Sleep is the normal physiological process of our body which is as important as respiration and digestion. Sleep is vital for maintaining our physical and mental health. Normal adults require 8 hours of sleep every day, whereas it 14 to 15 hours of sleep is recommended for for infants and toddlers.

What are the different stages of Sleep

Every human has a natural circadian clock in their body, which is responsible for maintaining our sleep - wake homeostasis. The different stages of sleep include REM and NREM that is rapid eye movement sleep and non rapid eye movement sleep respectively. REM is the deep sleep stage in which it is very difficult to wake up the person as this stage includes the sensory inhibition and all voluntary muscles along with almost all interactions with the surroundings are inhibited. Therefore, a person s physical stress and tiredness also gets relieved during this stage of sleep. NREM sleep is the stage between REM and awakening and here the person may have sensory connection with his or her surroundings, but may not respond.

Sleep and its benefits
Sleep and stress have a very strong connection with each other. The best way to relieve stress and any other mental disturbance is sleep. It is essential to have knowledge about sleep psychiatry for almost all physicians as they face many sleep deprived patients in their day to day practice.

    Sleep is not only responsible for relieving mental stress and depression, but has other benefits as well
    Sleep is also essential for the normal physiological growth in early infancy and it is vital for development of normal alertness, attention and knowledge
    It also relaxes our voluntary muscles and thereby, relieves us from physical stress
    Sleep disturbance may also aggravate diseases in our body. Sleep is also the state of recovery and healing.

Sleep psychiatry also insist on meditation and ensures that people have normal pattern of sleep, in order to maintain the mental health of the person in a normal state.

Sleep Pyschiatry: Its Stages and Benefits

There are various neurodegenerative disorders and Huntington Disease is one of them. It is characterized by loss of thinking ability, chorea or uncontrolled writhing and jerking movements, and psychiatric difficulties. 

Nerve cells in the brain are impaired in this disease. This leads to loss of coordination and involuntary movements. As the disease progresses, patients slowly fail to control their throat and mouth muscles and simple tasks like eating, swallowing, and speaking becomes challenging.

Huntington's Disease may also affect the reasoning and thinking abilities of an individual and makes communication and conversations more challenging. The problem of swallowing food can lead to choking as food can go down the wrong way or a lung infection in more severe cases. 

Speech-Language Pathologist or Speech Therapist helps the patients with speaking and swallowing problems with the help of various therapies.

Visiting a Speech-Language Pathologist in the initial stage of Huntington's Disease is advised. This helps in planning in advance about the ways to handle changes as the disease progresses. The therapist can help the patients when they begin showing an inability to speak or understand and swallowing problems. The symptoms showing swallowing difficulties may include choking, coughing and altered eating habits of the patient and loss of weight.

Symptoms

Dysarthria, in which the ability to remember words, understanding and forming a sentence is not lost but clear speech becomes difficult.

Stammering.

Slow or imprecise speech.

Aphasia, inability to understand what is being said and inability to remember grammar and vocabulary, and the pattern of losing a word in between the sentences.

Weak voice or low volume because of respiration issues.

Scanned Speech or unusual lengthy pauses between words.

Problem with pitch control and resonance.

Treatment

The progression of Huntington s disease varies from patient to patient and the therapy also varies as per the needs and challenges of the patients. The therapy usually starts with the discussion of problems and symptoms faced by the patients. 

For swallowing difficulties, patients may be recommended to maintain a journal of swallowing problems and fixing a time for meal intake every day. He/she may be recommended to eat soft food items, and eat slowly and chew the food properly.

As for speech therapy, one may be recommended breathing exercises. The therapist may demonstrate the patients how to overemphasize certain mouth movements to make the words easier to understand. The family of the patient is advised to reduce distraction while communicating with the patient. 

Assistive devices can also help with communication such as computers, smartphones or tablets. Other low-tech objects from everyday life, such as calendars, picture boards with a depiction of daily life activities, and object images and notebooks can also be helpful.

Take Away
Huntington Disease is a brain disorder where it becomes difficult for a person to control mouth muscles. In this, speaking, swallowing, and eating becomes a task for them. There are speech therapies that can help the patients to gather control over their words and communication problems.

 Huntington's Disease - How Effective Is Speech Therapy In 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

A migraine often causes throbbing pain at one side of the head accompanied by sensitivity to sound and light, nausea and vomiting. The pain can last from a few hours to few days. Some warning signs of the pain take over include tingling of the leg or face, flashes of light and blind spots. Medication can help in avoiding the pain or manage it considerably.

Diagnosis:
Detection of a migraine is fairly easy for a medical professional. If a patient has a family history of a migraine, a doctor can prescribe the following to lock in on the diagnosis:

Blood tests: Through blood tests, a doctor tries to understand any possible problems in the blood vessels, spinal cord or presence of other toxins in the system
Magnetic Resonance Imaging: Better known as MRI, this is a process of capturing the detailed image of the blood vessels and the brain. It readily detects any possible problems related to a migraine.
Computerized tomography: More commonly known as CT scan, this is a process of capturing an image through a line of x-rays to detect any possible problems related to a migraine.
Lumbar puncture: This test is prescribed in extreme cases when a doctor suspects that there is a possible chance of bleeding in the brain.
What are the treatment options available?
There are two kinds of medications available- preventive medication and pain relieving medication. The treatment strategy is decided based on the frequency of the headaches and other health factors.



Some pain reliever medication includes triptan, ergots, opioid, glucocorticoids, anti-nausea medications etc. These medicines constrict the blood vessels and block the pathways of the pain in the brain cells. While some medicines are required to be consumed immediately after the symptoms starts, some should be taken regularly to avoid the pain in the first place. These pain relievers have side effects and should be consumed after prior discussion with a doctor.



Preventive medication, on the other hand, is only suggested by a doctor when a patient suffers from a migraine twice or more in a month, the pain lasts for more than 12 hours and the pain relievers do not work. Some of the common group of medicines that are suggested for these set of patients include cardiovascular drugs, anti-seizure drugs, anti-depressants etc.

Alternative medicine approach:
Alternative medicines are often witnessed to fetch positive results for migraine patients:

Acupuncture: this form of treatment involves inserting thin needles into the skin at various points to give relief from pain
Cognitive behavioral therapy: This is a form of treatment which focuses on perceiving pain with behavioral changes.
Biofeedback: This is a relaxation technique that teaches to control physical responses such as pain, stress, muscle contraction etc.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Migraine - Treatment Options Available!

SSHL is not like any other normal hear-loss trouble. Rather it is quite a severe condition. Sudden deafness can occur at any time due to several reasons. This trouble does not affect both the ears rather only one specific ear is usually affected, and thus this is one of the prominent signs that can help the doctors to understand that SSHL has occurred. 


What are the leading causes of this hearing loss?

    Head injury: If you have faced any severe kind of head injury ever, then it might bring SSHL. This is why you are suggested to get necessary treatment on time so that this kind of hearing loss can be avoided.
    Loud-noise exposure: If your ears are exposed to louder noises or sounds in a consistent manner, then there is a greater possibility of the occurrence of this hearing loss. Thus, you should stay away from unwanted noises. 
    Ageing: With the increase in age, hearing power slowly decreases. However, if you take proper precautions from the very beginning, then SSHL can be definitely avoided. 
    Blood-circulation troubles: Interrupted blood-circulation creates different physical troubles out of which hearing loos is one of the most prominent one. And if timely treatment is not provided, then it might get converted into SSHL. 
    Ototoxic medication: This kind of medication should not be continued for long without doctor's prescription otherwise SSHL might occur. 
    Lyme disease: This is a kind of disease, which occurs due to tick bites and this is pretty infectious in nature. Apart from that, this disease is now considered as one of the main sources of SSHL. 

How to evaluate this hearing loss? 

    History analysis: The history of the patient needs to be known first otherwise SSHL cannot be perfectly treated. If the history shows that the patient already has an existing trouble of ear loss for which SSHL has been proven, then in accordance with the same the treatment can be prescribed. 
    Laboratory and imaging: Laboratory analysis is one of the main methods for evaluating SSHL and necessary images of the ears boost the potentiality and importance of this kind of analysis to a great extent. 
    Quick evaluation: This kind of medical evaluation is mainly made on the basis of the symptoms. The doctors often follow the signs thoroughly in order to determine as to whether the patients have SSHL or not. This evaluation is highly supported by different medical tests that are prescribed by the doctor.

Sudden Sensorineural Hearing Loss: Causes and Evaluation

A deaf child is the one who suffers from hearing loss. Children with deafness may also fail to develop speech. Such children might have no defect in their speech but they cannot speak anything. The main reason is deafness. They do not hear a speech, therefore, cannot develop it. Deafness may not be hereditary, but it occurs due to several other causes. 

The period of 5 years is crucial in a child s life. During this period, they develop their speech and language. Therefore, parents need to take the utmost care for the early identification of hearing loss and treat the child accordingly. 

Causes of Deafness in Children

There are several causes of deafness in children.

Otitis Media: In young children, if the eustachian tube is not fully formed, it forms fluid behind the eardrum. This fluid can get infected and affect the hearing. The fluid may not cause any pain or infection but still, it can harm and cause hearing loss even if it stays for a short time. 

Problems by Birth: Some children have hearing problems by birth. Sometimes, the problem lies in the genes. But, other times during pregnancy or prenatal care, the problem arises. If a mother, while pregnancy, has diabetes or preeclampsia, she is likely to deliver a deaf child. A prematurely born baby also has a high risk of deafness.

Illness or Injury: Some young children suffer hearing loss due to some injury in the ear or some other illness. Illness includes meningitis, measles, chickenpox, and flu. Head injury or listening to loud music for a long time can also be a reason.

Symptoms of a Deaf Child

A deaf child shows no reaction to the loud noises.

He/she doesn t respond to the voices.

The sound of the child is simple that taper off.

The child may pull or rub the ear several times, which is noticeable.

The child is continuously cranky for no particular reason.

He/she does not pay any attention when anyone is talking.

He/she has very little energy to do anything. 

He/she fails to understand the direction.

Often asks to raise the volume of TV or radio.

Have fever and ear pain.

Treatment of the Problem

Hearing loss affects a child s learning ability. So, the problem must be diagnosed and treated immediately. Here are some treatment approaches: 

Treatment for Otitis Media: The very first thing parents and doctors can do is watchful waiting because sometimes the problem cures itself. Some pediatricians might prescribe some antibiotics. If the problems continue, then the doctor will suggest getting an ear tube to the child that will allow the fluid to drain. For this, the child will have to visit an ENT doctor also called Otolaryngologist. 

Treatment for other causes: The child may use a hearing aid. Some can get cochlear implants. 

Conclusion
It is necessary for parents to accept the child with deformity and stay by his/her side. They must get themselves educated and communicate the problem with others to get help. It is essential to stay in touch with the child and take care of him.

Deaf Child - What Should You Know?

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