Dementia is the declining condition of the brain to function that interferes with daily life. It is not a disease but rather various symptoms. In such a condition, the communicative skills, as well as cognitive functions of the patient, compromised. Dementia is knowns to affect the functioning of memory, visual perception, and attention. These symptoms often cause disorientation, impaired judgment, and depression.

Speech therapy in Dementia is a way in which a speech-language pathologist can help the patients in maintaining a certain level of independence in themselves. Speech therapy helps in stimulating the cognitive abilities of the patient by engaging and practicing certain activities.

There are certain ways in which the cognitive functioning of the brain can be stimulated:

Spaced Retrieval errorless learning

Memory books and other Memory Aids

The speech therapists determine the changes in how a person is eating, swallowing, and drinking. The changes, if directed towards the improper cognitive abilities, are managed by certain strategies.

Other than normal activities, the person with Dementia also faces difficulty in communication aspects. It can either be verbal or non-verbal or both which includes gesturing, speaking, writing, and reading. The major areas that get affected by Dementia include social interaction, behavioral self-regulation, academic performance, as well as vocational performance.

It can get difficult to communicate with the person showing symptoms of Dementia. Hence, there are certain ways to help such situations.

Speaking Way

Speak calmly and clearly

Speak at a slower pace, so that the person processes the information and respond accordingly

Avoid speaking in sharp or loud voices

It is advisable to use simple and short sentences

Try speaking in a humorous way

You can also try to indulge them in conversations with others

Include them in a social group. Doing this can help in maintaining a sense of identity for the person with Dementia

Apart from this, speech therapists suggest that there are certain things you can talk about with the person of Dementia.

Whatever you are saying, say in a positive way

Try and avoid the direct questions

If you re asking questions, ask one at a time and try framing them in  yes  or  no  category

Try another way if the person cannot understand too complicated information. Don t repeat the same sentences.

Try to break down too much information in simpler explanations and sentences

A person with Dementia may have difficulty in determining particular information to be true or false. In such a case, try not to contradict them directly rather try to steer the conversation around the topic.

Take Away
A person showing symptoms of Dementia may have difficulty in carrying out simpler tasks of everyday life. Moreover, the patient may show certain behavioral, social, and physical imbalance. Such imbalance is caused by the declining cognitive abilities of the person. A speech therapist can help to overcome these disabilities through persistent training and practice.

Dementia - Know Speech Therapy For It!

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

Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.

Prologue:

Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain,that forms a tumor in the brain.Tumours can be either benign or malignant.

Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.

Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.

Symptoms:

There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.

Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:

Headaches.

Seizures.

Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.

Difficulty walking or clumsiness.

Vision changes.

Changes in alertness.

Behavioural impairment.

Causes:

Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.

What are the risk factors for brain cancer?

Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome

Personal history of cancer or family history of brain cancer

Impaired immune system

Radiation therapy of the head

Treatments Options:

Treatment

Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.

Stereotactic radiosurgery

Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors.

Brain Cancer

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.

Acoustic Neuroma - What Are The Risk Factors?

Sleep apnea is a disorder which is characterized as interruptions in breathing when you are sleeping. These interruptions or pauses in breathing usually last for about 10 to 20 seconds and may be repeated over 100 times alongside the duration of your sleep. This condition leads to poor sleep resulting in drowsiness, fatigue and poor concentration throughout the day.

Sleep apnea can be classified as:
1. Central sleep apnea: Central sleep apnea impairs the central nervous system wherein the brain fails to control muscles which regulate breathing while you sleep.
2. Obstructive sleep apnea: This type of sleep apnea occurs when the soft tissues present in the back of the throat block the airway and thus resulting in loud snoring.

Signs and symptoms
The various signs and symptoms of sleep apnea are
1. Loud and chronic snoring during sleeping
2. Interruptions in breathing
3. Shortness of breath during sleep
4. Fatigue during the day
5. Choking and gasping during sleep
6. Extreme irritability and drowsiness
7. Experiencing headaches in the morning
8. impaired concentration and forgetfulness
9. Chronic sore throat and dry mouth
10. Depression

The various risk factors for sleep apnea are:
1. If you are overweight
2. If you are male
3. If you are over the age of 40
4. If you have a large tongue and tonsils
5. If someone in your family has sleep apnea
6. Nasal obstruction due to sinus problems

There are certain prevention measures to control sleep apnea, they are:
1. Limit smoking: Smoking may cause you to retain fluid in the throat which contributes to sleep apnea.
2. Exercise: You should exercise regularly to keep off weight as being overweight increases the chances of getting affected by sleep apnea.
3. Schedule your sleep: You should get enough sleep every day so that your body is refreshed and revitalized. Getting enough sleep, thus helps in preventing sleep apnea.

Risk Factors Associated with Sleep Apnea

Sleep-Wake Disorder is a very uncommon syndrome which causes irregular sleeping patterns without any real schedule.

Causes
Persons with brain malfunctioning and those who do not have a regular routine during the day experience such disorders. People with changing work shifts often experience such disorder. Also, travellers who often move from one country to another with different time zones may also have these symptoms.
There's no cure for this disorder, but treatments, including hormones, medicine, and light therapy, can help get you closer to a normal sleeping pattern.

Symptoms

Symptoms may include any of the following:

Sleeping or napping more than usual during the day
Trouble falling asleep and staying asleep at night
Waking up often during the night
Exams and Tests
A person must have at least three abnormal sleep-wake episodes during a 24-hour period to be diagnosed with this problem. The time between each such episode varies from 1 to 4 hours. The doctor may advise you to go ahead with a device called actigraph in case the diagnosis is unclear. The device looks like a wristwatch, and it can tell when a person is sleeping or awake.

Treatment
Though there is no simple cure for irregular sleep-wake syndrome, however, several therapies and lifestyle changes may help a person return to a normal sleep-wake cycle. These include:

A regular daytime schedule of activities and mealtimes need to be fixed.
You should not stay in bed during the day for long.
Use bright light therapy in the morning like those from computer screens and television. The period of exposure should also be increased. Exposure to blue light should be minimized at night.
You should take melatonin at bedtime. This is a hormone that controls the sleep-wake cycle. By taking doses at the right times, you might be able to shift your body clock earlier or later.
Make sure to make the room dark, quiet, and as comfortable as possible at night.
Also one should try to minimize the amount of noise in the sleep environment.
Add more structure to the patient s day by scheduling social interaction, exercise, and other activities.
Your doctor may prescribe drug to control the timing of the sleep-wake cycle.
Finally, you should take proper care of yourself. Make positive changes in your lifestyle. You can even ask your boss to make your work schedule a bit flexible.

The ultimate goal of these lifestyle changes is to help the person sleep longer at night and make him feel active and awake during the day. Most people have sleep disturbances on occasion. But you need to see your doctor if such sleep disorders occur regularly.


Sleep Wake Disorder - Irregular Sleeping Patterns

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