Devshi Visana-Arpan Neurology Center

After a tough workout session or a strenuous day at the office, your muscles may feel floppy and exhausted until you have given them a chance to rest. However, persistent muscle weakness with no apparent cause or explanation can be a sign of an underlying medical problem.

What causes muscle weakness?
Voluntary muscle contractions and movement are generated when the brain sends a signal through your spinal cord and nerves to the particular muscle. If there are any hindrances in the connections between them, it can result in muscle weakness. However hard you try, the muscle is such cases becomes abnormal.

Here are some common causes of muscle weakness:

1. Lack of Use: One of the most common causes of muscle weakness, lack of muscle fitness may occur as a result of a sedentary lifestyle. If the muscles are not used, then the fibers are partially replaced with fat.
2. Ageing: As we age, our muscles tend to get weaker and lose strength. Muscles become bulky and recovery times during injury are greater. However, with physical activity, it is still possible to increase the muscle power. So stay active and instill strength in your muscles.
3. Infections: Infections and inflammation can cause temporary muscle fatigue. Even though recovery is quick, if the infection is severe the weakness can last for some time. Without proper care, it can lead to permanent damage.
4. Pregnancy: During and just after pregnancy, high levels of steroid in the blood and low levels of iron can cause muscle tiredness. Lower back pain is common during pregnancy and all your muscles may feel floppy.
5. Chronic Diseases: With conditions of diabetes, heart disease, kidney disease and anemia, it can lead to muscle weakness by thwarting the essential blood or nutrient supply to the muscles. Also, chronic pain related ailments cause weakness.
6. Injuries: Injury or trauma such as sporting injuries, pulls and sprains can deter the muscles. Along with localized pain, it can also lead to muscle weakness if not taken care of properly.
7. Sleep Disorders: With disturbed or reduced sleep there is a general sense of tiredness that leads to fatigue in the muscles. Insomnia, anxiety, depression and other mental disorders also affect the muscles a great deal.
8. Conditions affecting Nerves: Conditions like Myasthenia gravis or motor neuron disease affects the nerves and thereby fail to relay signals to the muscles, leading to weakness.
9. Genetic disorder affecting muscles: There are also certain inherited diseases which can affect the muscles like muscular dystrophy.
10. Spine-related disorders: Conditions like slip disc and other disorders affect the muscles served by the irritated or compressed nerves of the spinal cord. In case you have a concern or query you can always consult an expert & get answers to your questions!

Loss of sensation refers to numbness in a particular or several areas of the body. Individuals suffering from the condition becomes incapable of feeling touch, temperature, pain, and vibration in the affected regions of the body. When this happens, it may lead to issues with balance, walking, driving and coordination which makes them more susceptible to injuries. If numbness is present for a long span of time, it may cause a host of issues. Such people are not able to notice infections, ulcers, and injuries since they are not able to feel pain at all which in most cases leads to further complications.

How does the pathway for sensation work?
In order to feel the normal sensations, the sensory receptors are supposed to detect the information in as well as around the body. These receptors should send the signal through the sensory nerves and the nerve roots which are formed by joining together the sensory nerves into thick and short branches. It may also reach through the brain stem and to the area of the brain which is in charge of perceiving and interpreting the sensory signals.

What are the causes of partial or complete loss of sensation?

• Different conditions can lead to numbness, and they may include:
• Blocking or reducing the supply of blood to the nerves present in the body resulting from a stroke
• Damage in the pathway for sensation which may result from sudden injuries or hereditary problems affecting the nerves called Friedriech ataxia.
• Compression in the pathways of the nerve or infection in the nerve which typically occurs in HIV infection or Lyme disease
• Metabolic abnormalities which occur in high blood sugar, vitamin B12 deficiency, and arsenic poisoning.

Sometimes, excessive pressure on various parts of the neural pathway may lead to loss of sensation. When a person repeats the same movements over and over again, it leads to internal swelling which may cause partial or complete loss of sensation. Herniation or rupture of the disk in the spine can cause osteoarthritis or narrowing of the passageway of the spinal cord. Lastly, an injury or a tumor or formation of pus near the spinal cord may result in this condition as well.

What are the treatment options for partial or complete loss of sensation?
When the sensations are impaired, the treatments for the problem depends on the cause of the problem. Sometimes, doctors recommend painkillers for treating abnormal sensations. One must also practice careful and proper foot care which also includes cutting the toenails in a podiatrist's office. But in case a pinched nerve or sciatica is the cause of impaired sensation, surgery can help in relieving the conditions to a great extent.

Thus, a loss of sensation is not to be overlooked and a doctor is to be consulted at the earliest to avoid complications. In case you have a concern or query you can always consult an expert & get answers to your questions!

A migraine often causes throbbing pain at one side of the head accompanied by sensitivity to sound and light, nausea and vomiting. The pain can last from a few hours to few days. Some warning signs of the pain take over include tingling of the leg or face, flashes of light and blind spots. Medication can help in avoiding the pain or manage it considerably.

Diagnosis:
Detection of a migraine is fairly easy for a medical professional. If a patient has a family history of a migraine, a doctor can prescribe the following to lock in on the diagnosis:

• Blood tests: Through blood tests, a doctor tries to understand any possible problems in the blood vessels, spinal cord or presence of other toxins in the system
• Magnetic Resonance Imaging: Better known as MRI, this is a process of capturing the detailed image of the blood vessels and the brain. It readily detects any possible problems related to a migraine.
• Computerized tomography: More commonly known as CT scan, this is a process of capturing an image through a line of x-rays to detect any possible problems related to a migraine.
• Lumbar puncture: This test is prescribed in extreme cases when a doctor suspects that there is a possible chance of bleeding in the brain.

What are the treatment options available?
There are two kinds of medications available- preventive medication and pain relieving medication. The treatment strategy is decided based on the frequency of the headaches and other health factors.

Some pain reliever medication includes triptan, ergots, opioid, glucocorticoids, anti-nausea medications etc. These medicines constrict the blood vessels and block the pathways of the pain in the brain cells. While some medicines are required to be consumed immediately after the symptoms starts, some should be taken regularly to avoid the pain in the first place. These pain relievers have side effects and should be consumed after prior discussion with a doctor.

Preventive medication, on the other hand, is only suggested by a doctor when a patient suffers from a migraine twice or more in a month, the pain lasts for more than 12 hours and the pain relievers do not work. Some of the common group of medicines that are suggested for these set of patients include cardiovascular drugs, anti-seizure drugs, anti-depressants etc.

Alternative medicine approach:
Alternative medicines are often witnessed to fetch positive results for migraine patients:

• Acupuncture: this form of treatment involves inserting thin needles into the skin at various points to give relief from pain
• Cognitive behavioral therapy: This is a form of treatment which focuses on perceiving pain with behavioral changes.
• Biofeedback: This is a relaxation technique that teaches to control physical responses such as pain, stress, muscle contraction etc.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Alzheimer's disease is a neurodegenerative disorder that causes a degradation and eventually death of the brain cells. People with Alzheimer's disease suffer from a memory loss. There is also a progressive decline in the cognitive capacity of the brain.Today, Alzheimer's disease and dementia have become almost synonymous with old age. It is a heartbreaking experience to see aged people with Alzheimer's disease. They have little or no memory of the present time, of their loved people or the things around them.

The Alzheimer's disease starts off as a mild condition and then gradually progresses through stages. In this article, we will discuss the different stages associated with Alzheimer's disease.

1. The first stage: This stage shows no significant changes in the affected person. Thus, without any diagnostic tests (such as a PET scan), it will be difficult to detect the condition in the initial stage.
2. The second stage: This stage brings about some changes in the person. The person might misplace things or may even forget words (something that is often brushed aside as a small problem). However, this seldom interferes with their daily activities. Like the first stage, this stage, in most cases, goes unnoticed.
3. The third stage: This is the stage that brings about visible changes in the person concerned such as
   • The person experiences difficulties in trying to organize things.
   • They forget things they have read, or heard just a few seconds back.
   • In some cases, the person may not be able to recollect a person's name they have just met.
   • Some people may end up repeating the same question over and over again.
4. The fourth stage: This stage marks a further decline in the mental health. The person gets forgetful about himself or herself. They also start mixing up with the dates and months or makes major goof up while cooking (misses out on ingredients).
5. The fifth stage: The mental deterioration reaches a step further. The person slowly starts forgetting about the present, such as their address, the time of the day, their profession and even phone numbers.
6. The sixth stage: The problem is getting worse. Hallucination is slowly setting in. The person is starting to forget people and their faces, mixing one identity with another.
7. The seventh stage: The final and unfortunately, the worst stage. The person stops talking to people, eating, or even walking. They stay confined to their world, oblivious of their immediate surrounding.

Dealing with an Alzheimer patient

• In addition to the treatment and medication, a person with Alzheimer's disease needs the love, care, and support of their close and dear ones. Isolating them will only worsen the situation.
• It may not be easy to deal with an Alzheimer's patient as the disease progresses, but do not be rude to them. Give them the confidence.
• Always keep a paper containing their name, address and emergency contact number in their wallet.
• People after the age of 50 should undergo regular health check ups.

In case you have a concern or query you can always consult an expert & get answers to your questions!

As children, you have probably learnt that paralysis is complete inability to move, sense, touch or control other bodily sensations. But little did we know that paralysis comes in many forms depending on the extent to which a person is immobilized. So, what is the difference between partial and total paralysis?

What is Total Paralysis?
Whether temporary or permanent, paralysis is the inability to move part of the body due to nerve damage. However it does not mean that people with total paralysis cannot move any parts of the body – they can still use their faces and necks. The extensive form of paralysis is typically referred to as quadriplegia, which involves diminished or absence of movement in the trunk, arms, legs, hands and feet. Some common symptoms of total paralysis are as follows:

• Difficulty swallowing
• Unable to control bowels and bladder
• Pain anywhere in the body
• No sensation below the site of injury
• Difficulty breathing

What is partial paralysis?
A smaller portion of the body is affected by partial paralysis. One of the most common types of partial paralysis is Paraplegia that occurs below the waist. If affects both the legs, hips and other functions. Other forms of partial paralysis can be Monoplegia where a single area like one limb gets affected and Hemiplegia where parts of the body on the same side get affected. Some common symptoms of partial paralysis are as follows:

• Inability to walk
• Difficulty with sexual functioning
• Pain below the site of injury
• Unable to feel or move your legs or arms

How to Predict the type of paralysis?
The location of the injury or site of nerve damage will usually determine the type of paralysis. Damages in the cervical spinal cord almost inevitably lead to total paralysis associated with quadriplegia. The higher the injury is located, the more extensive the paralysis will be. Lower injuries commonly lead to partial paralysis. The prognosis is generally much better with this type of paralysis. With proper care and therapy, individuals may experience intermittent difficulties with movement and can regain.

Can paralysis be treated?
Whether it is total paralysis or partial paralysis, the positive prognosis is certainly possible, given the condition of the patient and other factors. Physical therapy involves teaching the brain and spinal cord to work around the damage and also aid neuron healing over time. Paralysis can be classified under a number of ways and the most basic classification is that of partial or complete paralysis. Talk to your doctor to understand what type of paralysis you have and adopt a positive outlook to help you towards recovery.

In case you have a concern or query you can always consult an expert & get answers to your questions!

When particular nerve cells in the brain don't function properly, it leads to epilepsy, which is a common brain disorder. There are several variants of epilepsy, and the one that you are suffering from would play a major role in the type of seizure you are likely to have. Here are the two most common type of seizures:

Common types of Seizures

• Generalized seizures: This type of seizures take place when nerve cells on both sides of the brain start misfiring. They may lead to black out, fall or muscle spasms.
• Focal seizures: It starts in a particular area of the brain, and the names of the seizure are based on the affected area of the brain. They may lead to both emotional and physical effects which may affect the way a person feels or sees or hear things that have no real presence. In particular cases, the symptoms of focal seizures are regarded of some other kinds of mental or nervous disorder.

Seizures are not considered an either-or thing since some people tend to have a particular type of seizure which gradually alters its course. It is not always easy to classify certain types of seizures which are called unknown-onset seizures and may lead to both physical and sensory symptoms. Both focal and generalized seizures can be categorized into various groups. The most common are listed below:

Subcategories of focal and generalized seizures

• Simple focal seizures: It may change how the senses read the surroundings of a person. It can make a familiar taste or smell appear strange. Some people feel dizzy or visualize flashes of light or make the affected individual feel nauseated or sweaty.
• Complex focal seizures: It normally happens when a part of the brain which controls emotion and memory gets affected. The affected person may feel awake even when he has lost consciousness. It can take several minutes for a person to come out of the problem.

Secondary generalized seizures: It starts when a part of the brain spreads to the nerve cells. They may lead to a few physical symptoms including muscle slackness and convulsions.
On the other hand, there are six variants of generalized seizures:

• Clinic seizure: The muscles tend to have spasms which make a face, neck, and arms jerk rhythmically. It can last for minutes together.
• Tonic-clonic seizure: These are the most notable type of seizures and leads to stiffening of the body, jerking and shaking along with the loss of consciousness. It can last between 1 to 3 minutes, and in case they go for a longer span, it is important to seek immediate medical attention. It may lead to breathing issues and may cause the person to bite his tongue or cheek.
• Tonic seizures: When the muscled in the legs or arms or trunk tense up for more than 20 seconds, it is called a tonic seizure. If the affected person is in standing position, he or she may end up falling.

Other types of generalized seizure include atonic seizure, absence seizure and myoclonic seizure which are commonly seen in people who have epilepsy. If you wish to discuss about any specific problem, you can consult a Neurologist.