Surgery to remove abnormal growths of the brain, peripheral nervous system or the spine or any disorder can be tricky because the brain and the skull that shields it are complex areas. In the old days, open surgery was the only way to access the brain or spinal cord. But, with the invention of laparoscopy, keyhole surgery to treat neurological issues is gaining ground.

What is Neuroendoscopy? 
Neuroendoscopy is a surgical procedure that is favoured by doctors and patients alike because it is minimally invasive.
Before the surgery, you will be administered general anaesthesia so that you will be unconscious during the entire duration. During the surgery, the surgeon will drill a minute hole into your skull just above the eyebrows. You skull also has two natural openings. That is why the surgeon may make use of the nose or the mouth to access the region that needs to be operated upon.

Neuroendoscopy is useful because -

  It lets the surgeon reach regions that are not accessible with open surgery
  The tumour can be removed without any damage being done to surrounding tissues

An endoscope is a delicate device with a high-resolution camera mounted on it. There is an eyepiece on the other end. The device is also fitted with a light. When it is inserted into the brain, it lights up the passage and the eyepiece allows the surgeon to take a look inside. The camera sends a live feed of the path it is traversing and this guides the surgeon. When the tumour is reached, it is gently removed with other surgical instruments that too were inserted through the cavities or the drilled hole.

Benefits of Neuroscopy -
There are several advantages of relying on laparoscopy -

  The patient endures less pain
  Fewer chances of infection
  Faster recovery
  Very little scarring of tissues

Which Disorders call for Neuroendoscopy?
Any of the following disorders can be put to rights with a neuroendoscopic surgery -

  Pituitary tumours
  Rathke s cleft cysts
  Pineal area tumours
  Ventricular tumours
  Skull base tumours
  Brain inflammation triggered by an infection
  Chordomas
  Cerebrospinal fluid fistulas
  Trigeminal neuralgia
  Cerebral aneurysm

After Surgery-
Once you undergo the neuroendoscopic surgery, you will have to be rehabilitated so that your condition can be monitored round the clock. Neuroendoscopy is a state of the art clean and efficient surgery that is beneficial to both surgeons as well as the patients.

Know More About Neuroendoscopy And Its Uses!

The brain contains numerous nerve cells which help in its normal functioning. Epilepsy or seizures occur when there is a disruption in the activity of the nerve cells in the brain. A neurological disorder of the CNS (Central Nervous System), epilepsy can affect all and sundry, irrespective of their age, sex and ethnicity. However, children and aged people (above 60 years) are more susceptible to the condition. A study suggests approximately 10 million people in India suffer from epilepsy.

Types of Epilepsy
Based on the activity of the brain that causes an epileptic attack, Epilepsy can be of two types - Focal or Generalized
Focal Epilepsy: An epileptic attack triggered by unusual activities restricted to a particular area of the brain.

In some cases, focal epilepsy may result in unconsciousness. A person may also lose awareness and become unresponsive (keeps staring into space), a condition termed as Focal Dyscognitive Seizures. A person with this condition may behave strange, such as walking in circles, chewing or rubbing their hands.
In another type of focal epilepsy known as Focal seizures without loss of consciousness, a person does not lose consciousness. In such cases, there may be sudden and involuntary jerking of the arms or the legs. There may also be dizziness or a tingling sensation.
Generalized Epilepsy: Here, the seizures or epilepsy result from unusual activities throughout the brain. Generalized epilepsy, may, in turn, be of the following subtypes

Tonic seizures: This affects the muscles of the legs, arms, or the back, causing them to stiffen and tighten up.
Atonic seizures: Here, a person may suddenly fall down due to loss of muscle control. The condition is also known as Drop Seizures.
Absence seizures: Mostly affecting children, the affected person may lose awareness (temporary) and behave strangely such as staring into spacing, smacking their lips, or blinking their eyes continuously.
Clonic seizures: They are characterized by sudden and continuous jerking movements of the arms, face, and neck muscles.
Tonic-clonic seizures: Here, a person may suddenly lose consciousness. There are violent shaking and stiffening of the body. Some people may even be seen biting their tongue.
Myoclonic seizures: In this arms, and legs of a person suddenly twitches and jerks.

What triggers an Epilepsy?
Epilepsy may be an outcome of the following factors

Medical conditions such as stroke or even brain tumors may affect the normal activities of the brain, thereby resulting in epilepsy. Diseases such as Viral Encephalitis, AIDS or Meningitis act also act as a trigger, accelerating the chances of epilepsy.
Developmental disorders such as Neurofibromatosis or Autism can also trigger epilepsy.
In some cases, epilepsy may be a genetic predisposition. Thus, a person with a family history of epilepsy may suffer from the condition.
Epilepsy may also be an outcome of a prenatal brain injury due to oxygen deficiency or an infection to the mother.
People with dementia may also suffer from an epileptic attack.

Epilepsy - Know The Most Common Types!

Are you looking for an ideal treatment and management for various kinds of headaches? Do you suffer from migraine headaches? You should opt for Ayurvedic treatment, which is considered to be very effective in dealing with headaches of various types.

Migraine headaches

Migraine is a form of headache that is known as Sooryavata according to Ayurvedic principles. Such headaches worsen during sunrise, peak during the afternoon and tend to reduce during evening. Migraine occurs because of an excessive stimulation of blood vessels in the brain. A person affected with migraine is likely to experience nausea and vomiting, along with a throbbing headache on one side of the head. Migraine headaches can be caused due to hormonal changes, allergy from certain food items or excess stress. Apart from regular exercises and a proper diet, the most effective Ayurvedic remedies for dealing with migraine headaches are as follows:

Shirolepa or the applications of herbal pastes on the head is effective for pacifying pitta dosha. Camphor, jatasmansi, and sandalwood are also effective.
Shiro Dhara, an Ayurvedic therapy, where a thin stream of liquid is poured over your scalp is helpful.
Taila dhara is effective for migraine headaches as well, in which oils such as chandanadi taila and ksheerabala taila are used for treatment.
Cluster headaches
Cluster headaches refer to headaches on one side of the head. It is known as Suryavartham according to Ayurveda. These consist of a series of short, but painful headaches, stretched over weeks or months together. Such headaches occur because of disruptions in the nervous system. Usually, the pain starts early in the morning in the eyes. There are several Ayurvedic remedies for the management of cluster headaches. Some of them are as follows:

Use an ointment or paste made of dried ginger and Kermpferia.
Use a paste of Indian aloe vera, asafoetida and coriander for pain relief.
Grind cumin seeds and mix it with lemon juice. Keep the mixture on the painful area of your head for quick relief.
Have coconut water.
Recurrent headaches
Any form of headache, which tends to reoccur after some time instead of ending is referred to as recurrent headache. There are several Ayurvedic remedies for the effective management of recurrent headaches. They as are as follows:

Boil one teaspoon of haritaki powder in water and drink it.
Massage your neck gently using warm calamus root oil.
Lie down with your nostrils parallel to the ceiling, and apply sesame oil in your nostrils. This is known as nasal therapy.
There are several other Ayurvedic remedies that are effective in dealing with all forms of headaches. You should consult an Ayurvedic practitioner for getting the most ideal remedy for your problem.

Migraine - How Ayurveda Can Help You Treat it!

Parkinson s disease is a disorder involving the nervous system. It can start with a mere tremor of one hand and advances to slow movement and stiffness. The face might show little no symptoms in the beginning but the speech might become slurred. With every passing day, the condition worsens. This condition has no permanent cure but the symptoms can be improved with proper medication.

What are the symptoms?
Some unmistakable symptoms include the following:

A sudden shaking of the limb. A sudden tremor of the hand is a very common symptom of this disease.
A stiffness of the muscles that can limit the range of motion and sharp pain.
The posture of the body might get compromised. Often balancing problems are witnessed among many patients.
There could be problems with speech leading to soft, slurry or quick speech. The speech in some cases can become monotonous devoid of inflexions.
Parkinson s disease can lead to slow movement and makes performing of simple tasks difficult.
Patients often find writing very difficult
What are the possible causes of Parkinson s disease?

Specific genetic mutation can lead to Parkinson s disease in folks who have a family history of Parkinson s disease. Certain variations of the gene increase the risk of this disease
Exposure to certain environmental factors or certain toxins can trigger Parkinson s disease in an individual.
Certain cells in the brain known as Lewy bodies can trigger Parkinson s disease.
A certain kind of protein cells within the brain known as alpha-synuclein can trigger the Parkinson s disease in an individual
What are the risk factors?

Heredity: Having an immediate family member or a close relative suffering from Parkinson s disease can increase the risk of getting this disease in an individual
Age: Although not a prime risk factor, but an individual over the age of over 60 have an increased risk of getting this disease
Toxins: Exposure to pesticide or certain herbicide increase the risk of Parkinson s
Sex: Men are more likely to get Parkinson s disease than women
What is the medication for Parkinson s disease?

Carbidopa-levodopa: This is a natural chemical that gets passed to the brain and is converted to dopamine by the body. The benefits of this medication might reduce with increased symptoms.
Carbidopa-levodopa infusion: A popular drug in this category is known as the Duopa. It is administered directly into the small intestine in the form of gel through a feeding tube.
MAO-B inhibitors: Drugs from this group include rasagiline and selegiline. This is a powerful medicine. Many patient experiences hallucination during the initial days of consuming these drugs.
Anticholinergics: This medication is mainly used to counter tremors of the limbs in the early stage of the Parkinson s disease.

Parkinson's Disease - What Are The Risk Factors?

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Sleep is known to most as a period of rest and relaxation, but there are multiple disorders which are associated with sleep too. Hypersomnolence or hypersomnia is one of the most common sleep disorders. This is characterised by excessive daytime sleepiness and prolonged periods of sleep at night. They wake up fresh in the morning, but can easily go back to sleep any time of the day without feeling strained or tired. There is again no freshness associated upon waking up. Funny as it may sound, they can doze off even during a meal or in the middle of a conversation.

Causes: This condition is most common in men and in the early adolescent days.

There is no underlying cause that has been identified, though there is a genetic predisposition.
People with history of head trauma are more affected
People with anxiety, depression, bipolar disorders, epilepsy, and other mental disorders are also more likely to be affected
People with sleep apnea often are hypersomnolence
Restless legs syndrome, narcolepsy
Neurodegenerative disorders like Parkinson s and Alzheimer s tend to sleep more.
Symptoms:

Sleeping for longer hours at night time
Excessively sleepy during daytime
Able to doze off anytime during the day
Inappropriate and involuntary sleeping pattern
Having difficulty getting out of bed after waking up, even after prolonged sleep
Feeling of disorientation
Feeling agitated, anxious, lethargic, and irritated
Impaired cognition and memory
All these lead to extreme state of drowsiness
Increased tendency for hallucinations
Reduced appetite and even weight loss in some people
There is restlessness, reduced pace of thinking and speaking
Overall reduced energy levels
Social interactions are affected including work life, social functions, etc.
Diagnostic criteria:

If a person happens to sleep more at night or falls asleep during the day easily for more than 3 times a week, it is usually concerning.
The added feature of no tiring physical activity can also lead to suspicion
In acute cases, these symptoms are present for at least a month and in chronic cases, it could be seen for up to 3 months
It cannot be explained by lack of sleep on a regular basis
One or more of the above conditions could be present, which can help in making the diagnosis
Treatment:
Most cases of hypersomnia would need treatment only to improve their energy levels and improve the quality of life. Very often, treating the underlying condition can lead to improvement of hypersomnia. The tired, lethargic, restless feeling affects the overall performance of a person, leaving them with a lowered self-esteem. Brain stimulating drugs like amphetamines are used to improve daytime alertness and also reduce sleepy feeling during the day.


Hypersomnolence - How It Can Be Managed?

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