciences centered based on the concept of ‘Integrated Neuro Care’
Highlights:
Dr. K. Sridhar is a Life member of various organizations such as;
- Association of Spinal Surgeons of India
- Skull Base Society of India
- Neurological Society of India
- Indian Society of Pediatric Neurosurgery
- Congress of Neurological Surgeons
- Neuro-oncology Society of India
- He Recipients various awards:
- Best Doctor Award
- Prof Rajaratnam Oration Award
- Health Warrior Award
- Prof Dayananda Rao Oration Medal.
Hospital Website: https://mgmhealthcare.in/
17. Dr. P R Krishnan
Qualification:
- MBBS
- MD (AIIMS, New Delhi)
- DM
Brief Profile:
Dr. P R Krishnan is a famous Neurologist in Bangalore with an experience of more than 14 years.
His clinical interests are:
- Parkinson’s disease,
- Memory Disorders such as Alzheimer’s disease (Alzheimer patients: Issues to deal with Alzheimer), Balance Disorders, Stroke, Dizziness/ Vertigo, Neck/ Back Pain, etc.
- He was awarded Diplomat National Board in Neurology as MNAMS.
- He awarded the Award of Merit and in 2009 Bahrain Neurosciences Association.
Hospital Website: https://www.fortishealthcare.com/
18. Dr. Srinivasan Paramasivam
Qualification:
- MBBS
- MCh
- Fellowship
- MRCS
Brief Profile:
Dr. Srinivasan Paramasivam is a famous neurosurgeon with the experience of more than 17 years in his field. He is a very hardworking and talented surgeon in India.
Highlights:
Dr. Srinivasan Paramasivam is a member of various societies:
- Indian Medical Association,
- Neurological Society of India,
- Society of Vascular and Interventional Neurology
- Royal College of Surgeons of Edinburgh, United Kingdom.
He is also a member of the following organizations:
- Editorial Board Member Journal of Craniomaxillary diseases
- World Journal of Clinical Case Conference
- Austin Journal of Cerebrovascular Disease and Stroke.
Hospital Website: https://www.askapollo.com/
19. Dr. Arun Garg
Qualification:
- MBBS (Swai Man Singh Medical College, Jaipur)
- MD (Swai Man Singh Medical College, Jaipur)
- DM (Swai Man Singh Medical College, Jaipur)
Brief Profile:
Dr. Arun Garg is one of the famous and respected neuromuscular surgeons in Gurgaon Best multi-specialty accredited hospitals from Gurgaon with the experience of more than 26 years. He is famous for making a three-tier system, where primary and secondary brain rescue centers are connected to hub hospital, Medanta, Gurgaon by the connection of ambulances and telemedicine. He did his training in stroke prevention/ treatment/rehabilitation/ education/ latest research at the University of Massachusetts Amherst, Massachusetts, USA. Dr. Garg has developed a “Brain rescue” program with stroke, covering entire north India with an epicenter at Medanta hospital.
Highlights:
- Dr. Arun Garg has started the role of thrombolysis in Acute Stroke.
- He has published many articles in various national as well as international journals.
- He has a keen interest in teaching also.
Hospital Website: https://www.medanta.org/
20. Dr. Pradyumna Oak
Qualification:
- MBBS
- MD
- DM
Brief Profile:
Dr. Pradyumna J Oak is a famous and respected Consultant in the Department of Neurology and he has several years of professional experience of more than 22 years in his field. He is specialized in the treatment of Cerebrovascular accidents (strokes) He has given treatment to many patients suffering from neurological disorders in India and handles each case very sincerely.
Highlights:
- Dr. Pradyuman Oak has published many papers in India and abroad.
- He is an active member of many famous medical organizations.
- He is also an active member of the Indian Association of Neurology.
Hospital Website: https://www.nanavatihospital.org/
know more about Neurology hospitals in India.
Anxiety Disorders- Foundation of Fear and Worry
Anxiety Disorders- Foundation of Fear and Worry
Anxiety Disorders is a group of mental disorder mainly constituting of fear and anxiety, where is anxiety is a worry about the future and fear is mainly a reaction to the current situation. There are several types of anxiety disorder and often people have more than one anxiety disorder. The disorder is mainly differentiated based on the symptoms experienced.
Classification:
-
Generalized anxiety disorder:
It is the most common type of anxiety disorder characterized by long-lasting anxiety that does not focus on any one object or situation. The people having generalized anxiety disorder experience persistent fear and worry. They become highly concerned about everyday matters. It most commonly affects older adults.
The diagnosis for Generalized Anxiety Disorder is conclusive when a person has been excessively worried about everyday problems for at least six months. The symptoms are
-
- Restlessness
- Fatigue
- Concentration problem or lack of concentration.
- Irritability
- Muscle tension
- Sleep disturbances
- Strained appearance
- Tearful
- Sweaty hands and feet
- Children can experience headaches, restlessness, stomach colic, sometimes heart palpitations.
2. Specific phobias:
This type of anxiety is triggered by a specific stimulus or situation. The sufferer of this type of anxiety anticipates terrifying outcomes from encountering the objects that they fear off. The most common phobias are fear of flying, water, blood, closed space.
Symptoms of this type of phobias are:
- Trembling
- Shortness of breath
- Rapid heart rate
3. Panic disorder:
The attacks of this anxiety disorder aggravated by stress, irrational thoughts, fear or even exercise. These attacks can start abruptly reaching its peak within a few minutes and can last up to hours.
The symptoms of panic disorder are:
- Trembling
- Dizziness
- Nausea and vomiting
- Shaking
- Confusion
- Difficulty in breathing
- Heightened awareness
- Agoraphobia: Anxiety caused by a certain situation or place. This type of anxiety is often linked to panic disorder. Agoraphobia is often used to refer to behavior that causes avoidance of a certain situation or place that usually has serious consequences and often reinforces the cause of fear.
4. Social Anxiety Disorders:
The people who suffer from this type of nervous disorder fear negative publicity, public embarrassment, humiliation, and even social interaction. Social anxiety is very common in adolescent girls. Social anxiety can sometimes lead to social isolation.
The symptoms are:
- Blushing
- Sweating
- Difficulty in speaking in public
- Post-traumatic stress disorder: This type of anxiety disorder is a result of exposure to extreme situations like rape, natural disaster, child abuse, hostage situation, bullying or a serious accident.
The symptoms are:
- Anxiety
- Anger
- Hypervigilance
- Depression
- Flashbacks
- Separation anxiety disorder is mostly seen in infants and children being separated from a person or a place.
- Situational anxiety is seen in people when they are exposed to a new situation or change in events. Panic attacks are very common.
- Selective mutism
- Obsessive-Compulsive Disorder
Spinal Fusion: a spine supporting Fusion Surgery
Spinal Fusion: a spine supporting Fusion Surgery
Spinal fusion is a surgical fusion of two or more vertebrae. This process is also known as spondylosyndesis. This is a surgical formation of ankylosis (restriction of joint movement) between the vertebrae.
Spinal fusion mimics the healing process of fractured bones. The surgeon fuses two or more vertebrae together by placing a bone or a bone like substance between the vertebrae so that they are fused together. Titanium plates, screws, and rods are also used to hold the vertebrae in the correct place.
Why is the vertebra fused together?
The fusion of the vertebrae gives stability, treat spinal deformity and to reduce pain. Spinal fusion surgery is indicated under the following conditions:
- In cases of spinal deformities like scoliosis or spinal stenosis
- In people with spinal weakness and instability of vertebral joints, mainly caused due to the excessive motion of the joint. This instability of the joint further can cause arthritis.
- In people with a herniated disc.
Pre-surgery care:
Prior to the surgery, the doctor will ask you to follow certain advice. The advice given before the surgery are:
- To get a high-resolution MRI done.
- Avoid smoking or chewing tobacco
- Avoid consuming alcohol
- Avoid stress
- Get pre surgery check-ups done and consult the doctor with the reports.
- Take medicine as directed by the doctor. Inform your doctor about the medicines that you are taking including herbal medicines and nutritional supplements.
- Shave the area of surgery before the surgery.
What to expect during the surgery?
The surgery is performed under general anesthesia. The surgeon chooses the best surgical procedure for the patient.
- The doctor makes an incision either in the neck or back, sometimes if the doctor finds to support the vertebra from the front then the doctor makes an incision in the throat or in the abdomen.
- After making an incision, the doctor then grafts a bone or synthetic material very much like a bone that enhances the bone growth and speeds up the process of spinal fusion. The bone for a bone graft is usually extracted from the pelvic bone.
- Once the graft is placed the spines are fused together with the help of titanium plates, rods, and screws.
Post-surgery care:
Post-surgery the patient must stay in the hospital for the next three to four days, depending upon the site of surgery and the pain. The doctor advises a few tips:
- Take medicines as advised
- Do not lift heavy things
- Avoid nicotine rich things including tea, smoking or chewing tobacco until the wounds heal.
- Avoid alcohol until the wounds heal.
- Consult a physiotherapist to help you learn how to sit, stand or walk so that the alignment of the spine is not disturbed.
Complications:
The complications post-surgery is:
- Infection
- Delay in wound healing
- Pain
- Bleeding
- Blood clots
- Injury to nerve and blood vessels
When to see a doctor post-surgery?
If you experience the following symptoms after surgery, please visit your doctor. The symptoms are:
- Redness, swelling, and pain
- Fever with chills
- Pus near the site of incision
Spine Decompression: A Corrective Surgery
Spine Decompression: A Corrective Surgery
Decompression surgery is a corrective surgery which to give enough space for the spinal cord and the nerve to pass through it. Spine decompression surgery is mainly performed in cases of stenosis/narrowing of the spinal canal which if not treated causes pain, numbness or weakness of muscles, especially of hands and legs.
If the symptoms are not subsided after medication and physiotherapy only then the surgeon thinks of surgery.
Types
Decompression surgery is a corrective surgery can be done anywhere along the cervical spine to lower lumbar spine, where there is stenosis of the spine. Stenosis usually occurs as an age-related complication, arthritis, enlargement of joints, bone spurs, bulging disc, and thickened ligaments. The different types of spine decompression surgeries are:
- Laminectomy
- Laminotomy
- Foraminotomy
- Laminaplasty
- Discectomy
In some cases, fusion is also done to bring stability to the joints.
Who can undergo this procedure?
Surgery is for those patients who have undergone mediations and physiotherapy without much relief to their symptoms. The patients who can undergo the surgery are:
- Significant pain, numbness or weakness in legs and feet.
- Pain in lower extremities, pain in extremity more severe than the back.
- Pain unmanageable even with medicines.
- Stenosis is prominent in the spine in CT scan and MRI.
- Difficulty in walking or standing because of the pain in the lower extremity.
Contraindication for the surgery?
The surgery is not performed in the following conditions:
- If the person is having cauda equina syndrome.
- In people who have rapidly progressing neurological deficit
- In very young people
Pre-operative care
Before the surgery the patient is advised:
- To undergo pre-surgical blood tests
- Stop smoking or chewing tobacco at least two weeks before the surgery
- Stop taking steroids two weeks before surgery
- Stop taking alcohol two weeks before the surgery
- Stop blood thinners and non-steroidal anti-inflammatory drugs one week before the surgery.
- Do not take food or fluid at least 8 hours before the surgery.
What to expect during surgery?
- After checking the vitals, anesthesia is administered to the patient. After administering anesthesia, the patient is turned on their stomach supported by pillows on the sides.
- The surgeon makes an incision in the middle of the back at the desired level of the vertebrae that must be operated.
- The incision site is confirmed by taking an x-ray.
- The surgeon then removes the whole or a part of the lamina and or ligament flavum.
- After removing the lamina and ligament flavum the surgeon decompresses the spinal cord followed by decompression of the spinal nerve.
- If necessary, then the surgeon can opt for the fusion of the adjoining vertebrae to give extra stability.
- The muscles and skin are then sutured together.
Post-operative care
After an operation, the patient is kept in the ICU overnight. After two to three days the patient is discharged only if the vitals are normal.
Post-surgery care:
- Avoid lifting heavyweight for a month after surgery.
- Avoid bending and twisting back for a month post-surgery.
- Avoid nicotine products
- Avoid strenuous work including sex for a month.
Surgery of the Skull Base
Surgery of the Skull Base: Risk factors, Diagnosis, and Treatment
The surgery of skull base is a complex surgery performed by a neurosurgeon along with either an ophthalmologist, head and neck surgeon, otolaryngologist, plastic surgeon or oral and maxillofacial surgeon. This surgery is mainly used either to remove or repair any abnormalities beneath the brain on the bony surface of the skull base.
The surgery is either approached through either the traditional way or craniotomy, by opening the skull, or through the minimally invasive way by operating through the nostrils and mouth with the help of an endoscope. This procedure is known as transsphenoidal surgery.
When is the procedure performed
Skull base surgery is an option only when all the conservative treatments fail, and surgery is only the primary treatment. The procedure is useful under the following conditions:
- Tumour in skull base
- Aneurysm
- Brain abscess
- Inflammation of the trigeminal nerve
- Hematoma
- Hydrocephalus
- Arteriovenous malformation
Preoperative care
- The patient must tell the doctor about the medicines including the medicinal herbs and nutritional supplements.
- Let your doctor be aware of any allergies that you are having
- Do not wear any valuables when you go for surgery
- Do not eat food at least eight before the surgery.
- Get your pre-surgery tests done and consult the doctor with the reports.
- Manage your blood pressure within the physiological range.
- Do not get stressed before the surgery.
What to expect during the surgery?
The surgery can either be a craniotomy or transsphenoidal surgery.
- In the case of craniotomy: The surgeon makes an incision in the skull base near the site of anomaly followed by temporarily removing the bone flap which is replaced properly after the surgery. Enough care should be taken while removing the bone so that the neighboring structure is not damaged.
The doctor further exposes the brain by making an incision on the dura mater. Once the brain is exposed the doctor carefully does the surgery which is basically microscopic surgery.
After the surgery, the doctor sutures the dura matter and closes the bony flap with titanium plates and screws and finally sutures the incision on the scalp.
- Transsphenoidal surgery: In Transsphenoidal surgery, an endoscope is inserted through one of the nostrils in the brain through the opening of the sphenoidal sinus that is behind the nasal cavity. The endoscope provides enough light and magnification for the surgeon to perform the surgery. After the surgery is finished the doctor sutures any opening that was made during the surgery.
Post-operative care
- The patient is discharged after 3-4 days post-operation.
- The patient is given pain killers to relieve pain. In patients who have undergone craniotomy, other medicines are used to control seizures too.
- Patients who have undergone craniotomy are advised not to indulge in any physical activity for at least one month after the operation, however, walking short distance is encouraged if the patient feels like. In transsphenoidal surgery, the patient can resume light exercise after two weeks.
Multiple Sclerosis: Depletion of the Myelin
Multiple Sclerosis: Depletion of the Myelin
Multiple sclerosis is a chronic condition of the central nervous system that causes depletion of the myelin which is a protective covering of the nerve cells. Depletion of nerve axons are also seen within the brain as well as sometimes in the spinal cord also, but the depletion does not occur at the same time. The depletion of myelin causes temporary, repetitive or sustained disruption in nerve impulse conduction which will result in symptoms like weakness, numbness, visual disturbances and loss of bladder and bowel control.
Multiple sclerosis is a debilitating disease where more than half of the people affected by this disease are unable to do their work within ten to fifteen years of the first onset of symptoms, and within twenty-five years after the onset of first symptoms half of the people having multiple sclerosis are unable to walk.
Types of multiple sclerosis:
Four main categories of multiple sclerosis are:
- The benign type in which there are several episodes of nervous system dysfunction and later there is a complete recovery.
- The primary progressive type in which there is a rapid loss of neurological functions that do not resolve to cause severe functional impairments that worsen over time.
- Relapsing and remitting type multiple sclerosis is the most common variant. These patients meet only partial restoration of neurological functions. Secondary progression of the disease sometimes may result in the gradual accumulation of visual motor or may cause sensory disability.
Symptoms:
- Nearly a quarter of patients having multiple sclerosis have visual disturbances and some people also develop blindness.
- Blurred vision due to optic neuritis or inflammation of the optic nerve
- The weakness of muscles of one or more limbs.
- Continuous contraction of certain muscles or muscular spasticity.
- Numbness
- Nystagmus
- Fatigue
- Tremors
- Unstable gait or abnormality while walking
- Recurrent urinary tract infection caused due to bladder dysfunction.
- Cannot hold urine, lack of bladder control.
- Alteration of mood
- Depression
- Loss of bladder and bowel control
- Dizziness
- Slurred speech
- Tingling in parts of the body
Causes:
The cause of the disease is not known and is assumed that the disease has an autoimmune basis.
Risk factors:
The factors that increase the risk of having multiple sclerosis are:
- This condition can occur at any age however people between sixteen to fifty-five are at higher risk.
- Women are twice more at risk than men.
- European-American is at higher risk.
- People with close biological relatives having multiple sclerosis are at higher risk.
- People with low levels of vitamin D and with low exposure to sunlight are at higher risk.
- People who smoke are at higher risk
- People who have a thyroid disorder or diabetes or inflammatory bowel disease are at higher risk.
Complications:
- Stiffness of muscles
- Paralysis
- Forgetfulness
- Depression
- Epilepsy
- Mood swings
Patient care:
- Avoid fatigue, overexertion, exposure to extreme climate, and stress.
- Exercise regularly
- Promote safety at home and workplace
- Taking medicines regularly
- Avoid smoking tobacco
- Eat healthy food.
Brain Trauma: Aftereffect of a Violent Blow
Brain Trauma: Aftereffect of a Violent Blow
Trauma to the brain can happen by a violent blow to the head or the body. Anything from outside which penetrates inside the skull also causes trauma.
The traumatic injury can either be mild which means that the effects of the injury will only be for a small time and is temporary. The more serious injury which causes physical damage such as tearing of tissues, bruises, bleeding or any other physical damage can cause serious complications and can be fatal too.
Symptoms
The symptoms of trauma to the brain sometimes are observed immediately and sometimes the symptoms appear after days or weeks.
The symptoms that appear when the trauma is mild
- Loss of consciousness. The consciousness is usually retained within few seconds to few minutes.
- Dazed
- Confusion
- Nausea and vomiting
- Fatigue or tiredness
- Drowsiness
- Sleeping more than usual
- Difficulty in balancing
- Slurring of speech
- Blurred vision
- Ringing in ears
- Bad taste in the mouth
- Sense of smell altered.
- Mood swings
- Memory or concentration issue.
Symptoms caused because of moderate trauma
- Loss of consciousness. Consciousness is regained usually after several minutes to a few hours.
- Persistent nausea and vomiting
- Severe headache that worsens over time.
- Sudden seizure
- Dilatation of pupils
- Weakness and numbness of extremities
- Difficulty to weak up
- Discharge of clear fluids from nose or ears
- Confusion
- Slurred speech
- Agitation
- Coma
- Loss of coordination
- Children tend to weep and lose interest even in playing their favorite games.
Causes of Brain trauma
Usual causes of trauma are:
- Fall
- Vehicle-related collision
- Violence
- Sports injuries
- Explosive blasts
- Combat injury
Risk factors
People who are at risk are:
- Infant and young children
- Young adults
- Older adults
- Males are at higher risk.
Complications of Brain trauma
The complications of traumatic brain injury sometimes are very severe. The complications are:
- Coma
- Damage in brain tissue can cause vegetative state which can be permanent but usually patients recover.
- Brain death
- Seizure
- Hydrocephalus or accumulation of fluid in ventricles of the brain.
- Vertigo
- Headaches
- Damage to of the blood vessels.
- Paralysis
- Altered senses
- Dizziness
- Ringing in the ears
- Vision impairment
- Difficulty in swallowing
- Loss of vision
- Anger and anxiety
- Loss of vision
Prevention of Brain trauma
The trauma can be prevented by following a few safety tips:
- Preventing fall by taking necessary intervention
- Wearing helmets
- Using a seat belt and airbags while driving
Brain surgery for epilepsy: A ray of Hope in Seizures
Brain surgery for epilepsy: Risk factors, and Types
Epilepsy is a debilitating disease, which is primarily managed by medication. But if the symptoms become unmanageable by medicines then the doctor can suggest surgery based on the radiological and other pathological reports. Brain surgery for epilepsy has a good percentage of success rate.
During this surgery, the doctor removes a part of the brain where the seizure begins to form, sometimes instead of removing the part they alter it.
Brain surgery is usually indicated when two drugs fail to control seizures. Brain surgery for epilepsy is only useful when the seizure begins only at one place in the brain.
Epilepsy: When to undergo surgery?
This surgery is usually done to avoid complications of epilepsy especially in patients who do not respond to the medications as expected.
Surgery is indicated only when two anti-epileptic drugs fail to manage the symptoms. If surgery is not performed it can lead to life-threatening complications such as drowning, physical injury during a seizure, delayed growth in children, depression, severe anxiety and sometimes death too.
Types of epilepsy surgery
There are different types of surgeries performed to treat epilepsy. The doctor decides the best surgery for the patient mainly based on the site of the nerve cell that triggers a seizure and the age of the patient. The types of surgery include the following:
- Resective surgery which the most common type of epilepsy surgery where a small part of the brain that triggers the attack is removed.
- Laser interstitial thermal therapy is a minimally invasive technique guided by MRI.
- Deep brain stimulation is also an MRI guided procedure where an electrode is permanently implanted deep in the brain and generator to send electrical pulse is implanted in the chest.
- Corpus callosotomy is usually performed in children who experience abnormal brain activity that speeds from one side to the other side of the brain.
- Hemispherectomy in this procedure the gray matter of one hemisphere of the brain is removed. It is usually performed on children who experience seizures which originates from multiple sites of a single hemisphere.
- Functional Hemispherectomy is usually performed for children in which a seizure-inducing hemisphere is undercut thereby there is no loss of brain tissues.
Epilepsy Risks Factors
- Headache
- Stroke
- Mood swings
- Depression
- Visual impairment
- Difficulty in comprehension
- Forgetfulness
- Memory disorder
- Difficulty in understanding language and using language.
Epilepsy pre-operative evaluation
The doctor first evaluates the patient to find the source of abnormal brain activity through :
- ECG
- Video EEG
- MRI
- WADA test
- Brain mapping
- Functional MRI
- Some Neurological tests
After the evaluation, the doctor chooses the best type of surgery for the patient. Remove the hair of the head before surgery to avoid infection.
Epilepsy Postoperative care
- Patients need to spend one night after the surgery in ICU and are discharged after 3-4 days from the hospital.
- For pain doctors advice medicines and ice packs.
- Avoid mental stress
- Avoid physical exertion
- The patient can resume office and school only after 3 months.
Neurology Hospitals in India
- INDO AMERICAN HOSPITAL, KERALA
- B J Medical College and Sassoon Hospital, Pune
- Institute Of Neurosciences Kolkata
- Fortis Hospital, Shalimar Bagh, New Delhi
- Max Super Specialty Hospital New Delhi
- Manipal Hospitals – Jayanagar, Bengaluru
- Indraprastha Apollo Hospitals, New Delhi
- Jehangir Hospital , Sassoon Road, Pune
- Kokilaben Dhirubhai Ambani Hospital, Mumbai
- D Hinduja Hospital For Neurology, Mumbai
- Institute of Human Behaviour & Allied Sciences Delhi
- National Institute of Mental Health And Neuro Sciences
Surgery for Re-attaching Severed Body Parts
Surgery for Re-attaching Severed Body Parts
Micro-vascular surgeries are useful in reattaching severed body parts such as finger, hands, or arms by connecting the small blood vessels again and to make sure that the blood circulation is properly restored in the severed part as soon as possible to prevent the death of tissue due to lack of blood supply.
Micro-vascular surgery involves surgery on very minute blood vessels mostly those whose diameter is three to five millimeters. Micro-vascular surgeries mostly performed through an operating microscope which helps to enhance the visibility of the minute blood vessels that needs restoration and to manipulate the minute needles and sutures to fix the blood vessels.
When is micro-vascular surgery done?
Micro-vascular surgery helps people who have amputated body parts like fingers, hands or arms. This surgery needs to performed as soon as possible to prevent the death of tissue. With the help of microvascular surgery, the severed body parts can be reattached to the body and necessary care must be provided so that the reattached part becomes functional within a few months again.
Other than in emergency people who can undergo this surgery are:
- People suffering from certain diseases that cause deformity of the body parts such as cancers (know more about cancers)and other diseases that affect blood vessels, muscles or tissues.
- Congenital absence of tissues
- In people who have infertility caused by an obstruction in the major keyway.
Preoperative care
This surgery can either be performed as emergency surgery, but in cases where this surgery is not performed on an emergency basis must follow the following restrictions to promote speedy recovery:
- Avoid smoking
- Avoid excessive consumption of alcohol
- Take medicines as advised by the doctor
What to expect during the procedure?
This procedure is performed as soon as possible in cases of emergency followed by an X-ray to know the present condition.
For surgery, the patient is first administered general anesthesia. Since microvascular surgery is quite complex and performed under a microscope, the surgery takes around 12-15 hours to reconnect the blood vessels and cut the tissue damage.
Things to take care of post operation
The patient is on intravenous fluids for the next 12-24 hours post-surgery. The patient is not allowed to eat solid food for at least 2 days. Several imaging techniques are required to decide that the procedure was successfully performed.
The patient has to refrain from smoking and drinking alcohol as consumption of alcohol and smoking tobacco slows down the healing process and increases the chances of contracting the infection at the site of the surgery.
After the surgical wounds heal the patient must undergo physiotherapy to make sure that the reconstructed body part is functioning perfectly.
Postoperative complications
- Blood clots
- Allergy to anesthesia
- Embolism especially Pulmonary embolism
- Deep vein thrombosis
- Necrosis of the tissues
- Infection of the wound
- Delayed healing of the surgical wound.
Brain tumour: an overgrowth of cells in brain
Brain tumour: an overgrowth of cells in brain
A brain tumour is an inappropriate term used for any intracranial mass which could either be neoplastic, cystic, inflammatory or syphilitic. These tumours are either benign or non-cancerous, or it is malignant or cancerous.
There are different types of tumours depending on their site of growth and nature. The treatment and symptoms also depend on the site of the overgrowth.
Symptoms
The symptoms vary differently in different people mainly based on their site, rate of growth and the size of the overgrowth. The symptoms that are generally seen in cases of brain tumour are:
- Headaches which gradually becomes severe and there is also an increased frequency of headaches.
- Nausea and sometimes vomiting also.
- The blurring of vision.
- Loss of peripheral vision.
- Loss of sensation in parts of the body
- Difficulty in balancing
- Difficulty with speech
- Sometimes the movement of an arm or legs is also affected.
- Confusion
- Difficulty in hearing or hearing impairment
- Changes in personality and behavior.
- Seizure
- Drowsiness
- Fatigue
- Memory problems
- Sleep problems
- Inability to do daily activities
Causes
The following causes of brain tumour are the following usually:
- Family history
- Exposure to radiation especially radiation from atom bombs and sometimes from the radiation that is given to treat cancer.
- Metastasis of cancer from other sites of the body. The secondary brain tumour is very common in people who have a history of cancer, especially in adults.
Risk factors
The people who are at higher risk of having brain tumour are:
- People who have a history of chickenpox are at lower risk of developing brain tumour.
- Older adults are at higher risk of developing a brain tumour.
- People of the Caucasian race are at higher risk of developing brain tumour.
- African Americans are at higher risk of having meningioma.
- Exposure to certain chemicals increases the risk of developing brain tumour.
- Exposure to radiation increases the risk of brain tumour.
- Family history.
- History of cancer.
Complications
The complications associated with a brain tumour can and sometimes life-threatening too. The complications seen are:
- Obstruction in the flow of cerebrospinal fluid mainly from the third ventricle of the brain leading to death.
- Cerebral hernia
- Hemorrhagic stroke can cause loss of vision, speech, unconsciousness and sometimes paralysis too.
Lifestyle changes to manage symptoms
- Quit smoking tobacco and avoid excessive consumption of alcohol.
- Avoid drugs.
- Exercise regularly.
- Research has shown that taking a vegan diet reduces the risk of cancer.
- Some research states that a ketogenic diet, a diet low in carbohydrates may slow the growth rate of a tumour.
- Maintain a healthy lifestyle.
- Avoid exposure to radiation.
- Avoid carcinogenic chemicals.
- Know about your family medical history.
- Mediation, relaxing music and acupuncture also help to manage symptoms.
- Keep yourself busy and speak to your friends to keep yourself motivated.
- Do consult your doctor if you experience new symptoms and discuss with him your new symptoms.
Migraine: a pulsating headache affecting half skull
Migraine: Symptoms, Causes & Risk factors
Migraine is a common disorder often marked by periodic, unusual unilateral pulsating headaches, which usually begins in childhood or early adult life, and it tends to recur with diminishing frequency in later life. It is also known as hemicrania, which means half skull as it affects half of the head (skull).
There are two closely related types of Migraine.
- Classic Migraine
- Common Migraine
Classic Migraine is one in which an aura or a sensation is felt only by the person and maybe preceded by an attack. The feeling (aura) could either be visual, olfactory, auditory, sensory, or taste hallucination.
An aura does not precede common Migraine.
Migraine Symptoms:
Before the onset, few people experience the following symptoms:
- Mood changes
- Fatigue
- Difficulty in thinking
- Depression
- Sleepiness
- Hungry
- Thirty
- Frequent urination
- Altered libido
Few people experience also experience the following symptoms:
- Increased energy levels
- Increased appetite especially for sweets
- Clarity of thoughts
Symptoms during the attack:
- The headache usually on one side of the head, but sometimes the problem is bilateral.
- Nausea and vomiting, which may last for a day or two.
- Sensitivity to light and noise.
Women during reproductive years experience a migraine at a higher rate, and the headache usually begins during premenstrual tension and fluid retention.
Many people also link their Migraine attack to indigestion caused by a particular food, exposure to bright light, or sometimes to change in air pressure.
Causes:
- Family history
- Allergic hypersensitivity
- Emotional disturbances
The aura which precedes migraine in cases of classical migraine is caused due to the reduction of regional cerebral blood flow in the posterior part of the cerebral hemisphere; usually, it is the same side of the headache.
Migraine Trigger points:
- Hormonal changes, especially in women in their reproductive age.
- Alcoholic beverages.
- Beverages, which are rich in caffeine, such as tea and coffee.
- Bright sunlight or bright lights.
- Loud sounds
- Strong odor
- Lack of sleep
- Intense physical exertion
- Skipping meals
- Certain medicines
- Changes in air pressure
- Excessive consumption of salt
Migraine Risk factors:
People at higher risk of developing this condition are:
- People with a family history.
- Children and young adults are at higher risk.
- Women are at higher risk of developing this condition than men.
Migraine Complications:
- Depression and anxiety
- Sleeplessness
- Vertigo
- Rebound headache
- Serotonin syndrome causes complications like agitation, confusion, diarrhea, twitching of muscles, and tachycardia.
- Stomach ulcer in cases where the patient takes over the counter drugs or in cases of drug abuse.
- It can also lead to migraine induced seizures.
- Migrainous stroke
- Difficulty in breathing
- Numbness
Patient care:
If a person has a migraine attack, he should relax in a quiet place.
It is essential to educate the patient with the techniques for coping with discomfort.
Take medicines as directed by your doctor.
Lifestyle changes to check symptoms:
- Exercise regularly
- Do not skip meals
- Get proper sleep
- Do not overexert
- Reduce stress
- Eat healthy food
Interventional Neurology: A Radio-logical intervention
Interventional Neurology: Types and Complications
Interventional neuroradiology is also known as interventional neurology or endovascular surgical neuroradiology is a medical subspecialty of radiology.
Interventional neurology technique was originally developed in the 1980s by the joint efforts of neurosurgeons and radiologists. Neurosurgeons and radiologist worked together and devised a minimally invasive image-based technique to detect and sometimes also used to treat the diseases of the head, neck, and spine.
The technique of Interventional neurology usually requires catheters and radiology to treat and diagnose different conditions and diseases associated with the central nervous system.
This is a minimally invasive technique which requires a tiny incision in contrary to the large incision as in open surgery.
When is interventional neuroradiology required?
It is useful in a variety of conditions with minimal invasion. The treatment includes treatment of stroke by directly delivering clot bursting medicines directly at the site of the blockage. In cases of Aneurysm of blood vessels, platinum wires are inserted to prevent clotting or rupture of blood vessels. This procedure is mainly used in diseases associated with the central nervous system. Some condition where interventional neuroradiology is suggestive is:
- Metastatic spine tumour
- In cases of the fractured vertebra.
- Arteriovenous malformation Embolism
- Balloon occlusion test
- In cases of angioplasty
- Discogram
- Epidural Injections
- Cisternogram
- Facet block
- Stroke treatment
- Cerebral Embolism treatment
- Myelogram
Pre-procedure care
The patient should know about the procedure and its benefits and risks associated with the procedure. Once the patient agrees with all the terms then the blood samples of the patient are collected to conduct various blood test which includes blood sugar, the coagulation time so that there is no unnecessary blood loss. Blood pressure must also be within the normal range. Doctors may prescribe a few medicines to get all the levels in control.
Types of procedure used
The different types of procedure used by the radioneurologist are:
- Thrombolytic therapy to break clots either in the brain or in the blood vessels or anywhere else in the body.
- Endovascular coiling is a technique where a very thin wire that has been inserted in the Brain Aneurysm to prevent blood flow. The clipping or coiling of the thin platinum wire helps to cure Aneurysm and prevent the rupture of the affected blood vessel.
- Minimal invasive spine surgery is useful in treating disorders associated with the spine including fracture, tumour, and compression of the spine.
- Cerebral angiography helps the doctors to study the blood flow in one’s brain.
- Carotid artery stenting or angioplasty which helps in reopening the narrow arteries.
Postoperative care
After the procedure, the patient has to take rest for a few days and refrain from lifting heavyweight and prevent overexertion. The patient is also advised not to take stress and exercise regularly as advised by the physiotherapist.
Complications
The complications usually seen after this procedure are:
- Hemorrhage
- Intravascular blood clots
- Increased risk of cancer
- Fever
- Infections at the site of incision
- Difficulty in breathing
Epilepsy: A marker of Recurrent Seizures
Epilepsy: Symptoms, Risk factors and Causes
Epilepsy is a condition that is marked by recurrent seizures caused due to repetitive abnormal electrical discharge within the brain. Epilepsy is most common among children and older adults, young adults are rarely affected. It is one of the most common neurological disorder. Epilepsy can affect anyone irrespective of their age, sex or race.
The symptoms of epilepsy also vary in different people. Few experience mild symptoms during a seizure-like stare blankly while the others may experience twitching of muscles of hands and legs.
A single episode of seizure does not mean that a person is having epilepsy at least two unprovoked seizure is usually required to diagnose epilepsy.
Epilepsy is incurable generally but with regular medications the symptoms are manageable.
Types of seizure:
An epileptic seizure is divided broadly under two headings:
- Generalized seizure
- Focal or partial seizure
Generalized seizure: This type of seizure results from electrical discharges that affect both the hemispheres of the brain.
A tonic-clonic seizure is a type of generalized seizure in which there is loss of consciousness with violent movements of the extremities, and in absence seizure which is also a type of generalized seizure, there are brief interruptions of awareness and activity.
Focal or partial seizure: The seizure activity in this type is limited only to one hemisphere of the brain. They may generalize in some instances. When the patient remains awake during a seizure episode the seizure is known as simple and partial but if the patient loses consciousness after a partial seizure the syndrome is known as complex and partial.
Symptoms:
The symptoms vary in different people. The symptoms observed are:
- Convulsion without temperature.
- Blackout or loss of consciousness
- Sudden stiffness of the body
- Sudden bouts of blinking
- Uncontrollable jerking movements of the extremities
- Fear and anxiety
- Changes in the senses of touch, smell, and sound.
- Extreme weakness of muscles
Causes:
- Epilepsy acquired brain may develop due to congenital or acquired brain diseases.
- Genetic influence
- Injury or trauma of the head
- Brain tumours, brain abscesses, stroke or brain trauma.
- Encephalitis or meningitis
- Prenatal injury.
- Anoxic brain
Risk factors:
The following people are at higher risk of developing the ailment:
- Young children
- Older adults
- Family history of epilepsy
- High fever with seizure in childhood
- Injury or trauma in head
- People having strokes or other vascular diseases
- Brain infections
- Dementia increases the risk of epilepsy in older adults
Complications:
The complications often associated with epilepsy are:
- Falling and injuring themselves
- Drowning
- Depression with suicidal tendencies
- Anxiety
- Accidents
- Complications during pregnancy and giving birth to a child with birth defects.
- Sudden unexpected death
When to see a doctor?
Visit the doctor at the earliest if you experience the following symptoms:
- A seizure lasting for more than four minutes.
- Two consecutive seizure immediately.
- If you have a high fever.
- During pregnancy.
- If you have abnormal blood glucose levels.
Spine Disc Replacement: Surgery for Pain Relief
Spine Disc Replacement: Surgery for Pain Relief
Back and neck pain is a very common condition, but only a few people with back pain or neck pain have to opt for surgery to get relief. However, surgery is not indicated for all, Spine Disc Replacement is indicative for only those patients who are having back or neck pain for more than six months and there is no relief in symptoms even after medication. (How does back pain affect productivity?)
The disc that can be replaced are:
- Lumbar disc, and
- Cervical disc
Cervical Disc Replacement
Indications
Cervical degenerative disc disease with clinical features of cervical radiculopathy, or myelopathy which has shown no improvement to conservative treatment.
Contraindications
- People having spondylosis or foraminal stenosis.
- In cases where there is compression of spinal nerve
- People having diffuse ossification of posterior longitudinal ligament
- Severe kyphotic deformity
- Active infections
- Malignancy
- Inflammatory spondyloarthropathy
- Allergy to implant materials
- Metabolic bone disease like Osteoporosis, renal osteodystrophy
- Osteoporosis
The risk associated with cervical disc replacement:
- Bleeding
- Infections
- Nerve injury
- Spinal fluid leak
- Voice change
- Difficulty in breathing and swallowing
Complications of cervical disc replacement surgery:
- Fever
- Headache
- Pain that does not respond to pain killers.
- Redness at the site of incision
- Numbness and weakness
- Difficulty in breathing and swallowing
- Hoarseness
Lumbar Disc Replacement:
Indications:
Lumbar disc replacement is indicated for people with back pain mostly from 1 or 2 disks in the lower spine and is not excessively overweight.
Contraindication
- Overweight
- Previous history of spine fusion
- History of spine surgery
- Spondylosis
- Joint disease
- Spinal deformity such as scoliosis
- History of failed spine surgery
- People younger than 60 years of age.
The risk associated with lumbar disc replacement:
- Infections
- Narrowing of spine
- Stiffness of spine
- Blood clots in legs due to decreased activities
Complications of lumbar disc replacement surgery:
- Infections
- Dislocation of the disc
- Bladder problems
- Bleeding
- Vertebra fracture
- Male sexual dysfunction
- Phlebitis
- Spinal fluid leak
- Slow intestinal movement
- Nerve or Spinal cord damage
Spine Disc Replacement Pre-surgery preparation
- Avoid smoking at least a few days before surgery
- Inform the doctor about the medicines taken
- Avoid any food or drink at least 6 hours before surgery
What to expect during the procedure:
- Anesthesia is administered
- The surgeons make an incision near the site of disc replacement
- Replacement of the old disc with a new one
- Suturing of the incision together by catgut
Postoperative care:
- The patient is shifted to the ICU post-operation.
- The patient stays about 4-5 days in the hospital.
- Provide necessary support for the movement of the patient.
- Start solid food gradually and in case of cervical disc replacement liquid should be started only once the pain starts to subside.
- Encourage physical activities slowly.
- Avoid contacting infections.
When to see a doctor?
Do visit the doctor if you experience any of the complications or any new symptoms or aggravation of old symptoms.
Neurological endoscopy or Neuroendoscopy
Neuroendoscopy: Risk factors, Diagnosis, and Treatment
Neurological-endoscopy-or-Neuroendoscopy is a boon for brain surgery especially for those parts of the brain that cannot be reached through traditional surgical methods. It is a minimally invasive surgical process in which a surgeon removes the tumor through small holes either in the skull or through mouth or nose.
A telescope equipped with a high-resolution camera is used to do Neuroendoscopy. The high-resolution camera helps the surgeon to have access to the tumor.
Neuroendoscopy was first performed a hundred years in around 1910 by a urologist for choroid plexus surgery in a patient having hydrocephalus. Neuroendoscopy plays a significant role especially in the treatment of pineal gland tumor.
In what kind of brain tumor neurological endoscopy used?
Neurological endoscopy is useful for the following brain tumor surgery:
- Pineal gland region tumor
- Pituitary tumor
- Tumor at the base of the skull
- Rathke’s cleft cysts
- Ventricular tumor
Indications for neurological endoscopy
Clear visualization of anatomy is very important to do an endoscopy. With crystal clear cerebrospinal fluid lesions in Ventricular system subarachnoid space and Cystic lesion give the best condition for endoscopy.
Hydrocephalus small intraventricular lesion space occupying and arachnoid and parenchymal cysts are successfully treated using neuro-endoscopy.
Endoscopy along with neuronavigation together increases the chances of the accuracy of the surgery and it also is a positive sign that this technique will expand in the future.
What to expect during the procedure of neurological endoscopy ?
For the surgery, the patient lies down in supine position with the slightly anteflexed head which rests on a horse-shoe shaped pillow after inducing anesthesia. The best place for entry of the endoscope is determined through CT scan and MRI to avoid unnecessary brain cell trauma.
The procedure of neuroendoscopy uses an endoscopy which is a small flexible tube, which has a small camera attached to it along with a small set of surgical instruments.
This procedure is either used to remove tissue samples mostly for biopsy or to remove a part of the tumour.
The small holes made during Neuroendoscopy are sutured together and are tended.
The optical cable used while surgery must be of the correct size. Correct light intensity is used during Neuroendoscopy. The procedure is done at a low temperature to avoid thermal injuries to the neighboring brain cells.
Postoperative care
Post operation the patient is shifted in the ICU and there they spend at least one night.
Introduce solid food slowly.
Avoid infection
Complications of neurological endoscopy
Prolonged operation time can cause damage to the neighboring brain cell due to the rapid rise of temperature in the site of operation and can further lead to thermal injury to the neighboring brain cells.
Pros of neuroendoscopy
Neuroendoscopy is a minimally invasive technique thus the chances of complications are quite low and the healing is quite fast.
