The word epilepsy brings to mind visions of people frothing at the mouth and rolling on the ground. However, epilepsy affects each patient in a different way. This can make it hard to recognize at times. In the more serious cases of epilepsy, an epileptic attack can make a patient injure himself or develop other life threatening conditions. In rare cases, epilepsy can even cause death. Thus it becomes imperative to understand how to deal with epilepsy.

Treatment options for epilepsy can be categorized as medication, surgical procedures and dietary changes.

Medication
Medication for epilepsy is prescribed on the basis of the symptoms presented and the type of epilepsy the patient is suffering from. In most cases, seizures can be controlled with a single type of medication, but in others, the doctor may need to prescribe a combination of medicines to control epilepsy. These forms of medication do have side effects and hence any reactions to the medication must be immediately brought to the doctor's notice. The dosage for epilepsy medication may need to be varied with time. An epileptic patient should never discontinue medication on their own.

Surgery
Depending on the type of seizures and the area of the brain affected, a doctor may advise surgery in cases of severe epilepsy. Surgery can help reduce the number of seizures experienced or completely stop them. Surgery to treat epilepsy is of many types. Some of the common procedures are:

1. Surgery to remove tumor of any such conditions that may be triggering the epileptic attacks
2. Surgery to remove a small section of the brain from where a seizure originates. This may also be referred to as a lobectomy.
3. Multiple subpial transaction or a surgery that involves making a series of cuts in the brain to prevent the seizures from spreading to other parts of the brain.
4. Surgery to sever the neural connections between the right and left hemispheres of the brain.
5. Surgery to remove half the brain's cortex or outer layer

Dietary changes
A diet rich in fats and low in carbohydrates can help reduce seizures. This is known as a ketogenic diet and aims at making the body break down fats instead of carbohydrates. It can cause a buildup of uric acid in the body and thus should be practiced only under the guidance of a dietician. In cases where epileptic attacks are triggered by malnutrition and birth defects, taking vitamin supplements can help lower the frequency of seizures.

How to Deal with Severe Epilepsy

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

Migraine vs. Headache: know the difference

How to differentiate between a migraine and headache?

When you feel pain or pressure in your head, it may become difficult for you to assess whether you are experiencing a common headache or a migraine. Let's understand how different they are from each other.

A typical headache usually affects both sides of your head and varies from a mild to moderate pain. It can last from 30 minutes to up to a period of one week.

Some specific areas which get affected by a headache are:

  temples

  forehead

  back of your neck

Factors that trigger this headache type are a muscle strain, stress or anxiety. 

A migraine, on the other hand, is also a type of a headache which results in an acute throbbing sensation in one part of your head. Usually, migraine headaches are highly painful. Migraine pain makes it difficult for a person to carry out his/her daily tasks. Symptoms or signs associated with migraine attacks are:

  vomiting

  nausea 

  sensitivity to sound or light

  pain in the temples

  temporary loss of vision

  pain behind your ear or eye

What are the common causes of a migraine?

  hormonal imbalances in women - fluctuations in oestrogen, especially during menopause or pregnancy seem to trigger a migraine

  drinks like wine and extremely caffeinated beverages 

  foods such as salty foods, aged cheese as well as processed foods can trigger the migraine attack.

  medications - vasodilators such as nitroglycerine and oral contraceptives can intensify migraine pain.

How to treat a headache?

Fortunately, you can get rid of stress-induced headaches through over-the-counter treatments, which include:

  aspirin

  acetaminophen

  ibuprofen

How to treat a migraine?

If you experience migraine attacks less frequently, these medicines may give you quick relief:

  triptans, such as rizatriptan (Maxalt) or almotriptan (Axert)

  antinausea medicines, such as chlorpromazine (Thorazine), promethazine (Phenergan) or prochlorperazine (Compazine)

  non-steroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen, naproxen sodium, aspirin or ibuprofen

Some preventive tips:

  make changes in your diet such as avoid such foods, including caffeine and alcohol which are believed to trigger headaches.

  you can also try muscle relaxation exercises, yoga or meditation to ease the migraine attack. 

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 8 Common Migraine Triggers You Must Stay Away From

Migraine Vs. Headache: Know the Difference

Cerebral palsy is a neurologic condition that occurs in children, and is due to brain injury that develops before, during, or after childbirth. The condition presents with motor impairment, and therefore there is generalized physical and mental dysfunction. The brain continues to develop for the first two years of life, and so conditions like premature birth, asphyxia at birth, and postnatal meningitis and encephalitis.

The diagnosis could be trigged by the slow motor development, poor muscle tone, and delayed response of the baby. One of the main noticeable feature that becomes evident is the spasticity of the limbs. The child may not be able to voice it out, but pain is a significant disabling factor too. While doctors would advise that physical movement is required to keep the spasticity at bay, the pain keeps the child away from most activities. This further adds to the spasticity and worsening of the condition.

Pain control therefore assumes a significant role and the modes can range from physical therapy to pain killers to injections to surgery. The idea, in addition to pain control, is also to:

Improve range of motion
Improve motor response
Promote good motor development
Reduce and control contractures
Improve overall lifestyle
Improve muscle strength
Improve exercise tolerance
Reduce spasticity
Some of the non-medical ways to control pain are listed below. 

Of course, pain killers and injections are always used when immediate relief is required. A structured physical therapy program that includes medications and exercise is the best way to manage cerebral palsy pain. Though initially difficult, over a period of time, it improves range of motion and improves joint movement.

Acupuncture: Triggering specific points via needles is believed to stimulate the nerve endings and help in pain control
Alternating ice and heat therapy: This is also believed to improve pain control, blood circulation, and muscle movement.
Positioning in bed: A well-positioned child in bed may have less pain compared to another child who is not. Special equipment may be used also to keep the child in place, once the most comfortable situation is located.
Muscle massage: The affected muscles need to be massaged repeatedly so that blood flow improves, joint movement is better, and pain is controlled.
Botox is successfully used to pain control, as it paralyzes the specific muscles along with providing pain control.
Medications are used regularly, which are mainly anticholinergic and anti-spastic medications. They reduce stiffness, control pain, and help in pain control too.
Surgery is the last option and needs to be explored with the doctor.

Pain Management Of Spasticity With Cerebral Palsy!

Epilepsy is a neurological disease which is characterised by recurring epileptic seizures. These seizures can be brief or can persist for prolonged periods. Vigorous episodes which last long can result in physical injuries such as broken bones. Mention that 6th February is International epilepsy day.

Causes of Epilepsy
The cause of this condition isn t very evident; however, most medical practitioners attribute epileptic seizures to brain injury, tumours, infections in the brain or birth defects. Some doctors believe that epilepsy is caused due to genetic mutations and is an outcome of abnormal activity of cells in the brain. Other causes for this condition can be alcohol or narcotics withdrawal and electrolyte problems.

Symptoms

Repeated seizures
Impaired memory
Bouts of fainting
Short spans of blackout
Sudden bouts of blinking and chewing
Panic
Inappropriate repetitive movements
Types of Seizures
A seizure, also known as fit, is usually a brief episode characterised by uncontrollable jerking movement and loss of awareness due to abnormal neuronal activity in your brain. A collective occurrence of these seizures causes epilepsy.

There are three types of seizures an epileptic person usually encounters.

Idiopathic: This kind of seizure has no apparent cause
Cryptogenic: The doctors believe that there is a cause for the seizure but cannot detect it
Symptomatic: These seizures occur due to a reason.
Treatments

Medication: Medication is the most common treatment in case of epilepsy. Drugs taken on a regular basis can stop the seizure partially. But in very severe cases, they seem to have no effect at all.
Surgery: For symptomatic seizures which are caused due to abnormal brain function, surgery can be a way to get rid of seizures. In some minor cases, nerve stimulation in the brain and special diets can be prescribed to control the epileptic seizures.
Five facts about epilepsy you need to know:

Epilepsy is not psychosis or madness and can be treated easily 
Popular celebraties with epilepsy include Aristotle, Alfred Nobel, Alexander the great, Sir Isaacs Newton, Martin Luther and Julius Caesar etc. 
Woman with epilepsy can have a normal pregnancy 
Newer medicines for epilepsy are effective and very safe 
Surgery can cure epilepsy in some patients.

All You Need To Know About Epilepsy

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. 

1. 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.

2. 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.

3. 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.

4. 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.

Ways to Treat Insomnia

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