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!

Snoring is something that not only spoils the sleep of your partner but leaves you embarrassed while travelling or any family gatherings. It is more popular among males but these days, women are also facing this issue. The problem only worsens with age and weight. On the other hand, the person suffering from Sleep Apnoea not only affects his and his partner's sleep but puts his life at risk.

Difference Between Sleep Apnoea And Snoring:

There is a huge difference between just Snorers and those suffering from Sleep Apnoea. Sleep Apnoea almost always results in frequent and loud snoring, while disturbing the breathing pattern. This leads the person suffering from Sleep Apnoea to feel tired even after long sleeping hours.

While Sleep Apnoea will almost always lead to loud snoring, snoring alone does not mean that one is suffering from Sleep Apnoea.



Causes And Symptoms

Snoring

  When a person sleeps, the throat muscles relax and the tongue bends backwards. This narrows down the throat to some extent.
  As the person keeps inhaling and exhaling, the throat muscles vibrate. These vibrations lead to snoring. The narrower the throat becomes, the more are the vibrations and the sound.
  The throat muscles tend to relax more with age. This is why snoring usually increases with age.
  If a person has obstructions in the form of Tonsils, Nasal polyps or Deviated nasal septum, the narrowing gets worse and leads to extensive snoring.
  If there is an inflammation in the throat or nose due to some infection or allergy, the throat may become narrower and result in loud snoring.
  In some people, sleeping positions like sleeping on the back or otherwise may abate snoring.
  Alcohol consumption during evening time may abate throat muscle relaxation and give rise to snoring.

Sleep Apnoea

  It is better described as episodes of pauses in breathing for more than 10 seconds at a time.
  The immediate cause of Sleep Apnoea is extensive narrowing or complete collapse of the upper airway.
  As breathing is paused temporarily, it causes a shortfall of Oxygen in blood. As it happens, the heart works harder to make up for it, even when the person is sleeping. This increases the risk of heart attack and stroke.
  It causes disturbance in the natural sleep cycle.

Treatment

Snoring

  Avoidance of risk factors like various allergies
  Correction of sleeping position with training

Sleep Apnoea

  The most common treatment is CPAP (Continuous Positive Airway Pressure). This is a mask like device worn on the nose before sleep. It keeps the upper airway open with a small positive pressure delivered.
  There is also the option of Uvulopalatopharyngoplasty. This is a surgical intervention to remove excess of soft palate tissue and open up the airway. The remaining tissue becomes stiff and thus minimize vibration.
  If there is a Tonsil or Deviated Nasal Septum or Nasal Polyp, it needs to be resected out in order to minimize obstruction to the airway.

Snoring and Sleep Apnoea are very common issues and can be treated by experienced doctors very easily.

Ways to diagnose snoring and sleep apnoea:

The doctors ask about the allergies you are suffering from, as well as your eating patterns, medicines and drinking and smoking habits. The doctor also examines your throat and nasal passages to ascertain if there are any kind of nasal, dental, mouth jaw, or throat deformities that are triggering your snoring. If your doctor will feel that you may be suffering from sleep apnoea, then your partner may be asked to keep a diary noting your sleeping and snoring patterns.

Polysomnography and CPAP Titration are some other ways through which the doctors diagnose sleep apnoea.

Polysomnography: Polysomnography, also called a sleep study, is a type of test that is conducted to diagnose sleep disorders. In this test, the doctors record the brain waves, the oxygen level in the blood, heart rate and breathing, as well as eye and leg movements of the patient.

CPAP Titration: A CPAP titration study is a type of in-lab sleep study that is carried out to calibrate continuous positive airway pressure (CPAP) therapy. It is a common treatment that is used to manage sleep-related breathing disorders including obstructive sleep apnea, central sleep apnea and hypoventilation and hypoxemia.

In case you find out that you are suffering from snoring or sleep apnoea, you should immediately visit a pulmonologist to get the proper treatment. 

Snoring And Sleep Apnoea - How To Get Rid Of Them?

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

Sleep apnoea is a kind of disease that can affect people of any age and is basically a kind of sleep disorder. The person suffering from sleep apnoea may feel extremely tired and fatigued even after having a full night s sleep and his snoring may become extremely loud which is again a serious problem.

What are the symptoms of sleep apnoea?

There can be many cases where the symptoms of central sleep apnoea and complex sleep apnoea may be overlapping which makes it a bit difficult to get diagnosed properly. But, there are certain very basic symptoms of sleep apnoea.
Very loud snoring is a basic characteristic of patients with sleep apnoea.
The patient may suffer from regular episodes of cessation when they are sleeping as might be pointed out by other people.
The patient may awaken from sleep regularly due to shortness of breath and problems in the sleeping order.
The patient suffering from sleep apnoea may wake up from sleep with a very dry mouth and or a sore throat.
The patient may suffer from a bad headache often and in many unfortunate cases, the patients may also suffer from insomnia which is the problem of sleeplessness.
Patients of sleep apnoea suffer from intense problems of irritability and bouts of morning sleepiness.
Shortness of breath may intensify in a patient so much so that the person may get awakened from sleep gasping for air as if choking.
Excessive bouts of daytime sleeping may cause a person to perform very poorly in his work as well.
It is at these times when a patient should immediately consult a doctor for a proper treatment and further solution to this problem.

Causes of sleep apnea

Obstructive sleep apnoea is caused when the muscle in our throat starts relaxing. It is this muscle that gives support to the triangular piece of tissue that hangs from the uvula which is the soft palate and the side walls of the tongue. Basically, when this muscle relaxes, the airways in the body gets narrowed as a result of which the blood does not get enough oxygen which is required for proper breathing. It is then that the brain starts sending signals to get up from sleep so that the nasal passage can be reopened for sufficient amount of oxygen.
There can also be cases where the brain is unable to send a proper signal to the muscles that help us to breath as a result of which a person does not breathe for a certain period of time. This, in turn, makes the patient awaken abruptly from sleep with shortness of breath and the patient finds it difficult to fall asleep.


Sleep Apnea - Know The Common Signs Of It!

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.

There are several types of head injuries from mild as a cut, bruise, bump, contusion to severe ones caused due to a concussion, fractured skull bone, deep cut, internal bleeding, brain damage, etc.

A head injury is a comprehensive term which consists of an array of injuries that damage the skull, scalp, brain, and blood vessels and tissues in the head. It is generally referred to as a traumatic brain injury (TBI) and brain injury, depending upon the type and extent of trauma.

Causes of Head Injury-

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

Vehicle accidents

Domestic violence

Street fights

Fall from height

Child abuse

Subdural hematomas

Brain hemorrhages

Symptoms of Head Injury-

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

Nausea and vomiting.

Fatigue or sleepiness.

Extreme headache.

Confusion.

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 related visual problems; Blurred vision, photosensitivity, blindness, loss of muscle control in the eyes.

Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood.

Problem breathing.

Low pulse rate.

Increase in blood pressure.

Difficulty in swallowing.

Loss of hearing.

Problems in cognitive functions.

Numbness or tingling in the limbs.

Loss of bladder and bowel control due to loss of control over muscle functions.

Loss of consciousness.

Treatment 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:

Cardiac and pulmonary function test.

Glasgow Coma Scale test.

Pupil dilation and corneal function test.

Brain stem reflex tests.

The most common way of diagnosis is the use of CT scans and MRI scans.

A severe head injury often needs surgery to reverse symptoms like chronic fatigue, bleeding, or loss of bodily function. Diagnosis involves finding out the type and severity of the injury and treatment involves removing the problem surgically.

Take Away-

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.

All You Must Know About Head Injury & Its Treatment!

A neurological disorder 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 injuries

For example, advice on special swimming equipment to prevent drowning if he/she gets seizures in the pool

Padding out sharp corners in the house to prevent damage if fallen on

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.

How can physical exercise help with seizures?

Physical exercise improves fitness, energy, and mood and even relieves stress. Improving overall health and well-being 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, keeps 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 can result 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.


Epilepsy - Understanding The Role Of Physiotherapy In It!

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