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!

A neurological disorder is characterized by sudden recurrent episodes of sensory disturbance, loss of consciousness, and convulsions associated with abnormal electrical activity in the brain.

Role of Physiotherapy in Epilepsy

It helps improve strength, mobility, and increases the range of motion and sphere of movement.
It helps improve sensory awareness, response, balance, and coordination.
It helps to improve quality of movement and physical performance.
The Goals of Physiotherapy

To develop strength enough to support one s head upright
To have balance and motor control to maintain their trunk at midline
To use many different muscle groups
To assist necessary motion in their trunk and extremities
The physiotherapists write short-term goals for each of the items on the problem list that need to be covered to help the patient achieve the long-term goals
To understand what the patient is good at and does well
To focus on what he or she capable of doing rather than on what they can t do
To educate and provide awareness with a view to prevent injury. For example, advice on special swimming equipment to prevent drowning if he/she gets seizures in the pool
Physiotherapy treatment for a healed fracture consists of strengthening muscles that have got weak from being immobilized and stretching muscles that are stiff owing to being in the cast for a long period of time.

Physical exercise improves fitness, energy, and mood and even relieves stress. Improving overall health and wellbeing in this way can help reduce seizures. It can also help people feel more in control of their health. It also helps release  feel good  hormones into the brain, helps keep the muscles active, reduces fat levels in the body, and increases oxygen flow to the brain. It can also increase the bone density. A research showed that regular sessions of aerobic exercise (for example running, walking, swimming, cycling) for 60 minutes, twice a week, for 15 weeks resulted in a significant reduction in the number of seizures they had.

Drink water, diluted fruit juice, or squash while exercising to help replace the fluids and body. Do not exercise straight after a meal.

Team sports or group activities such as walking or gardening groups can also be a good way of increasing self-confidence. Making new friends may help with any feelings of isolation. Most sports, including contact sports like football, hockey, basketball and rugby, have not shown to increase the chance of someone having a seizure, but contact sports come with an increased risk of head injuries, which could affect people with a history of epilepsy. Protective sports headgear helps to reduce this risk. 

Role Of Physiotherapy In Treating Epilepsy!

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?

Sleep apnea is a sleeping disorder in which you experience frequent breathing pauses while sleeping. In case of some, the pauses may last for just a few seconds, while for others, it may continue for a few minutes. Sleep apnea is generally chronic in nature. There are three types of sleep apnea, namely Central, Obstructive and Complex sleep apnea. Central sleep apnea occurs if the brain fails to transmit signals to the muscles responsible for your breathing functions. Obstructive sleep apnea occurs due to relaxation of your throat muscles. Complex sleep apnea refers to a combined condition of both central and obstructive sleep apnea.

Some of the possible causes of sleep apnea are as follows: 
1. Blockage of airway during sleep can cause sleep apnea
2. Putting on weight can cause obstructive sleep apnea
3. In some cases, large tonsil tissues can lead to obstructive sleep apnea in small children
4. Intake of certain medicines like Oxycontin or MS Contin can cause central sleep apnea
5. Male people are more prone to sleep apnea
6. Smoking is also a potent trigger for sleep apnea
7. At times, high blood pressure can induce sleep apnea
8. Suffering from sinus can also lead to sleep apnea
9. Large neck size (more than 16 inches) may cause sleep apnea
In case of some people, sleep apnea might be an inherited condition.

The most common symptoms of sleep apnea are mentioned below:
a. Sometimes, obstructive sleep apnea is accompanied by choking or snorting sounds.
b. You may encounter breathing trouble while sleeping, leading to a disruption of your sleep.
c. Maximum times, sleep apnea is accompanied by snoring.
d. Sleep apnea leads to a dry mouth, which can disturb your sleep.
e. You may feel dizzy during daytime.

Causes and Symptoms of Sleep Apnea

Staying up late at night intentionally is not insomnia. If you find it difficult to fall asleep, or cannot sleep soundly for long, then it is indeed a case of insomnia. The inability to sleep can have terrible repercussions on your physical and psychological health.

A number of reasons could cause insomnia. Understanding the causes could help you identify your sleeplessness as insomnia and seek treatment right away.

What Health Issues cause Insomnia?

Here are some health problems of both the mind and body that can keep you awake  

  Stress Chronic stress and worry born out of our tense lives is a direct cause of insomnia. Long-term anxiety, panic disorders, as well as PTSD can induce sleeplessness.

  Irregular Sleep Patterns Your body would hate it if you deviate from the Circadian Rhythm   the body clock. It regulates the functions of your body, including your sleep patterns. But if you defy your body clock by sleeping at irregular hours   suppose you are staying up late to get some extra work done, or you may have opted for a night shift, or if you are experiencing a jet lag   then you will notice that when it is finally time for you to hit the bed, sleep will be elusive.

  Depression Depression is a horrific psychological disorder that makes a person lose interest in life itself. And one of the indicators of depression is loss of sleep. It is not just depression, but also other illnesses that cause psychological turbulence such as bipolar disorder and obsessive-compulsive disorders, triggering insomnia.

  Breathing Issues Sleep apnoea is a dangerous disorder that stops your breathing multiple times every night and will wake you up every time. Yet you will possibly not even remember waking up. However, this does disturb the quality of your sleep and affects your health adversely.

  Dementia Dementia is accompanied by a gradual loss of memory. But sometimes people who are suffering from dementia display anxiety, restlessness or even aggressive behaviour when it is time for them to go to bed. This is called the sundown syndrome and it might even keep them up all night.

  Pain Pain is one of the commonest reasons for losing sleep. Pain can originate due to any number of reasons   arthritis, a sprained joint, an injury, or if you are undergoing chemotherapy or radiotherapy, then it may keep you awake at night. This is actually a vicious circle because the inability to sleep will aggravate your pain. Talk to your doctor who will prescribe the appropriate pain medication.

  Parkinson s disease This disease is another reason behind insomnia. Parkinson s disease interferes with your nerve signals and this might cause disruption in your sleep.

  Menopause When a woman inches closer to her menopause, her body reduces the production of oestrogen and progesterone. This imbalance of hormones can trigger sleep loss.

How long can you go without sleeping?

There is no data on how long a human can function without sleep. The longest someone stayed awake is 11 days. Usually, the body cannot last that long without some sound shut-eye. Your brain flushes out the waste matter its cells produce during sleep. That is why even 24 hours without sleep can make your brain sluggish and disoriented. If you stay awake for more than 48 hours at a stretch, your cognitive abilities will start failing you. Sleep is instrumental to a healthy mind and body. If you are experiencing insomnia, talk to a doctor immediately or look up some remedies.

Health Problems That Keep You Awake!

Neurodevelopmental disorders refer to any impairment and disorder of the brain and nervous system growth and development. Disorder in the brain and nervous system can affect the emotional, physiological, psychological ability and overall timely development of a child. With advanced technology and continuous study in the medical field, one can now assess the neurodevelopment of his/her children. Neurodevelopmental Assessment concentrates on the overall growth and development of a child including his/her weaknesses and strengths. A complete developmental profile is generated with the help of various tests and examinations. This assessment is used to analyse the various developmental factors including social and communication skills, functional and motor skills, cognition and learning abilities, and language and speech development. Neurodevelopmental Assessment involves a team of child s close people including parents, guardians, and family members who help to understand the medical history if any. It helps doctors to provide appropriate ways to assist the child in his/ her growth and development.

Tests and Examinations

Tests for the Neurodevelopmental Assessment may vary from child to child depending upon their condition. But, there are usually some tests that are done to understand the overall development of the child. These tests may include speech tests, hearing tests, blood tests, physical examinations, and questionnaires, which may be given before or during the assessment process.

Assessment

The assessment processes and sessions may vary depending upon the need of the child. However, usually, there are three major sessions that help the pediatrician understand the concerns of the family and parents. These sessions include consulting about the detailed medical history of the child, understanding the problem and its possible cause, and providing proper ways and treatment options for the patient. 

In the first session, parents and guardians are asked about any medical concern they have and the medical examination of the child is carried out accordingly. A standardized assessment with the child will be carried out by a clinical psychologist and the parents and guardians are asked to complete a questionnaire for the assessment. Depending upon the age, questionnaire may be sent to school for teacher/s to complete.

The next session is usually led by language and speech therapist to discuss and understand the current language and speech concerns of the child. Previous assessments and medical examinations are taken into account to carry out further assessments. An occupational therapist will assess the child s ability to perform self-care activities and other tasks according to his/her age. The session may include the assessment of a child s motor skills and abilities and reflection on any probable sensory-based problems that may be affecting the child s occupational performance.

The last session mainly includes the discussion with the parents and guardians to help them understand the problem, its causes, and treatment options. If the child requires any further assessment or/and recommendations, then the parents are told about that too.

Takeaway
Neurodevelopmental Assessment of children is often performed on kids who do not show the developmental signs according to their age. Parents and guardians should not hesitate to consult their children to clinical psychologist and therapist as the early intervention and assessment can help in the timely growth and development of the children.

Neurodevelopmental Assessment (0-5 Years)  - What Should You Know?

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