One of the common ailments in the elderly people is the Parkinson s. A progressive disorder, when left untreated, results in worsening of the symptoms. Hence, it is essential to understand the treatment options available to manage the condition effectively. You may be suggested surgical therapies if medication is not effective enough to treat the symptoms.

Surgical treatment options can be beneficial for patients who are suffering from symptoms, but they do not help with treating the disease. In the past, surgical methods like Thalamotomy and Pallidotomy were used to destroy brain cells that contributed to the symptoms. While these methods are still used, they are very rare and situational.

Deep Brain Stimulation (DBS), an FDA-approved procedure, has become much more popular as it is much safer and does not involve invasive surgery. Instead of destroying brain cells like traditional methods, DBS involves sending electric pulses to the affected brain cells to reduce the symptoms. It is not a treatment procedure, but a means of bringing down the severity of Parkinson s to allow better and more comfortable treatment.

Deep Brain Simulation   Who are the right candidates?
Deep Brain Simulation is commonly used for Parkinson  s disease, but it is not recommended for everyone. It is a preferred method of treatment for people who have had Parkinson s for at least four years but have complications which include long periods of time where medications do not work, or symptoms return, uncontrolled and involuntary movements or the freezing/stiffness in the body.

Deep Brain Simulation is not recommended for those who have Dementia as it can lead to memory problems. The general rule of thumb that neurosurgeons follow is that Deep Brain Simulation can help with symptoms that do not get better with medication. DBS can help reduce medication requirements for patients as well as reduce the side effects that may occur due to medication.

Disorder specialists and neurosurgeons can conduct tests to determine if DBS is going to be effective for a patient before going ahead with such a procedure. An extensive assessment is necessary to understand the symptoms, the effect of Parkinson's drugs and also brain imaging is done. All of the expected benefits are then evaluated for the patients, and if the procedure can help alleviate the symptoms, DBS is given a green signal by neurosurgeons and patients can undergo the procedure.

How Does Deep Brain Simulation Work?
Deep Brain Simulation is a very complex procedure. Brain cells communicate with the rest of the body through electric signal, and these become irregular and do not work properly when affected by Parkinson's. DBS smoothens the functioning of these brain cells and reduces symptoms through electric pulses through the implantation of a medical device known as neurostimulator which is also referred as brain pacemaker.

But, as with any treatment procedure, DBS has potential risks and side effects, hence discuss with neurosurgeon thoroughly to access the suitability.

Adopting Deep Brain Stimulation For Parkinson's disease

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?

Epilepsy is a neurological condition that leads to recurrent seizures. Seizures arise when electrical activity in the brain suddenly surges causing a temporary disturbance within the messaging systems located between the brain cells.

Epilepsy is more common in children below the age of two years and adults above the age of 65 years.

Seizure Types

Seizures are classified into two main categories depending on their area of impact. 

A focal seizure is one that affects only one part or area of the brain whereas a generalised seizure affects the whole brain. Further, both focal and generalised seizures have various sub-categories which are as follows-

Previous nomenclature- 

Partial Seizure

  Simple Partial Seizure
  Complex Partial Seizure
  Partial Seizure with Secondary Generalization

Generalized Seizure

  Absence Seizures
  Myoclonic Seizure
  Atonic Seizure
  Tonic Seizure
  Tonic-clonic Seizure
  Mixed Seizure
  Status Epilepticus

Latest nomenclature of seizure types:

Focal seizures-

  Focal aware seizures
  Focal impaired awareness seizures (previously called complex partial seizures)
. Bilateral tonic clonic seizures

Generalised onset seizures-

  Tonic clonic seizures.
  Atonic seizures (sometimes called drop attacks) and tonic seizure.
  Myoclonic seizures.
  Absence seizures.

Symptoms

The well know symptom of epilepsy is a convulsion/ fit, a few other symptoms include-

  Intermittent spells of fainting. When this happens the patient is likely to lose control of his/her bladder or bowel movements. Following this, the person is likely to suffer from extreme tiredness.
  Spells of a blackout with difficulty in remembering
  Becoming unresponsive to any instructions or questions asked during brief periods of time
  Bouts of continuous blinking without any known reason
  Inappropriate movements that keep on occurring
  Changes in sensory perceptions
  Sudden stiffness in the body

Reasons for Epilepsy

Messaging systems within the brain are responsible for every function that goes about in your body. A disruption to this system caused by defective electrical activity leads to epilepsy in a person. Many people inherit epilepsy while others may develop this condition as a result of-

  Head trauma sustained during an accident
  A stroke or a tumour that has affected the brain impairing its normal capabilities
  An injury to the brain before or during birth
  Associated with developmental issues
  Infections of the brain

Treatment for Epilepsy

Epilepsy in childhood can be treated by using medications and by adopting dietary changes in some cases. Medications for epilepsy mainly include-

  Anticonvulsants - Helps control seizures and manages the symptoms of epilepsy
  Medications for nerve pain - Reduce pain that is caused by the damaged nerves

These medications should be consumed as and when prescribed by the doctor. You must consult a paediatrician for this, as he/she will take your child s physical and mental in consideration before starting the treatment.

Seizures that occur in childhood may be benign. This means that it will not continue into one s adult life. Further, those children who have suffered from epilepsy in their childhood have been seen to have normal mental and intellectual development in their adulthood. However, some epilepsy syndromes in children can have a devastating effect on the child.

Seizure threshold is a term that is used to refer to the conditions that are important for the production of seizures. The threshold is lower for people who are more prone to having seizures whereas the threshold is higher for those who do not have a tendency to suffer from seizures.

A Complete Guide To Childhood Epilepsy!

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

Sleep problems, which can be defined as a sleeping pattern where the parents are unsatisfied, are one of the leading concerns of parents. Children should get a minimum nine hours of sleep so that their health and brain development can occur. Sleep problems can affect not only their health, but also their social and school life. Any interruption or abnormality in a child's sleeping patterns should be examined by a doctor and parents should make necessary efforts for knowing the actual causes of sleep interruption of their kids.

What are the causes of sleep disorders in children?

    Injuries and accidents
    Behavioural troubles
    Overeating
    Slow-reaction times
    Performance problems
    Mood problems
    Learning, concentration and memory troubles

Commonest signs of sleep troubles in kids:

    Difficulty in falling asleep
    Occurrence of unusual events at the time of sleeping like nightmares or sleep-walking
    Snoring and breathing pauses
    Difficulty in staying awake in daylight
    Daytime performances can be adversely affected

Best methods for dealing with sleep disorders in children:

    Regular bed-timing should be sincerely maintained at night.
    Relaxing routine for bedtime needs to be followed,including story-book reading, getting warm bath and others.
    Noise in the house, especially at night, should be minimized so that unwanted disturbances can be eliminated.
    If the room temperature is pretty comfortable, then your kids can sleep peacefully.
    Giving caffeine in excess quantity, especially before sleeping, should be reduced otherwise the kids will not sleep well.
    Meals should not be provided just before bedtime; rather they should be taken a few hours before sleeping.
    If your kids are so very addicted to different electronic gadgets or devices like telephones, televisions, computers and others, then they might face sleeping troubles. Thus, it is your duty to keep your kids away from this kind of addiction.
    If your kids are too very tired, then do not keep them awake forcibly; rather you should make them sleep immediately so that they can get a relaxed sleep at night.

If you think that sleep disorder has become a serious issue with your kids as well, then nothing can be a better option than consulting any health physician. They can best analyse the underlying cause of this issue with your kids.

How to Deal With Abnormal Sleep Behaviour in Children?

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