Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them and possibly even prevent them. The two types of migraine are- 

Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.
Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
Motor: Usually related with the movement problems like the limb weakness
Verbal: It is related with the speech problems
Headache: In case of a migraine attack one might experience:

Pain on both sides or one side of the head
Pain is throbbing in nature
Vomiting and nausea
Sensitivity to smells, sound and light
Vision is blurred
Fainting and lightheadedness
Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

Onset of headaches >50 years 
Thunderclap headache - subarachnoid haemorrhage 
Neurological symptoms or signs 
Meningism 
Immunosuppression or malignancy 
Red eye and haloes around lights - acute angle closure glaucoma 
Worsening symptoms 
Symptoms of temporal arteritis
These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.
Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.
Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you.

Migraine - Identifying the Early Signs!

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

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

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

Abnormal blood vessels
Aneurysm
Bleeding
Blood clots in the brain
When the protective tissue or dura is damaged
Epilepsy
Due to nerve damage
Parkinson's disease
Any kind of pressure after an injury
Abscesses
Skull fractures
In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Risks:
Brain surgeries may be associated with several risks. They may be:

Allergic reactions to anesthesia
Bleeding
Blood clot formations
Swelling of the brain
A state of coma
Impairment in speech, coordination and vision.
Problems in memory
Strokes and seizures
Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease.

Brain Surgery - When It Is Required?

Parkinson s disease is a disorder involving the nervous system. It can start with a mere tremor of one hand and advances to slow movement and stiffness. The face might show little no symptoms in the beginning but the speech might become slurred. With every passing day, the condition worsens. This condition has no permanent cure but the symptoms can be improved with proper medication.

What are the symptoms?
Some unmistakable symptoms include the following:

A sudden shaking of the limb. A sudden tremor of the hand is a very common symptom of this disease.
A stiffness of the muscles that can limit the range of motion and sharp pain.
The posture of the body might get compromised. Often balancing problems are witnessed among many patients.
There could be problems with speech leading to soft, slurry or quick speech. The speech in some cases can become monotonous devoid of inflexions.
Parkinson s disease can lead to slow movement and makes performing of simple tasks difficult.
Patients often find writing very difficult
What are the possible causes of Parkinson s disease?

Specific genetic mutation can lead to Parkinson s disease in folks who have a family history of Parkinson s disease. Certain variations of the gene increase the risk of this disease
Exposure to certain environmental factors or certain toxins can trigger Parkinson s disease in an individual.
Certain cells in the brain known as Lewy bodies can trigger Parkinson s disease.
A certain kind of protein cells within the brain known as alpha-synuclein can trigger the Parkinson s disease in an individual
What are the risk factors?

Heredity: Having an immediate family member or a close relative suffering from Parkinson s disease can increase the risk of getting this disease in an individual
Age: Although not a prime risk factor, but an individual over the age of over 60 have an increased risk of getting this disease
Toxins: Exposure to pesticide or certain herbicide increase the risk of Parkinson s
Sex: Men are more likely to get Parkinson s disease than women
What is the medication for Parkinson s disease?

Carbidopa-levodopa: This is a natural chemical that gets passed to the brain and is converted to dopamine by the body. The benefits of this medication might reduce with increased symptoms.
Carbidopa-levodopa infusion: A popular drug in this category is known as the Duopa. It is administered directly into the small intestine in the form of gel through a feeding tube.
MAO-B inhibitors: Drugs from this group include rasagiline and selegiline. This is a powerful medicine. Many patient experiences hallucination during the initial days of consuming these drugs.
Anticholinergics: This medication is mainly used to counter tremors of the limbs in the early stage of the Parkinson s disease.

Parkinson's Disease - What Are The Risk Factors?

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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