Doctor in Appolo Hospital
Treatment of Nerve And Muscle Disorders
Treatment of Paralysis
Cerebral Palsy Treatment
Brain Tumor Surgery
Electroconvulsive Therapy (Ect) Treatment
Surgery Of The Facial Nerve
Radiofrequency Neurotomy Procedure
Spine Surgery Treatment
Traumatic Brain Injury (Tbi) Treatment
Treatment of Traumatic Brain Injury (Tbi)
Assistive Walking Device Training
Vagus Nerve Stimulation ( Epilepsy )
Deep Brain Stimulation Procedure
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Insomnia is a disorder where a person has difficulty sleeping. One can have problem falling asleep or staying asleep for long. Some people also have disturbed sleep. This can be a major problem as due to lack of sleep one feels tired and fatigued all day.
Recurring cases of insomnia hamper your daily activities and interfere with the smooth functioning of your life. Therefore, this condition should not be ignored and treated immediately.
Here are the various ways to treat insomnia:
Non-Medical (Cognitive and Behavioral treatment)
Several psychological and behavioral techniques can be used for the treatment of insomnia. Many of these methods can be easily self-taught and others require a therapist to be carried out properly.
- Relaxation training, which is also called progressive muscle relaxation involves the patient to tense and relax his muscles systematically in various parts or regions of the body. Relaxation techniques, such as breathing exercises, various forms of meditation, mindfulness and guided imagery are used for treating insomnia people. The use of audio recordings for guidance in these techniques is quite popular.
- Stimulus control enables building an association between the bedroom and sleep. This is done by limiting several kinds of activities done in a bedroom. This may include going to bed only when very sleepy and leaving bed if you cannot sleep within twenty minutes. A strict bedtime and wake up time schedule has to be maintained.
- Cognitive behavioral therapy or CBT involves changes in behavior like maintaining a strict sleep time schedule, elimination of afternoon naps and other habits related to sleep. A cognitive component is also added to this method. Unhealthy beliefs and fear regarding sleep are challenged and positive, rational thinking is encouraged. CBT is a very effective procedure for treating insomnia and the track record regarding success is high.
- Changes in lifestyle are required to treat insomnia and prevent recurrence of insomnia, you should change certain habits and start some new practices. You should limit your intake of caffeine, alcohol and nicotine. Do not consume coffee or tea before going to sleep and avoid smoking. The habits may be stimulating and will keep you awake. Your diet should be balanced. You should avoid having rich and spicy food before going to bed. Avoid late meals and maintain a proper schedule for meals. Regular exercise can improve the symptoms of insomnia and you should try to work out every day.
Medical Treatment: There are many forms of medicines, which can treat insomnia. This includes over-the-counter medicines, as well as prescribed medicines. The type of medicine required completely depends on the severity and symptoms of your insomnia and other factors related to health. Therefore, you must consult a doctor before having any kind of medicine for treating insomnia.
The most common medicines for insomnia, which are usually prescribed by doctors are benzodiazepine hypnotics, non-benzodiazepine hypnotics and melatonin receptor agonists. However, medicines should only be taken after consulting with a specialist. Insomnia not only affects your health but also interferes with all your daily activities. Proper treatment should be taken to treat the same.
Acoustic neuroma is the development of noncancerous and slow-growing tumors on the main, vestibular nerve that travels from the inner ear to the brain, connecting the two organs. They are also known as vestibular schwannoma, as it arises from Schwann cells covering the vestibular nerve. It rarely grows rapidly or attains a large enough size that can press against the brain and interfere with the vital functions of the brain. Since the tumor is benign, the patient can be assured that it won’t spread to the other parts of the body; however, they can grow large enough to disrupt the normal function of the body.
The pressure from the acoustic neuroma on the main nerve can cause loss of hearing, a constant ringing in the ear and unsteadiness. As per a report published by the Acoustic Neuroma Association, 1 out of every 50,000 people suffers from this condition.
Risk factors for acoustic neuroma
Acoustic neuroma does not have quite as many risk factors. The only established risk factor for acoustic neuroma is having a parent who suffers from the rare genetic disorder neurofibromatosis 2 (NF2). However, having said that, neurofibromatosis 2 (NF2) accounts for only 5 percent of the reported cases. In most of the cases, it has been found that the tumors appear spontaneously without any indication of a family member having this disease or any medical history of the same.
The development of noncancerous tumors on the ear nerves as well as other nerves in the body is scientifically supported as a characteristic indication of neurofibromatosis 2 (NF2). Neurofibromatosis 2 (NF2) is also termed as an autosomal dominant disorder, which indicates that the mutated gene can pass from just one parent. Each of the children has a fifty-fifty chance of inheriting the disease.
However, scientists and doctors have failed to identify why specific people get these tumors. They have reached a generic conclusion about the risk factors, which may include:
- Loud noises near the ear.
- A parathyroid neuroma, which is a similar benign tumor of the thyroid.
- A chance of exposure to low levels of radiation in the childhood.
How to diagnose the risk factors for acoustic neuroma?
If you are experiencing loss of hearing or other neurological symptoms, try to keep track of them. Later on, mention them to your doctor for a proper diagnosis. A detailed history of the symptoms will help your doctor. Your doctor will perform a hearing test to check whether you have an acoustic neuroma. Then the doctor may perform a brainstem auditory evoked response tests along with an electronystagmography to detect any changes in eye movement, caused due to the inner ear. MRI and CT scans are also quite common diagnoses methods for acoustic neuroma.
- Traumatic Brain Injury - Happens due to trauma
- Anoxic/Hypoxic brain injury - Happens due to decreased blood or oxygen supply to the brain.
- Ischemic or hemorrhagic cerebrovascular accident (commonly referred to as stroke) - Happens due to clots occluding the blood vessels in the brain or due to bleeding of blood vessels in the brain
- Brain tumors and metastasis (spreading of cancer) to the brain
- Vascular malformations of the brain such as Arteriovenous malformation, aneurysm etc -
- Brain infections
- Autoimmune conditions such as Multiple Sclerosis and auto-immune encephalitis -
- Toxic/metabolic causes such as post transplantation, sepsis, liver failure and kidney failure
- Basically any injury or illness that affects your brain function for a prolonged period of time causing temporary or permanant damage
Usually individuals affected by these conditions can have a number of symptoms directly related to the brain injury such as
- One-sided or both sided weakness and numbness of the arms and legs
- Pain and tightness of the arms and legs
- Difficulty with speech
- Impaired consciousness (i.e. impaired arousal)
- Cognitive impairment such as memory problems, slow thinking skills, problems with attention
- Changes in their behavior such as aggression
- Changes in their mood such as depression and anxiety
- Difficulty in swallowing
- Bladder and bowel incontinence
- Visual problem
- Hearing problem
There are medical complications that can be noted a few weeks or months after a brain injury. Some common ones include
- Urinary tract infection
- Deep vein thrombosis – blood clot in the veins of your arms and legs
- Pulmonary embolus – blood clot in your lungs
- Pressure ulcers
- Heterotopic ossification – a condition which causes stiffness of your joints
- Post-stroke shoulder pain – shoulder pain in the weak arm
- Spasticity – tightness of the muscles of the affected arm and leg
- Paroxysmal sympathetic hyperactivity – a condition which causes fluctuations in your blood pressure, heart rate, and also causes abnormal stiffness of the arms and legs
- Hydrocephalus – a condition where fluid builds up in your brain
HOW REHABILITATION CAN HELP?
A comprehensive, interdisciplinary team approach (i.e. care being provided by various disciplines in a coordinated fashion) with Physician (Physiatrist), Physiotherapist, Occupational Therapist, Speech and Language Therapist, Neuropsychologist, Nutritionist and a Nurse can help reduce your symptoms directly related to the injury as well as prevent and treat common medical complications post brain injury. Not all patients will require all services and usually, a combination of these services is required for an individual patient.
Patients can be evaluated by the Physician first to determine the nature and severity of the medical condition then come up with a treatment plan that best suits them. Depending on the patient’s symptoms and medical complications (listed above), the treatment plan will include recommending therapy services, prescribing medications and performing injections. Medications are commonly prescribed for medical complications as well as to reduce symptoms directly related to brain injury such as arm and leg weakness, muscle tightness, speech impairment, mood and behavior issues, cognitive impairment and impaired arousal. The physician performs injections such as tendon injections, joint injections for joint or muscle pain as well as Botulinum toxin (commonly referred as Botox injections) and nerve block injections to help relieve muscle and tendon tightness.
A Physiotherapist will focus on various physical exercises to improve weakness in the arms and legs, improve their walking and balance and to reduce muscle tightness. They might use physical modalities to reduce pain and inflammation, muscle and tendon tightness and prevent muscle atrophy. They can also fit you with an orthosis to reduce muscle tightness as well as improve your walking and arm function.
An Occupational Therapist will focus on various physical activities required for daily living for patients with severe physical and/or cognitive impairment and also teach cognitive exercises thereby compensating the cognitive deficits. Visual Training exercises are provided to individuals with visual impairment due to the neurological problem. The final phase of treatment involves patient training for successful community integration (education, employment etc).
A Speech Language Pathologist (commonly referred to as a Speech and Language Therapist), will evaluate the patient’s speech, communication and swallowing skills. The treatment plan is broken down after an initial evaluation. The program will vary depending on the extent of the injury, the stage of recovery, and the individual’s particular areas of difficulty. Specific retraining and compensatory exercises are taught to improve the above skills. However, the major focus is on helping the individual gain back his/her quality of life.
A Neuropsychologist evaluates patients with depression and anxiety, that is commonly seen after any major life-changing illness or injury and guides them through the process of rehabilitation thereby improving their quality of life through motivation and counseling. Performing an in-depth cognitive assessment and planning cognitive re-training exercises and compensatory strategies is also a major treatment aspect of a Neuropsychologist.
Malnutrition or undernourishment is a common problem in this population. For optimal recovery, a Nutritionist recommends an appropriate intake of nutrition.
A Rehabilitation Nurse trains patients with central nervous system injury to manage their bowel and bladder independently. Performing and training wound care management for patients with pressure ulcers are also handled by a Rehabilitation Nurse.
EXPECTATIONS OF RECOVERY
Depending on the severity and chronicity (time duration since injury/illness) of the injury/illness, your recovery time may differ. Complete neurological recovery is often possible if the injury is mild to moderate. In the case of a moderate to severe injury, a complete neurological recovery may not be possible and therefore the goal will be to help you be as independent as possible and integrate you into the community despite your physical and/or cognitive limitation. If the injury is too severe, then the goal would be to improve your quality of life by helping you be as independent as possible with your day to day living, decrease pain and prevent complications.
Hi, How long can an end stage dementia patient can live? She is 90 years old. She is eating food and drinking water well. But for every activities she needs help. Most of the time she do not open eyes and keep saying she is not well. Can not recognize anything or anyone. But when we give food she eats it. She use to urinate in bed so we are using diapers. She talks rarely. Always in a doz off state when waked up. Is also having pain around hips and taking medicines for that.
I HAVE chronic migraine problem last 10 years. I took many types of medicines but no result. How will be cure? Please reply.
Hello Dr. Mera L4-L5 nas dab rahi h main physiotherapy kra rahi hu but koi fayda ni h. Dr. Dry needling karne ko bol rhe kya ye krana sahi hoga? Isse aaram milega? Please suggest me. Thanks.
Sleep is the most essential part of our lives because it is the time when our body gets rejuvenated and recharged. However, due to numerous reasons, quite a few individuals fail to achieve proper sleep or any sleep at all. This condition in which a person is unable to sleep at night can be termed as insomnia.
Causes of insomnia
There can be varied reasons for different people that can cause insomnia.
- Unhealthy lifestyle i.e. improper sleep cycle, improper food habits, untimely naps, substance abuse etc.
- Medical conditions like sinus allergies, gastrointestinal problems, endocrine problems, arthritis, asthma, neurological condition like Parkinson’s disease, chronic back pain etc.
- Psychological conditions like depression and anxiety
- Certain medications aimed to cure other health problems
In case of the treatable medical reasons, insomnia is gone once the problem is treated. However, for people who have no idea as to why they suffer from insomnia, here are certain tips that can help in fighting it.
Lifestyle changes to cure insomnia
Starting with a significant lifestyle change can be a great way to change one’s sleep cycles and get a good night’s sleep.
- Maintain a proper and healthy diet, with more fruits and vegetables and less carbs and fat.
- Try to sleep and wake up at the same time everyday (despite the fact that you may not feel sleepy). This will train the body and regulate the body clock.
- Avoid afternoon naps or any short naps during the day.
- Exercise daily for at least 30 minutes.
- Avoid caffeine as it has contains properties that keeps a person up for long hours.
- Avoid intake of alcohol and nicotine. Although alcohol is associated with fun and partying, it is actually a depressant and causes improper sleep.
- Avoid any meal right before bed time.
Tips that can help
- Take a good, warm shower right before sleep.
- Ask your partner to give you a nice massage before bedtime.
- Restrict bed activities to sleep and sex only, nothing more.
- Make a really comfortable and inviting sleep environment.
- Try and get rid of all your worries before going to bed.
- Reduce stress using a number of stress reduction therapies like meditation, deep breathing, progressive muscle relaxation techniques, etc.
Apart from the lifestyle changes and the tips that will help you gain a better sleep, there is another therapy, which may be useful. It is called the cognitive behavioural therapy. This therapy can give essential knowledge about sleep and help achieve normal sleep routines.