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Dr. Satish

Neurosurgeon, Bangalore

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Dr. Satish Neurosurgeon, Bangalore
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
More about Dr. Satish
Dr. Satish is an experienced Neurosurgeon in Banashankari, Bangalore. You can meet Dr. Satish personally at Radhakrishna Multispeciality Hospital(Gastroenterologist) in Banashankari, Bangalore. Save your time and book an appointment online with Dr. Satish on Lybrate.com.

Lybrate.com has a number of highly qualified Neurosurgeons in India. You will find Neurosurgeons with more than 36 years of experience on Lybrate.com. You can find Neurosurgeons online in Bangalore and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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#3\4, Sunrise Towers, JP Road, Giri Nagar, Banashankari 3rd Stage. Landmark: Opp. Canara BankBangalore Get Directions
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I am suffering from migraine from last few years. I could not find any solutions to that. I haven't got any treatment but it comes and goes suddenly. Won't let me eat frozen food. please help.

MBBS, MD - Anaesthesiology, FIPM, Fellowship in palliative medicine, certificate in interventional pain management
Pain Management Specialist, Pune
You seem to have migraine triggered by frozen foods. You should definitely avoid them. Migraine headache is characterised by unilateral pulsating headache associated with nause/vomiting and photophobia / phonophobia. There are triggers for migraine like sun exposure, certain foods or smell, lack of sleep, excess caffeine etc. The triggers are variable for different patients. Migraine attacks can be managed by simple painkillers like paracetamol but in resistant cases drugs like Sumatriptan may be needed. For frequent episodes of migraine preventive medications are to be taken by prescription. There are various medicines available for this and if control is not achieved with one medicine another drug is to be added. Don't take painkillers daily for migraine headaches, it's better to take the preventive medicines. Painkillers on long term basis can further aggravate the migraine headache into Medication Overuse Headace (Read my health tip on Medication Overuse Headache) Follow these lifestyle changes to avoid migraine headache 1. Maintain regular sleep wake cycle, even on holiday's. 2. Don't skip meals. Take regular healthy diet with adequate fluids 3. Do not consume excess caffeine / carbohydrates / alcohol or smoke. 4. Exercise daily (aerobics and cardiovascular) 5. Identify your headache trigger and try to avoid it. 6. Do pranayam daily. 7. Acupuncture treatment has shown some benefits in migraine. You can consult a pain specialist for therapies like dry needling or botulinum injections for your problem. Consult again for further queries.
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I am 62+ handicapped. I get severe cramp and pain in my only healthy foot/leg (knee down onwards) while sleeping in night. I get a feeling as if my only leg too getting paralyzed. I get up and start walking under severe pain. It takes about an hour to come to normal. I walk with help of a pair of under arm crutches. I am also diabetic and on insulin. Is there a remedy. Otherwise I am healthy:-)

MD - Psychiatry, MBBS
Psychiatrist, Patna
I am 62+ handicapped. I get severe cramp and pain in my only healthy foot/leg (knee down onwards) while sleeping in n...
Dear , it appears that due to prolonged diabetes your large arteries at leg are getting affected. In a diabetic person it is a serious sign of compromise of blood supply to the limb. I suggest you to immediately get a colour doppler of the lower limb done and discuss this issue with your physician.
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Whenever I sits like crossing my legs on ground for having my dinner my left leg falls asleep and when returned to standing there is lot of paining sensation in the leg and it takes some time to be normal is this problem arise due to blockage in blood flow to the leg? Any cure or prescription?

M. sc Psychology, BHMS
Homeopath, Hyderabad
Whenever I sits like crossing my legs on ground for having my dinner my left leg falls asleep and when returned to st...
Thats mostly due to improper blood circulation, whichbm8ght bedue to increased lipid profile, low cslcium, potassium, zinc, iron levrls or sny b vomplex deficirncy. So, take proper nutritious diet, regular exercises.
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Frequent heart palpitations with giddiness and fatigue. Duration of palpitations is half an hour n body shaking during palpitations. What is this condition. Is it related to heart problem.

MBBS
General Physician, Chandigarh
Frequent heart palpitations with giddiness and fatigue. Duration of palpitations is half an hour n body shaking durin...
It can be either because of anxiety or some heart related problem please consult a cardiologist and get clinically checked.
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Is warfarin safe for blood clothing in the upper side of right leg? I have this problem for a week. There is no more pain in this part but it is just like numb. Please suggest me a safe medicine name without doctor prescription in the homeopathy or ayurvedic or any other allopathy that do not have any side effects.

BHMS, PhD Arthritis
Homeopath, Chennai
Is warfarin safe for blood clothing in the upper side of right leg? I have this problem for a week. There is no more ...
hi, first u should avoid long time standing.. while sleeping your legs slightly better n upwards position use 2pillows.. take homeopathic medicine carboveg 30twice daily for 1month..
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When to Seek Medical Help for Epilepsy

MBBS, MD - Psychiatry
Sexologist, Mumbai
When to Seek Medical Help for Epilepsy

Epilepsy is a form of chronic disorder and it is characterized by recurrent seizures. The episodes of epileptic seizures may differ from person to person. These seizures could be a result of genetic disorder or a result of trauma or stroke. During a seizure, a patient may also experience symptoms of neurological disorders and sometimes lose consciousness.

Medical help for epilepsy
Epilepsy itself cannot be cured using medication, but proper medicines help in eliminating recurrent seizures. These medicines stabilize the electrical activity within the brain preventing seizures.

How effective is the medication for epilepsy?
The success of controlling seizures using medicines depends on the type and severity of the epilepsy. Medicines for epilepsy are usually very effective and may fully keep seizures under control. However, controlling seizures caused due to brain problems may be more difficult. Usually, epilepsy medicines can control seizures for a long period of time when they are taken regularly.

When is medical help needed?
The decision about when to start medicines for epilepsy is a tricky one. This is because a first seizure cannot confirm whether a person has an on-going epilepsy problem. A second seizure may occur after many years or may not happen at all. Prediction of seizures is also quite difficult.

The severity of seizures also indicates when to start medicines for treatment. In case a first seizure is quite severe, medication should be started at once. Some people have very mild seizures even though they may be recurring in nature, and medication can be avoided in this situation.

All the pros and cons must be thought over before starting medications for the treatment of epilepsy. It is advisable to wait for a second seizure and then start medications for treatment. In most cases, medication is started after a second seizure occurs, twelve months within the first seizure. You should always consult a doctor to know when you need to start taking medicines to treat the condition.

For making the most out of the medicines to control seizures, you should follow certain steps:

  1. You must take medications exactly as your doctor has prescribed.
  2. Before switching to generic versions of your medicines or before taking other prescribed medicines, you must consult your doctor.
  3. You should never stop taking the medicines.
  4. In case you experience enhanced depression, mood swings and suicidal thoughts, you should talk to your doctor immediately.
  5. In case you have migraine, you should let your doctor know so that he can prescribe you anti-epileptic medicines, which also prevent migraines.

Medicines cannot treat the underlying cause of epilepsy, but these help in controlling seizures and this is the most common symptom of epilepsy. Medication should be started at a proper time and must be continued without stopping.

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I live in sultanpur. From last two year I am in pain by migraine .what medicine to take for migraine.

BHMS, M.D.
Homeopath, Pune
hello lybrate user, avoid triggering factors like stress, certain food which induce headache. avoid fried and junk food.have healthy diet. mindfulness meditation and pranayam yoga do have effective role in stress reduction.try homeopathy for migraine.it is a safe, natural and holistic way of treatment. homeopathic medicine is selected on the basis of thorough details like medical history, causes, routine, temperament etc..; such well selected remedy gives complete relief and cure without side effects. message back for consultation.
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HOW TO PRESERVE YOUR HEARING

Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Audiologist, Delhi

Now, today's world is suffering from many unknown ailments, due to our modern lifestyle, diet and many more. One of the most hazardous problems today's world is suffering from is ear related i. E ringing sound or tinnitus with vertigo and hearing loss. So as an audiologist my request and advice to all to avoid unwanted loud sound and protect your hearing by either wearing ear plugs or ear muffs or by avoiding such detrimental situations by wiseness, because tinnitus is mostly related to your duration of noise exposure. Because your health is in your hand. So you people decide.

1. Want to know home remedies for Migraine Headache? 2. Why the Migraine headaches triggers?

Diploma in Public Health, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Greater Noida
Following are the few triggering points for migraine - Sudden loud noise like pressure horn of vehicle Sudden impact of light like direct looking to sun, camera flash etc. Any type of stress There is no home remedy for migrain.
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All About Parkison's Disease

MBBS, MHS, MD - Neurology (USA), Fellowship in Epilepsy, Clinical Attachment in Movement disorders
Neurologist,
All About Parkison's Disease

* Should I be afraid of talking to the doctor?
No. Every doctor wants his/her patient to recover as soon as possible. If patients have the right knowledge, they are able to interpret and report their symptoms better. Having this knowledge prevents unnecessary anxiety and greatly facilitates diagnosis and treatment.

It is the duty of every doctor to provide the right information to the patient, and every doctor tries to do this to the best of his/ her ability. Sometimes it is not possible to provide thorough information and answer all questions of a particular patient, because then the doctor will not be able to give adequate time to the next patient. Th is is the main reason behind writing this book. In many cases, patients do not want to talk to their doctor because they are afraid of knowing more about their illness. This is the wrong approach. Knowledge is power. I assure you that having the right knowledge will decrease your anxiety and help you get better.

I do have one suggestion: before going to the doctor, write down all your questions on a piece of paper. Almost all doctors will be very happy to answer your questions if you ask them efficiently.

* Why should I pay attention to my symptoms? just run some tests and you will know what disease I have...
Tests can be helpful, but they cannot diagnose all diseases. Often, no test can detect the small short-circuits in the brain that are responsible for causing seizures. Until very recently, there was absolutely no test that could diagnose parkinson's disease. Tests cannot tell the doctor how you are responding to the medication. For example, in parkinson's the doctor may ask you how you feel in the morning, how long the eff ect of medication lasts, do your arms or shoulders jerk after you take medication, and so on. Each symptom is important for the correct diagnosis and treatment of your condition. You and your immediate family members can provide the doctor with this essential information. If you have difficulty remembering your symptoms, you should note them in a notebook. If you have difficulty describing some of your symptoms, you should make a video recording for 3-5 minutes using a smartphone or digital camera (android, Iphone etc). Such recordings are tremendously helpful for diagnosis and treatment.


* What are the common tests used to diagnose brain diseases?
The three tests most commonly used are:
Mri, ct scan and eeg. Other specific tests have been described in the relevant chapters.
(i) Mri (magnetic resonance imaging) scan:
An mri scan is probably the most important test for diagnosis. It can diagnose many diseases such as a stroke, tumor and inflammation. Mri scanning is done in a big tube shaped machine which is attached to a bed. Th e patient sleeps on the bed for 30-45 minutes. Th e bed slowly moves back and forth through the machine. During this time the machine clicks very detailed pictures of the patient's brain.

Please note that during the scan you may hear some loud whooshing and clicking sounds. Th ese are just the sounds of

Magnets and motors inside the machine, and there is no need to be concerned by these noises. Some people may feel anxious because of the small space within the scanner, and a few people may need medications to decrease this anxiety. Mri scanning is extremely safe; there is usually no health risk. Before the scan, please inform the doctor about any metal inserts or implants (e. G. Heart defi brillator) In your body.

Mri test machines are of various strengths such as 1.5 tesla, 3 tesla and so on. Mri machines with a higher number (for example 3 tesla) take better pictures. This book was written in 2015, at this time the highest resolution mri available in india was 3 tesla.

(ii) Ct (computerized tomography) scan:
The CT Scan machine looks just like the mri machine. It has a bed that moves back and forth slowly while the machine takes a picture of your brain.

CT scan has a few advantages over mri:
(i) It is less expensive. An mri may cost around 5000-7000 rupees, while a ct scan usually costs around 1000 inr (indian rupees).
(ii) It can be done very quickly. An mri may take 1 hour or more, but a ct scan can be completed in 10-15 minutes.

Unfortunately, CT scanning has some significant disadvantages:
- The picture obtained by a ct scan is not as clear as that obtained by an mri. The difference in quality is striking: it is like the diff erence between a black-and-white tv from the 70s and the new lcd televisions available today.

- CT-Scan exposes your body to radiation.
Radiation is bad for your body, and especially a baby's body. Therefore, pregnant women should never have a ct scan. Ct scan is commonly used during emergencies. When a patient comes to the emergency room, a rapid ct scan may be done to look for emergencies which may need immediate surgery such as bleeding inside the brain. An mri is usually done the next day, when the patient is more stable.

If you have already had an mri, then usually you do not need a ct scan. Th ere are a few rare conditions (e. G. Calcification in brain) which are seen better on a ct, but these are very uncommon.

(iii) Eeg (electro-encephalo-graphy):
Our brain functions because of electric currents traveling from one place in the brain to another. An eeg measures this electric current.

To do this test, small pieces of wire are stuck to the head using glue. These wires are then connected to an amplifi er and the electrical activity in the brain is recorded. The machine itself does not send any current to the brain. It only records current. Therefore, there is no pain or discomfort, and this is an extremely safe test. Anyone can have this test, including pregnant women, babies and very sick patients. Th is test is most often used for evaluating seizures. An eeg is also used in cases where the patient is unconscious for a long time, without a clear reason.


1. Doctor, my hand keeps shaking. It stops shaking only at night. Why is this happening?
The shaking of your hands is called a tremor. There are many causes of hand tremor. Th e most common causes are essential tremor and parkinson's disease. If you have essential tremor, your hands will shake more when you try to do something. For example, writing may become very diffi cult or water may fall down when you try to drink form a glass.

If you have parkinson's disease, the tremor is maximum when your hands are resting and doing nothing. For example, when you are sitting on a chair and watching tv comfortably, the hand starts shaking. Besides these common causes, there are other causes. For example, shaking of the hand (s) can begin after a small stroke near an important part of the brain called the red nucleus or in a condition called dystonia which causes contraction of the hand muscles without any clear reason some medications (see list), severe anxiety and very excessive tea/coff ee can cause hand shaking. Finally, there are diseases that have symptoms exactly like parkinson's disease.

Therefore, I need to examine you carefully. Based on observing you so far, I think there is a possibility that you may have parkinson's disease.


2. Parkinson's! I have heard this is an extremely serious illness! is this disease fatal?
No. Parkinson's disease is not fatal. Yes, but it is important to treat parkinson's disease promptly. Th e diagnosis of parkinson's disease is often missed. If not treated on time, patients with parkinson's disease are significantly restricted in their day-to-day activities, practically becoming disabled if treatment is delayed for a long time.

Secondly, if left untreated, patients with parkinson's disease can have frequent falls causing serious injuries including fractures and head injuries. Hence the diagnosis and treatment of parkinson's disease should be done as soon as possible.


3. What causes parkinson's disease?
Our brain runs on electricity and chemicals. If there is too much or too little of a particular chemical in your brain, it causes a disease. Parkinson's disease is caused by the reduction of a chemical called dopamine in our brain.

Dopamine is produced in the back of our brain, in a part called the mid-brain. It is then transported forwards and is widely distributed throughout the entire brain. It fi res up the movement centers of our brain, and helps them communicate better with one another. In parkinson's disease the cells in the midbrain producing dopamine gradually

Die. No one quite understands why this happens. Then effect is that the movement centers of the brain don't Communicate well with one another, and this produces the various symptoms of parkinson's disease.


4. Ok so what are other symptoms of parkinson's?
You already know one symptom shaking of the hands while resting. There are many other symptoms in patients with parkinson's disease and recognizing them is often very easy:
- Their muscles are often stiff and become inflexible, but they often do not complain about it. Th ey may complain that they are not able to do some things such as comb their hair.
- They are very slow in doing everything. They walk very slowly. They often bend forward while walking.
- They have difficulty turning around when they are walking.
- Sometimes they can get stuck in one position. Often this happens while walking, but may happen while doing something else.
- In later stages, they can fall frequently.
- Their friends may notice that their face has become expressionless and they just appear to stare off without blinking into distant space.

All patients do not have all of these symptoms. Some patients experience just the shaking of hands; other people experience just the muscle stiffness and so on. Often as people get older, more and more of the dopamine producing cells are destroyed and patients start developing more symptoms. But it takes years for this to happen and it may not happen in all people. In some patients, parkinson's disease remains restricted to just a few symptoms.


5. Ok doctor, thankfully I seem to be having just the hand shaking at this time. But other than the symptoms you just described, I am having other symptoms. I am always constipated, I cannot sleep well, and my saliva keeps dribbling from my mouth. Is it possible that these symptoms are also related to parkinson's disease?
Yes. It is not just possible but very likely that all these symptoms are due to parkinson's disease. Parkinson's disease is recognized by all doctors as a disease affecting movement. But in addition to movement problems, patients can have many other problems.

These are frequently not recognized, even by physicians, and therefore left untreated. If recognized and treated (and simple treatments are available for many of these symptoms), their resolution can significantly improve the patient's quality of life. It is important that your doctor should think about other diseases too. For example

If you have back pain, it is important that the doctor should think about arthritis of the back, if you have impotence your doctor should think about diabetes etc. But in many cases, no other cause can be found - these problems are due to parkinson's disease. About 10-20 years ago, even doctors did not know about these complications of parkinson's disease. It is a matter of great pride for me that I had the opportunity to receive training from the world-famous indian professor who is at the forefront of research regarding these symptoms: Dr. Kallol ray chaudhuri at king's college hospital in london.


6. How can you be sure that I have parkinson's disease?
A better patient history and examination will help me to confirm my diagnosis. We need to rule out other problems which look like parkinson's disease. Certain drugs may produce symptoms that are very similar to parkinson's disease (see list). Make sure you are not taking these medications, and avoid these medications in the future.

There are a few other diseases which have almost the same symptoms at parkinson's disease. Their names are complicated! these include diseases such as progressive supranuclear palsy (psp), multiple systems atrophy (msa) and cortico- basal degeneration (cbd)! th names are not very important the important thing is that there are other diseases that look just like parkinson's disease. Some of these diseases are identified by your doctor by looking for small clues on your exam: such as your blood pressure and the way your eyes move. Now let me tell you something very frankly even after a very detailed history and meticulous examination, the diagnosis may not be clear in some patients, even to the best of doctors in the best of institutions.


7. So isn't there a test for parkinson's disease?
Unfortunately, there is no test for parkinson's disease which can prove it with 100% accuracy. An mri (see information for everyone section) can be helpful to rule out some other diseases e. G. Multiple strokes, and 
Therefore many doctors get an mri in patients with parkinson's disease. There is one test that can be helpful. It

Is called the dat scan. The dat scan is abnormal in parkinson's disease, but it is also abnormal in some other diseases that look like parkinson's disease! therefore it is helpful only in certain cases. There are a few other tests like a cardiac scan (mibg scan), but these are only available at a few research centers, and again, do not help to completely rule out other diseases.


8. But. That is very concerning. What you are saying is that in some patients the diagnosis remains unclear?
You are correct. In most cases, the diagnosis of parkinson's disease can be made with certainty. But about 10% of patients have an uncommon mixture of symptoms so that no doctor, no blood test, no investigation can confidently determine if the patient has parkinson's disease or if he/she has another, similar disease. In such cases, most doctors explain the situation to the patients, and give them anti- parkinson's medications such as levodopa. Usually, a dramatic improvement is seen if the patient has parkinson's disease. If a patient takes an adequate quantity of Levodopa for 4-6 weeks and there is no clinical improvement, it is very unlikely that he has parkinson's disease.

These medications cause clinical improvement in about 1/3rd of all patients with the other diseases such as msa, psp etc. However, this improvement is not as dramatic as the improvement seen in parkinson's disease and frequently does not last as long. As the years go by, other symptoms develop (such as urinary problems, eye movement problems and falling) and a more definite diagnosis can be made on the basis of repeat examination.

9. Hmm. Doctor, there must be several medicines for parkinson's. If the parkinson's is caused by a lack of dopamine, shouldn't consuming dopamine help to reduce the symptoms of the parkinson's?
Yes, there are many medications and yes you are correct providing extra dopamine to the brain is one of the best ways to make the symptoms better. I have provided a list of these medications, but it is worth highlighting two of them: levodopa is the oral form of dopamine. It is converted into dopamine when it goes inside the brain. Th is is usually the fi rst medication that is started. It is available in standard, dispersible and extended-release

Preparations. Young patients with very mild symptoms of parkinson's disease are given a diff erent kind of medication initially. These medications are called dopamine agonists. Th ere are 3 dopamine agonist medications: pramipexole, ropirinole, and rotigotine. Th ey are available in standard and extended release preparations.


10. So, what you are saying is that the dose of parkinson's medications does not stay constant throughout life?
You are correct. Parkinson's disease often progresses as patients grow older. Some symptoms change and become less prominent but on the whole the symptoms become more severe. Th is progression is probably caused by gradual death of more and more cells producing dopamine. Very few people have side eff ects due to these based on the symptoms that develop, the medications. Often, parkinson's disease dose of parkinson's medication may need progresses as patients grow older and new to be changed, or new medications may be given. For example, if you have trouble sleeping at night, then the doctor can ask you to take an extra levodopa pill at night or an extended release ropnirole pill. If the benefi cial effect of levodopa is not lasting for as long as it used to, the doctor may ask you to take entacapone with the levodopa. If you have constipation the doctor will prescribe a laxative and so on. Sometimes it may take a few trials of different medications over 1-2 weeks to find the right combination that works for you. Parkinson's is not a deadly disease. Th ere are many medications for parkinson's. Th e doctor needs to have precise information about the patient's symptoms in order to prescribe the right medications. In parkinson's disease, the doctor needs help from his/her patient. It is essential to record your symptoms accurately and visit your doctor regularly, every 3 to 6 months.


11. Doctor, you are saying that frequently the dose of levodopa needs to be increased. But what happens if too much levodopa gets into the person's brain?
Yes, this can happen but it is not life-threatening. When there is excessive dopamine in the brain, the body starts moving too much. Often there are small jerks in the neck, shoulders and sometimes in the leg. If you are a fan of michael jackson, you have seen break-dancing. Th ese excessive movements look like break-dancing. Th e medical term

For these excessive movements is dys-kinesias. It is very important for you to be aware of them and remember the word: dys-kinesias. Often, dys-kinesias are at their maximum 1-2 hours after you take levodopa. If you have trouble recognizing these movements, you should take a video of any suspicious movements on your smartphone and show it to your doctor. In the early stages of parkinson's disease, dys-kinesias are only seen when the

Levodopa dose is very high. But in more advanced stages, they may be seen at lower doses and giving the patient an adequate dose of levodopa without producing dyskinesias may become diffi cult. At this stage, some dyskinesias may need to be tolerated. If you are suff ering from dyskinesias, you can reduce the dose of levodopa that you are

Taking. But this may result in some of the symptoms of parkinson's disease (slowness, rigidity, freezing etc) to reappear. Another way in which dyskinesias may be reduced is by giving you amantadine.


12. I am getting it now, doctor. This is like a weighing scale isn't it? too little levodopa causes the parkinson's disease symptoms to come back, and too much levodopa action causes dyskinesias.
Yes! th at is absolutely right. In the initial stages, balancing this weighing scale is very easy. But after 10, 15 or in some cases 20 years, balancing this scale becomes diffi cult. After taking levodopa, many patients improve but also get dyskinesias. It becomes impossible to fi nd a levodopa dose that causes improvement without producing dyskinesias. Th erefore, at this stage, some dyskinesias may need to be tolerated as long as you are able to function satisfactorily.


13. So doctor, you told me what happens when there is too much dopamine action in the brain. What if the there is too little dopamine action in the brain? What if levodopa just stops working?
Levodopa never stops working. But it may become less effective, and its effect may become short-lived. Th ere could be many reasons for levodopa to become less eff ective. These are listed separately the most important reason is that the patient may not be taking the levodopa on an empty stomach. As parkinson's disease advances, the eff ect of levodopa lasts for a shorter duration of time. Here is a somewhat typical story from such a patient. Remember, this happens only in few cases:
Taking the tablet helps me only for a short time. When I wake up in the morning, my feet contract, twist and become painful.


14. I understand. It must be difficult at that stage to find the right combination of medications. What if the situation worsens further?
Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to find the right combination; sometimes even 3-4 trials of diff erent combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health.

Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's

Patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. Th en I take my morning dose of levodopa

And feel good. Sometimes I get some dyskinesias, but I don't complain about them because I am feeling good. But only an hour or 1.5 hours later, the symptoms of parkinson's disease start coming back. I become slower and slower, and then freeze. I get better again when I take levodopa, but I can't keep taking levodopa every hour!

I understand. It must be difficult at that stage to fi nd the right combination of medications. What if the situation worsens further?

Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to fi nd the right combination; sometimes

Even 3-4 trials of different combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health. Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. A proper mixture of medications may help this situation as well. I had given you an
Example of this earlier: entacapone can prolong the eff ect of levodopa.


15. Doctor. Brain surgery? are you kidding me? this is a big deal. By the way, what is this surgery called?
I know brain surgery is a big deal. This surgery is called deep brain stimulation, or this is a brain surgery, but a relatively dbs

If your symptoms are well controlled with medications, no doctor in their right mind would recommend you to have surgery. But in a few patients, medications no longer produce adequate improvement. Either the improvement lasts for a very short time, or the medication produces such dramatic dyskinesias that giving an adequate dose is impossible.

Approximately, 70% of such patients benefit from this surgery. The improvement is very significant, but dbs does not make all symptoms of parkinson's disease magically disappear. It is very important to have realistic expectations from the surgery. The improvement seen after surgery is batteries last for about 5 years, and can be Replaced when required.


16. Well. How is this surgery done?
This is a brain surgery, but a relatively minor one. A metal frame is usually attached to the patient's head. A very small hole (approximately 1 cm in diameter) is made in the head, and a thin (1 to 1.5 mm thick) wire is inserted through it. The wire is pushed into a very particular part of the brain called the sub-thalamic nucleus. Th e same process is repeated on the other side and another small wire is inserted. These wires are then connected to a small battery (a square of approx. 3 inch) that is kept in the skin below the chest. No part of this device can be seen from the outside, and any scars on the head are usually covered by hair in a few weeks. Th e device is usually turned on 4 weeks after the surgery. On an average, most.


17. I see. Doctor, does DBS cure all symptoms of parkinson's disease?
No. DBS surgery improves only those symptoms which improve after levodopa.

- Dbs surgery prolongs the eff ect of levodopa, decreases dyskinesias, improves slowness of movement, hand shaking, muscle stiff ness and in general makes the patient much more functional. However, symptoms that do not get better after levodopa such as freezing and falling usually do not get better after dbs.

- Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body. Other symptoms that we talked about e. G. Sleep problems may get better after dbs. I conducted an audit of sleep symptoms after dbs during my time in london at king's college hospital, and found that there is

Significant, but non-dramatic, improvement in many patients.

Two problems can become worse after DBS:
(i) Severe psychiatric problems such as severe depression and hallucinations and
(ii) Severe diffi culties of thinking and memory. If any of these problems are severe, dbs is usually not off ered to the patient. If a patient has severe psychiatric problems and is under treatment, dbs may be considered in the future if they completely resolve.


18. Okay doctor, what are the risks of this surgery?
Th ere is a small amount of risk involved in any surgery. Since dbs surgery is relatively minor, the risk is low but is not non- existent.
- The risk of death is less than 1%
- Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body.
- A few patients have minor problems such as problems in wire connections or a non-functioning battery. Th ese are easily corrected. In short, about almost 90-95% of patient do not have any complications during or after the surgery, and the risk of death or permanent problems is very small (lts 2%).


19. Can the doctor guarantee a significant benefi t after DBS surgery?
No. No doctor in the world can guarantee Improvement after dbs. Th at being said, improvement happens in most patients as long as they are carefully selected. Before off ering you option of surgery, the doctor will give you a large dose of levodopa and make sure that your symptoms improve significantly. He/she will tell you that this is the maximum benefit that you may get after dbs, and try to set realistic expectations so that you are not disappointed after the surgery. Often the surgery is followed by a period of temporary improvement, even before the battery is switched on. This improvement Goes away in a few weeks. Th is is expected and you should not be disappointed - this is a good sign. After the battery is switched on, it may take between 3-6 months to achieve the optimal balance between your dbs and medications. During this time, your symptoms will improve gradually. But you should be patient if your symptoms

Have not improved within 1-2 months there is a good chance they will improve with further dbs adjustments. Most patients improve after dbs surgery, but a few people do not improve. Th e reason why these people do not benefit from dbs surgery is unknown, and this is being vigorously researched in the us, uk and other countries. Read more here

4 people found this helpful

I had fisher surgery 10 yrs back. But something fisher problem raised sometimes bleed also. I take indrajeet capsule for temporary healing. I want final solution for this. Recently I started whey protein for body building but whenever I take motions start and I get burning effect.

MD
General Physician, Noida
Hi. Wat you need to do now is. Visit a surgeon personally for the examinations. Bcz may be your this prob. Has reoccured. Ok and second thing taking protien n having loose stools. Tat may be bcz your gut cnt digest it so simplly change the protien.
2 people found this helpful
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My father brain has been damage post bypass surgery due to doctor neglegence from right side so he has paralyse from left side. So I wanted to know can he able to be normal as before ?

BPTh/BPT, BPT
Physiotherapist, Hyderabad
Time and duration surgery after one year it may difficulty to recover, one just check with neurologist.
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I have a daughter with cerebral palsy and the Dr. said he will treat with drug please need opinion because right noe daughter can not walk, stand on her feet or weight, talk, can not grab anything with her hands or used her hand to feed her self. She is 5 years old.

MBBS, MCH Neurosurgery
Neurosurgeon, Hisar
I have a daughter with cerebral palsy and the Dr. said he will treat with drug please need opinion because right noe ...
Hi, cerebral palsy is a sequlae of hypoxic injury to brain .It can not be cured .Generally children with CP need extra care and dependent on their parents .You are advised to go to pediatric rehabilitation centre. Stem cell transplant may have some role in treatment. Thanks.
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Hi, My child has been evaluated as CP child and she is 2+ years old. She has a development delay and getting seizures. Following are the impression found during recent MRI evaluation. MODERATE DIFFUSE ATROPHY OF CORPUS callosum DELAYED MYLENATION WITH MYLENATION PATTERN CORRESPONDING TO 6-8 MONTHS. Could you please advise what the above impressions mean and what are the treatment & cure for the same.

MD - Paediatrics
Pediatrician, Pune
As you told about cerebral palsy and mri impressions.in your child. This implies to upcoming development delay in the baby which probably have been judged by now. Best solution is to get physiotherapy help to stimulate and occupational therapy for his daily needful motor activities. As cp patient requires multidisciplinary approach including speech therapist and so on.
1 person found this helpful
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My hands and head will shakes lightly, I have no bad habits, my son also suffering with the same problem (age: 30yrs),help me

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Do Take Tens Therapy for 12 days followed by strengthening exercise from Neuro physiotherapist best wishes
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What happens if lopamax tablet to prevent and control seizures (epilepsy) is eaten with SB tablet to clean stomach.

MBBS
General Physician, Srinagar
Hi and thanks for asking a question dear user sb tablet have cleaning property ot removes toxin and other materials from body and also treats skin disorders. So if lopamax is already crossed gut and liver then it will do its functions. And the current dose for sb tablet is 1 tablet at night after some light food and I suggest you to take lopamax before eating sb tablet there should be timegap. Thanks.
1 person found this helpful
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Sir while walking too much I feel like something is obstructing my breath I feel shakiness while walking. Feeling of numbness in brain regions.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Sir while walking too much I feel like something is obstructing my breath I feel shakiness while walking. Feeling of ...
Do take balanced diet and avoid stress anxiety and anticipating the things do regular physical activity and breathing exercises for about 30 minutes regularly best wishes.
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I am suffering with headache this may leads to migraine? Or normal headache I'll get headache daily.

MD - Homeopathy
Homeopath, Aurangabad
I am suffering with headache this may leads to migraine? Or normal headache I'll get headache daily.
Yes migraine headache can be cured by homeopathy take natrum mur 30 30 ml liquid sbl 1 drop daily on tongue for x 7 days and revert with feed back.
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I am suffering from migraine from last 16 years classic migraine during atack first I loss vision slowly than I suffer from headache it remains for few hours than I feel uneasiness for few days.

PDDM, MHA, MBBS
General Physician, Nashik
I have gone through your question and understand your concerns. Continous chronic migraine needs prophylaxis treatment for decreasing migraine attacks and remission. For management of migraine you need to follow following things. 1) avoid fasting, skipped or delayed meals, excessive chocolates or coffee. 2) take proper sleep and timely diet medication can be started flunarizine amitryptiline: sedation common side effects topiramate: memory disturbances and risk of angle closure glaucoma and renal stone divalproate: weight gain you need to discuss with your treating neurologist about all these options and associated risk and side effects. The response to treatment comes in a month time with these medications. For instant pain control, pain killers may be taken. Hope you found the answer helpful.
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