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!

Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

Head Injury is any trauma to head other than superficial injuries to face. It results in high morbidity & mortality. Head injuries are an important cause of loss of young people at their productive age.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Street fights

Fall from height

Child abuse

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of the possible symptoms of brain injuries:  

Nausea and vomiting, fatigue or sleepiness, severe headache, confusion, amnesia,  loss of consciousness, seizures, loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected, coma, dilation of the pupils and disturbance of vision, Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood, difficulty in breathing, low pulse rate, increase in blood pressure, difficulty in swallowing, loss of hearing, problems in cognitive functions.

Brain damage is a process, not an event. 80% are minor head injuries, 10% are moderate head injuries and 10% are major head injuries.

Management of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Glasgow Coma Scale

Pupillary reaction to light

Brain stem reflex tests

Head to toe examination

CT scan of head is the initial study of choice. MRI Brain is helpful in cases of non-haemorrhagic contusions, diffuse axonal injury and deep lesions.

Surgical Indications

Head injuries with intracranial hematomas causing significant mass effect

Massive cerebral edema

Hydrocephalus

Infection

Precautions for Head Injury

Use Helmets- both riders

Use Seat Belts

Keep vehicle speed under control

Follow traffic rules

Take adequate precautions during trekking, diving

Take Away-

No head injury is minor enough to be neglected nor severe enough to be given up.

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.



Head Injuries - All You Must Know!

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

One of the most debilitating conditions that anyone can experience is migraine. They can severely limit you by affecting your personal and professional life as you are in constant pain. Migraine can manifest in a type of headache with intense pain, an acute sensitivity to light, vomiting and nausea. Often described as a severe throbbing pain in the head, it may stop you from completing regular daily tasks and may delay or postpone your work.

How can migraines be treated?
The exact cause for these debilitating migraine pain hasn't been pointed out yet, but certain triggers such as stress, hormonal changes in the menstrual cycle, sun exposure, bright or flashing lights, among many others have been identified. The first line of defense for you would be to understand and identify what your triggers are. Once that is done, you can try and avoid them. If these still trigger a migraine or are about to trigger one, you can immediately take medications or steps to control it or at least lessen the pain to go through your day. Some of the options you can employ to this effect are mentioned below.

Medications to prevent a migraine attack: The medications mentioned here are specialized treatments and can only be taken after a consultation with a doctor. If you are deemed as a candidate for preventative medication for migraines, then either one or a combination of drugs from the following may be prescribed to you.
Valproate and Topiramate are anti-seizure medications which can be used to prevent migraines.
Propranolol, a type of beta blocker and used for cardio vascular problems, has proven to be very effective in preventing migraines.
Onabotulinumtoxin A or a type of Botox, has shown a lot of promise in preventing migraines and is being slowly rolled out as a proper drug as a treatment option.
Certain antidepressants have also shown to be quite effective in reducing the symptoms of migraines as well.
Medications to relieve pain: Some of the go to medications that help relieve your pain from migraine are mentioned below. Although some of them are OTC (over the counter) drugs, it is best advised that you consult with your doctor for medications which suit you better. The side effects of these medications can be bad and thus, it is not advised to continue them in the long run and to find other means to control pain from migraines. Some of the medications to relieve pain temporarily are:
Triptan is a drug used to treat severe migraines
Caffeine along with Ergotamine can also help dull the pain and deal with it.
Ibuprofen and aspirin and Acetaminophen are common pain killers that you can use
Codeine, which contains opioids are also used to treat this problem.
Metoclopramide and chlorpromazine are two examples of anti-nausea medications as vomiting along with nausea may frequently accompany your migraine.
Always remember that these medications can have strong side effects if not taken properly, therefore do not just pop a pill, consult your physician first and know which one should you take and how frequently. 

Severe Headache - Can it Be Migraine?

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 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

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