Common Specialities
{{speciality.keyWord}}
Common Issues
{{issue.keyWord}}
Common Treatments
{{treatment.keyWord}}

Dr. Narendra Yadav

Neurologist, Delhi

100 at clinic
Dr. Narendra Yadav Neurologist, Delhi
100 at clinic
Submit Feedback
Report Issue
Get Help
Feed
Services

Personal Statement

Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Narendra Yadav
Dr. Narendra Yadav is an experienced Neurologist in Bapa Nagar, Delhi. You can visit him at Delhi Poly Clinic in Bapa Nagar, Delhi. Book an appointment online with Dr. Narendra Yadav on Lybrate.com.

Lybrate.com has top trusted Neurologists from across India. You will find Neurologists with more than 44 years of experience on Lybrate.com. You can find Neurologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Info

Languages spoken
English
Hindi

Location

Book Clinic Appointment

Delhi Poly Clinic

EA-Pocket, Maya Enclave, Maya Puri, DelhiDelhi Get Directions
100 at clinic
...more
View All

Consult Online

Text Consult
Send multiple messages/attachments
7 days validity
Consult Now

Services

View All Services

Submit Feedback

Submit a review for Dr. Narendra Yadav

Your feedback matters!
Write a Review

Feed

Nothing posted by this doctor yet. Here are some posts by similar doctors.

Frequently I am getting headache. I check it's migraine. Now days it's coming frequently how to avoid it.

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Frequently I am getting headache. I check it's migraine. Now days it's coming frequently how to avoid it.
Hi Take ½ glass of carrot juice + Add ½ glass of spinach juice + Mix well + Drink this juice to cure headache 1-1 drop of cow ghee in both nostrils at night time before sleep...take pranacharya no tens capsule 1_1 twice a day...take shirshooladi vajra ras twice a day with honey....avoid tea and coffee .
1 person found this helpful
Submit FeedbackFeedback

Hello sir my wife is 23 year old and when she is siting is legs are go to sleep and so much pain when she is stand up so pls advise me some home remedies treatment and yoga or any thing else. Thank you.

BHMS, MD HOM.
Homeopath, Mumbai
Hello sir my wife is 23 year old and when she is siting is legs are go to sleep and so much pain when she is stand up...
Start with Homeopathic medicine:-- Cal carb. 200 Colocynthis 200 4 pills each medicine x 3 times daily x 30 days Take medicine as advised.
Submit FeedbackFeedback
Submit FeedbackFeedback

I have severe headache since 3 days. Though I am taking tablets its not working. Is it related to migraine?

BHMS
Homeopath, Faridabad
Hello, Some primary headaches can be triggered by lifestyle factors, including: Alcohol, particularly red wine Certain foods, such as processed meats that contain nitrates Changes in sleep or lack of sleep Poor posture Skipped meals Stress Insufficient sleep or rest Overexertion Nutritional deficiencies A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches. Get your blood pressure checked, make a chart. Let me know about the readings, will give you medication accordingly. Also, get eyes tested. Medication: Meantime, can start with homoeopathic medicine - Bakson's Mig-Aid tablet/ after every 2 hours.
Submit FeedbackFeedback

Two years back she was having pain in knees. After sitting she the pain was worst. After seeing a physician we went to a neurologist. He said that certain nerves were pinched after an x ray. She was prescribed pregabalin and some other medicines. After two months she got a fit lasting for a minute only. We stopped that medicine and went to another neurologist. He said that there is no problem with nervous system and that knee pain is due to weight. He advised for a CT scan which was normal. However he prescribed Oxetol 300 mg and 450 mg for 3 years. After one month she was tired with the medicine and stopped. Everything was normal for two years. Then again she was having severe pain in leg. We went to another physician and he gave medicines for neuropathic pain of which pregabalin was a medicine. After using for one month she got a fit during night. This time the duration was even shorter. Both times it happened when she awoke in night and fainted. She told a feeling of anxiety that night before sleeping and told her head went numb or cold. We went to physician. He checked history stopped all medicines only giving oxetol 300mg in the morning and 450mg in the evening. Two months passed and she is fine. Very slight pain in knees also. But the doctor says she had to take this medicine for 5 years. Please advice us. We do not know whether she is having epilepsy or it was side effect of the medicines given for neuropathic pain.

MD - Anaesthesiology
Anesthesiologist, Anand
Two years back she was having pain in knees. After sitting she the pain was worst. After seeing a physician we went t...
I do not think it is becase of side effect. It is because of epilepsy only. And she need to continue the treatment for 5 yrs. Even if she donot have epilepsy this drugs wil not harm her.
2 people found this helpful
Submit FeedbackFeedback
Submit FeedbackFeedback

I recently read that researchers believe certain foods might cure Alzheimer’s disease. Is this true? If so, which foods do this and how much would you have to consume to get the benefits?

MBBS, DPM
Psychiatrist, Bangalore
I recently read that researchers believe certain foods might cure Alzheimer’s disease. Is this true? If so, which foo...
Dear lybrate-user, Right now there are no treatment, tablet or food, to cure or reverse Alzheimer memory loss. Further deterioration can be prevented by tablets and food. Since Alzheimer is a gradually downhill course, it is worth preserving what is left of brain functions. All healthy foods are good for both physical and brain health. Why don't you join local Alzheimer's disease society? It will give you ideas of various persons trying in vain various things. In order to find a cure, many things are tried. Some optimistic reports will be there. If it is not significant or not replicated in others, it will not be useful clinically.
1 person found this helpful
Submit FeedbackFeedback

Parkinson s Disease

MBBS, DNB, Fellowship in Neurosurgery
Neurosurgeon, Kolkata
Parkinson s Disease

Deep brain stimulation in Parkinson’s disease

Abstract: Deep brain stimulation (DBS) is a widely accepted therapy for medically refractory Parkinson’s disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are safe and effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed surgery for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is infrequently used as an alternative for tremor predominant PD patients.

Patient selection is critical in achieving good outcomes. Differential diagnosis should be emphasized as well as neurological and nonneurological comorbidities. Good response to a levodopa challenge is an important predictor of favorable long-term outcomes. The DBS surgery is typically performed in an awake patient and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, physiological confirmation, and implantation of the DBS lead and pulse generator. Anatomical targeting consists of direct visualization of the target in MR images, formula-derived coordinates based on the anterior and posterior commissures, and reformatted anatomical stereotactic atlases. Physiological verification is achieved most commonly via microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be discussed.

Key words: deep brain stimulation (DBS); Parkinson’s disease(PD),  stereotaxis

Introduction

Parkinson's disease is a slowly progressive, neurodegenerative disease characterized by tremor, rigidity, bradykinesia and postural instability. It is the most common movement disorder in middle or late life with a prevalence of about 0.3% of the general population, rising to 1% in people over 60 years of age. Approximately 130 000 people suffer from it in the UK and it presents an increasing burden in our ageing population. Pathological findings in Parkinson's disease demonstrate greatly diminished neuromelanin pigmented neurons in the substantia nigra of the basal ganglia with associated gliosis, and Lewy bodies present in many remaining neurons.

James Parkinson, in his original 1817 Essay on The Shaking Palsy, gave an account of six patients in which he noted signs of tremor, festinating gait and flexed posture.  Nearly two centuries from Parkinson's observations, and almost four decades after Cotzias' dramatic demonstration of levodopa's efficacy, the limitations and complications of levodopa treatment for Parkinson's disease have become well documented Five years after initiation of therapy, a majority of patients develop medication related motor complications, namely levodopa induced dyskinesias (LID) and motor fluctuations. Deep brain stimulation (DBS) has been developed primarily to address these treatment related motor complications and therapeutic failures.

Pathophysiology of PD

The loss of dopaminergic neurons in the substantia nigra, the main functional characteristic of PD, affects the circuit described above and leads to the cardinal motor symptoms of PD. While the exact mechanism of this process is unknown, animal research as well as human recordings have provided functional and biochemical evidence that bradykinesia in PD results from excessive activity in the STN and the GPi. This leads to an exaggerated beta (10-30 Hz) synchronization within and between structures in the basal ganglia circuitry  that could also contribute to rigidity and akinesia.

The pathophysiology of rest tremor in PD is less clear and probably more complicated. This symptom most likely results from a dysfunction of both the striato-pallidal-thalamocortical and the cerebellodentato-thalamocortical circuits, with hyperactivity and hypersynchronization between central oscillators.

Possible mechanism of action of DBS

DBS acts through delivering an electrical current in a specific target area of the brain. This current can be modulated through modification of voltage, frequency and duration of each electrical pulse delivered. The delivered energy creates an electrical field of variable size and shape according to the parameters used for stimulation. Although initially believed to stimulate the target, thus the name of the whole process, it seems that

DBS actually excites the neuronal fibers, but inhibits the neural cells. In fact, GPi DBS decreases the GPi mean firing rate back to a normal range in animal models as well as PD patients, and high frequency DBS has a similar effect as dopamine replacement therapies, and promotes faster (about 70 Hz) nonhypersynchronous activity in the basal ganglia, correlated with clinical improvement. This might be achieved through stimulation of bypassing inhibitory pathways, synaptic inhibition, depolarizing blockade, synaptic depression, and simulation-induced disruption of pathological network activity. Overall, this leads to modifications of the firing rate and pattern of neurons in the basal ganglia, as well as local release of neurotransmitters such as glutamate and adenosine. In addition, it seems that DBS also increases blood flow and stimulates neurogenesis. Over the last few years, functional imaging, specifically functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and single-photon emission computed tomography (SPECT), has been used in an attempt to clarify the mechanism of action of DBS. In fMRI, blood-oxygen-level-dependent (BOLD) signals are acquired, and oxygenated blood marks areas of neural stimulation or inhibition. On the other hand, PET and SPECT allow for imaging of multiple activity markers, such as blood flow, glucose and oxygen metabolism. While fMRI is less powerful than nuclear medicine techniques, it provides a much better spatial and temporal resolution. Because of the suspected inhibitory DBS effects in electrophysiological studies, reduced STN blood flow or glucose metabolism would have been expected on functional imaging. However, the opposite has been found to be true in an overwhelming majority of imaging studies to date. In addition, BOLD activation in the area surrounding the electrode has been reported, despite the electrode imaging artifact preventing direct observation of the STN around the electrode. This discrepancy between apparent STN inhibition in single-cell studies and activation in imaging studies might be explained by a few hypotheses. First, electrophysiological recordings identify short neuronal modulation (in the order of milliseconds) while neuroimaging methods may reflect the summed activity changes over seconds to minutes. Second, non-neuronal contributions to the change in blood flow and/or glucose metabolism cannot be excluded, and could confound the results of neuroimaging.

Finally, it is possible that PET and fMRI actually detect the increased activity in the axons, rather than in the cell bodies. Complicating matters further, some imaging studies after STN DBS have showed increased

activity in the GPi while others reported decreased activity in that nucleus. In summary, it is still unclear how exactly DBS affects the firing rate and pattern of neurons and how these changes actually modify the symptoms of Parkinson’s disease. DBS is presently more of an empirically proven treatment in search of physiological explanation.

The effect of DBS on the cardinal symptoms of PD have been established in three randomized controlled clinical trials --- 

TABLE 1

Author, year

 

No of patients

Follow up

Target

Results

Deuschl et al., 2006

156

6 months

BL STN

QOL better with DBS, motor symptom better with DBS

 

Weaver et al., 2009

255

6 months

BL STN or GPi

Dyskinesia free ON time better with DBS

 

Williams et al., 2010

366

12 months

BL STN  or GPi

QOL better with DBS

 

 

PATIENT SELECTION for DBS in PD

Patient selection is a critical first step as poorly chosen candidates may not have optimal benefits and have increased morbidity. Several factors must be considered before determining if a patient is an appropriate candidate for DBS surgery. A multidisciplinary approach involving the neurosurgeon, neurologist, and neuropsychologist is important to determine the appropriate surgical candidate. It is also important that the diagnosis of idiopathic PD be confirmed prior to proceeding with DBS surgery. Key to this assessment is evaluating the surgical candidate in both the on and off medication states with a corroborating levodopa challenge. Perhaps the best prognostic indicator of a patient’s suitability for DBS surgery is their response to levodopa.In general, a levodopa challenge following a 12-hour medication withdrawal should provide at least a 33% improvement in the motor section of the Unified Parkinson’s Disease Rating Scale (UPDRS).

                     In our institute, we follow a simple chart(below) for screening of patients for DBS in PD.

 

 

  1.  

Age<75 years

 

  •  

No

  1.  

Idiopathic PD ( No PSP/MSA/NSD etc)

 

  •  

No

  1.  

Levodopa responsive  

                      

  •  

No

  1.  

Poor/adverse response to drug          

 

  1.  Increased off period                                                              

 

  1. Disabling dyskinesia                                                              

 

 

  1. Disabling motor fluctuations                 

 

 

Yes

 

Yes

 

 

Yes

 

 

No

 

No

 

 

No

  1.  

Degree of disability(UPDRS part III score)>25

 

  •  

No

  1.  

Neuropsychology, MMSE>24

 

  •  

No

  1.  

LEVODOPA CHALLENGE RESPONSE POSITIVE                                                   

 

(30% improvement in UPDRS after 12-hours off medication)

 

  •  

No

  1.  

Advanced  co-morbidity

 

Yes

  •  
  1.  

long term anticoagulation

 

Yes

  •  
  1.  

Willing for surgery and programming

 

  •  

No

 

 

PREOPERATIVE MANAGEMENT

A full medical assessment is a necessary part of the preoperative evaluation, as advanced PD patients tend to be elderly with significant comorbidities. Major issues are---

 

Anticoagulation/antiplatelets--- The risk of discontinuing medications that affect anticoagulation and

platelet aggregation should be weighed against the potential benefits in the quality of life offered by DBS surgery. However, timely discontinuation of these latter medications is mandatory for stereotactic surgery since intracerebral hematomas are the most serious of all potential complications from DBS. Any anticlotting medications, including aspirin, ticlopidine, clopidogrel, and all nonsteroidal anti-inflammatory drugs should be discontinued at least 7 to 10 days preoperatively to ensure the return of normal blood clotting function.

Arterial hypertension can also increase the risk of intracranial bleeding during stereotactic procedures and must be controlled in the weeks prior to surgery.

A prolonged discussion on the short- and long-term effects of DBS on Parkinson’s disease should be carried out with the patient, family, and caregivers.

The night prior to DBS surgery, the antiparkinsonian medications are typically held to pronounce the Parkinson’s symptoms at the time of surgery to see the clinical effects on symptoms during surgery and the families must be counselled regarding their role in facilitating the patient.

Target selection

The two main targets considered for DBS in PD are the STN and the GPi. current tendency is to prefer targeting the STN because of a greater improvement in the OFF phase motor symptoms as well as a higher chance to decrease the medication dosage and a lower battery consumption linked to the use of lower voltage in the STN compared to the GPi DBS. GPi can be the preferred target if LID is the main complaint. GPi DBS might be preferred for patients with mild cognitive impairment and psychiatric symptoms. Because STN DBS might have a higher rate of cognitive decline and/or depression and worsening of verbal fluency in some studies.

Surgical technique

The basic components of DBS implantation surgery involve frame placement, anatomical targeting, physiological mapping, evaluation of macrostimulation thresholds for improvement in motor symptoms or induction of side effects, implantation of the DBS electrode and implantable pulse generator (IPG).

Head-frame placement

The CRW frame is the most commonly used followed by the Leksell frame. Placement of the frame is done under local anesthesia unless anxiety or uncontrollable movements necessitate the use of sedation or general anesthesia.

Leksell stereotactic frame  placed over the head of a patient showing the correct method for placement of the Leksell head-frame. The frame should be placed parallel to orbito-meatal line in order to approximate the AC-PC plane. It is attached to the patient’s head using four pins under local anesthesia.

Imaging and anatomic targeting

Computerized Tomography (CT) scans and MRI are the two main imaging modalities used for targeting when performing DBS implantations. A thin cut stereotactic CT (_2 mm slices with no gap and no gantry tilt) is obtained after frame placement and is then fused with the stereotactic MRI on a planning station (Stealth station). The advantage of fusing the CT with MRI is the ability to avoid image-distortions inherent to MR imaging adding to the stereotactic accuracy. To better define the STN, T2-weighted images (TR 2800, TE 90, flip angle 90˚, slice thickness 2.0 mm) were obtained.

The AC and the PC were marked and the centre of the AC–PC line determined. The next step is planning the entry point and trajectory. The strategy here is to avoid surface and sub-cortical vessels. After trajectory planning, the patient is placed supine on the operating table and the frame attached to the table using an adaptor. Prophylactic antibiotics are given at least 30 min prior to incision. The head is prepped and draped in a sterile fashion. Under local anesthesia, a burr-hole is placed on the calculated entry point marked on the skull. The entry point is determined by the calculated arc and ring angles. Hemostasis is achieved with bone wax and bipolar cautery.

A Medronic Stim-Loc anchoring device (Medtronic, Minneapolis, MN) burr-hole base ring is then placed on the burr-hole and secured with two screws which are used at the end of the procedure to anchor the DBS electrode.

The dura is then cauterized and opened exposing the underlying surface of the brain. The microdrive is then assembled and cannulae inserted 10 mm above the target to avoid lenticulostriate vessels found deeper. Gel- foam and fibrin glue is applied on dural hole to minimize cerebrospinal fluid (CSF) loss and air entry into the skull. Subsequently, microelectrode recording and stimulation is undertaken.

Microelectrode recording/ Mapping

Microelectrode mapping is used to precisely define the target STN and its boundaries as well as nearby critical structures. We believe microelectrode mapping is crucial in order to give one the best chance for optimal placement of the DBS lead given anatomical inaccuracies due to image distortion and intraoperative brain shifts secondary to CSF loss, and pneumocephalus that can lead to inaccuracies in defining the initial target coordinates and shifts in the target itself once the skull is opened. Microelectrode mapping is performed using platinum-iridium glass coated microelectrodes dipped in platinum black with an impedance of around 0.3–0.5 Mo. These platinum-iridium microelectrodes are capable of recording single unit activity and can also be used for micro-stimulation up to 100 mAwithout significant breakdown in their recording qualities.

As the recording electrode was advanced, entry into the STN was identified by a sudden increase in the density of cellular discharge, with the characteristic irregular pattern of discharge—spikes of different sizes, occurring at random intervals. On coming out of the STN a quiet period (background noise) was seen followed by recording from the substantia nigra if the recording was continued far enough, described as high frequency (50–60 spikes/s) discharge pattern.11 Characteristic STN recordings (visual and audio) were identified and the depth of the STN activity was noted. Identification of STN activity was only based on the visual identification. The centre of the point of best electrical activity was selected as the final target. The microelectrode was replaced with a permanent quadripolar macroelectrode (Medtronic electrode no. 3389) to target the centre of the STN electrical activity. The proximal part of this electrode consists of four nickel conductor wires insulated with a polytetrafluoroethylene jacket tubing. The distal part has four metallic noninsulated contacts of 1.5 mm spaced at 0.5 mm intervals. The diameter of the distal electrode is 1.27 mm. Based on the clinical response any of the four contacts can be used for stimulation. Macrostimulation using the DBS electrode itself is then used to determine benefits and side effects. In most cases lateral skull x rays were obtained at this point with image intensifier carefully positioned to locate the target point in the centre of the Leksell-G frame rings.

Initial programming is always refined by using intra-operative macrostimulation data and a mono-polar review to identify the thresholds of stimulation for improvement in parkinsonian motor signs as well as the thresholds for inducing side effects at the level of each contact. The four variables that are used in programming are choice of contacts (0, 1, 2 or 3 used either as the cathode or anode), frequency of stimulation (hertz), pulse-width (ms) and amplitude (voltage).

POSTOPERATIVE MANAGEMENT

In the immediate hours after surgery, it is important to keep arterial blood pressure in the normal range. In addition, the patient’s preoperative drug regimen should be restarted immediately after surgery to avoid problems with dopaminergic withdrawal. Patients should undergo postoperative CT scans and/or MRI scans to assess the electrode location and intracranial status. In addition, plain X-rays are obtained to assess the location and geometry of the leads and hardware. Parkinson’s medications may need to be adjusted depending on the patient’s status. Cognitive and behavioral changes may occur in the postoperative period, particularly in older patients. Patients can be discharged as early as 24 hours after surgery, depending on their neurological and cognitive status.

Conclusion

For the last 50 years, levodopa has been the cornerstone of PD management. However, a majority of patients develop motor fluctuations and/or LID about 5 years after the initiation of therapy. DBS of the STN or the GPI grant to patients with PD improved quality of life and decreased motor complications, and has been approved as such by the Food and Drug Administration in the US in 2002. We reviewed the experience and available literature on DBS for Parkinson’s disease over the last decade and arrive at the following understandings.

The success of DBS surgery depends on the accurate placement of the leads and meticulous programming of the stimulation. Therefore, it is best accomplished by an experienced team of neurosurgeon, neurologist, and support staff dedicated to the treatment.

Reports of surgical complication rates and long-term side-effects of DBS are very variable, so benefits and potential adverse results should not be under- or over-emphasized.

While essentially equal in improving the motor symptoms of PD, STN and GPi might have their own benefits and risks, and the choice of the target should be individualized and adapted to the patient’s situation.

Knowledge to further improve DBS treatment for Parkinson’s disease, such as a more scientific and reliable protocol on programming, strategies to minimize cognitive and psychiatric complications, and the better

long-term maintenance of the implanted device, are still lacking.

Data on the impact of DBS on non-motor symptoms affecting the quality of life of PD patients, such as pain, speech or gastro-intestinal complaints, are still scarce. Further research in these areas will help make this useful treatment even more beneficial.

3 people found this helpful

Sir, I am having problem of fits. I completed a full course of oxetol medicine and in reports also it was cured. But from some days I am getting some minor shocks. Please help.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda,
No for an EEG, do pranayama along with these med ,brahmi tab, aswagandha tab twice daily before food, apply bhringamlaki oil on head.
Submit FeedbackFeedback

My wife is taking tegrital (Carbamazepine) 200 mg daily, earlier she was taking 600 mg daily but gradually reduced to 200. This medicine she is taking since the age of 12 due to seizures, and now she is 46 years old. The last attach had happened almost 15 years ago, hence my question is that she will continue the medicine or should stop it.

MBBS, Master In Health Science
Neurologist, Mumbai
You should talk to an epilepsy specialist before stopping it. The chances of seizure recurrence after stopping medications is about 50-50. Studying earlier Mris and repeating the eeg might help in predicting if she needs to continue taking medications.
1 person found this helpful
Submit FeedbackFeedback

I have a severe migraine problem and the duration of the pain 15 to 20 days. Though I have consulted a doctor at chennai the doctor gave me six month course of tablet and a pain relief tablet Naxdom 500 in 2014 but recently it is not working .what should I do to which Dr. Should I consult.

Mch neurosurgery
Neurosurgeon, Mohali
Mr. lybrate-user, recent change in character of headache is a concern. You shud get ct head done if that is normal then you will require migraine prophylaxis. Regards.
Submit FeedbackFeedback

I am suffering from migraine .please help me. I am 24 years old man. Please do something for me.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Bangalore
Hi. Thanku for writing into Lybrate. Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a viselike quality. A headache may appear as a sharp pain, a throbbing sensation or a dull ache. Headaches can develop gradually or suddenly, and may last from less than an hour to several days. If You give through a description of the condition, the type of pain and the timing and pattern of attacks and food habits. It can be helpful for us to give appropriate medication. Here by I am advicing few General medication which helps to relieve headache. Medication:-According to ayurveda based on individuals prakruti i, e body constitution, age, diet and life styles. In classics different modalities of treatment has been mentioned like shodhana (Panchakarma-detoxification procedure of the body), Shamana (internal medicine). Ayurvedic therapies (panchakarma) for migraine: 1.Shirolepa – Application of herbal pastes which pacify Pitta Dosha like Sandalwood, camphor, Jatamansi. 2.Shiro Dhara – pouring of thin stream of liquid over scalp. 3.Shiro basti-Retaining the medicated oils over the leather cap fitted over the scalp. Any vata-pitta pacifying oils are beneficial for this purpose. 4.Sneha nasya – Instillation of medicated oils can be carried to the nostrils. Shamana (Internal medication):- 1.Pathyadi khada-10 ml with warm water twice a day after food. 2.Tab Niargim-1 tab twice a day after food. 3.Tab Kamaduga with mouktik-1 tab twice a day before food. Tips:- 1.Do not take pain mitigating medicines frequently. Over intake of pain medicines may cause rebound headache and may eventually increase the frequency of migraines. 2.Make sure to sleep and eat at regular intervals. 3.Make sure to sleep at least 7 hours at night. 4.Avoid fasting. It will increase both Pitta and Vata dosha, worsening migraines. Do not skip meals. 5.Quit smoking and get rid of alcoholic addiction 6.Do not drink strong coffee / tea. Make it light. 7.Do not take too hot water bath or too cold water bath. 8.Avoid spicy n fermented food.
Submit FeedbackFeedback

What is an alternative for Vasograin as a painkiller to be taken in Migraine? What is the dosages and side effects of such medicine, if any.

MBBS
General Physician, Mumbai
For headache take tablet paracetamol 650 mg and for migrane we can start with tablet propranolol after personal examination
Submit FeedbackFeedback

Hi sir/madam, when I sit in the chair (bench) for even 2 min, my both legs got torpored (numbness). When I stand it is disappearing. But the pain at my legs lasts for 2 to 3 hours. I have been suffering from this problem for 4 months. Please suggest me how to cure that problem. Thank you sir.

DHMS (Hons.)
Homeopath, Patna
Hi sir/madam, when I sit in the chair (bench) for even 2 min, my both legs got torpored (numbness). When I stand it i...
Hello, Lybrate user, your nerves breakes while sitting on chair causing numbness. Go for a walk in the morning/evening. Go for meditation. Tk, plenty of water. Tk, homoeopathic medicine:@.Arnica mont 200-6 pills, thrice. Report wikly. Tk, care..
Submit FeedbackFeedback

I have headache every week I think it is a symptom. Of migraine what should I do doctor?

MBBS, cc USG
General Physician, Gurgaon
Hello, you may be having headache because of stress/ refractory problems/ any ENT problem or may be Migraine Headache follow advises given below: You can take(If No drug allergy) : 1. Tablet Crocin (Paracetamol 500 mg) one tablet after food when required for headache after food for 2-3 days (maximum 2 tablets with gap of 12 hour can be taken in a day) 2. Adequate sleep 6-8 hr in a day 3. Get check eyes for refractive error 4.We need to go for ENT evaluation to rule out sinusitis 5. Get BP checked 6. Regular physical exercise and meditation and yoga complete history of your headache for further management like duration, severity, aggravating factors/relieving/ triggering/ associated factor to reach diagnosis consult physician for further management.
Submit FeedbackFeedback

I live in Delhi & I am 34 year old male person. I have a tremor problem for last 4 months. What should I do ?

DNB (ENT), MBBS
ENT Specialist, Bangalore
Hi . Tremor problem is very common after stopping alcohol intake suddenly or after excessive intake of alcohol. If that is the case then see a physician. If alcohol is not the cause then other causes are thyroid problems and anxiety. You must then get t3, t4, tsh tests done.
Submit FeedbackFeedback

Hi doctor. When I was 6 months old I had polio however with the required care given I did not paralyzed me totally. But there is a weird thing my left leg is thinner and my right hand is thinner. Can you suggest me if there is any operation or any physiotherapy which I could use to strengthen these?

MPT - Orthopedic Physiotherapy, Fellowship in Orthopaedic Rehabilitation (FOR)
Physiotherapist, Kolkata
Hi doctor. When I was 6 months old I had polio however with the required care given I did not paralyzed me totally. B...
Hello lybrate-user, fortunately you are with positive mind, definitely you should do exercises on order to prevent further dystrophy (wasting of muscles) and to build up strength, endurance and overall functional independence. Best advice for you is hire a physiotherapist who can treat you at your home after a proper assessment. For your left leg depending upon the evaluation and current status of your condition, you may need to do quadriceps strengthening, hamstrings strengthening, gastroc-soleus strengthening, adductor & abductor strengthening, tfl and gluteus medius maximus strengthen, gemellus superior/inferior strengthening. For right hand do elbow flexor and extensor strengthening, wrist flexor extensor strengthening, finger strengthening. Hope it helps. Take care.
2 people found this helpful
Submit FeedbackFeedback

I am 25year old. My hand vibrate. Please Dr. Help me. I am not drink alcohol regular. Only occasionally.

BAMS
Ayurveda, Ambala
The cause of shaking of hands are * muscular weakness in hands * improper neurological functions of hand nerves * restlessness of body * deficiency of nutrition in body. To get relief from shaking of hands * give a balanced diet with vegetables, cereals, milk, fruits. Sit in the sun rays for atleast 8-10 minutes daily. * do bhramari pranayam twice a day. Practice sarwangasan and sit with the gyan mudra in hands. These asans & mudra calm down your brain & relieve from nervousness & restlessness. * take rogan badam (almond oil) and put it 1/2 tea spoon in a glass of milk and drink it in the morning. * take 2 teaspoon of ashvagandharistha added in a glass of water once a day
Submit FeedbackFeedback

I am taking roseday 20, metolar xr 25 and deplatt A 75 that medicine reason of constipation, hard in remember, insomnia and laziness. I got first heart blockage at the age of 23 now I 25 and medicine still continue. No stent insert in my heart, just cleared the blockage and I am on medicine.

MBBS
General Physician, Jalgaon
I am taking roseday 20, metolar xr 25 and deplatt A 75 that medicine reason of constipation, hard in remember, insomn...
Please wake up early go for morning walk in greenery daily do yogasanas and pranayam daily take tab abana by himalaya 1 1 at present continue your current medicine, we will change after one month, following above points.
Submit FeedbackFeedback

Sleep is as Important as Food

MD - Psychiatry
Psychiatrist, Chennai
Sleep is as Important as Food

"With advent of gadgets and night life, many have become sleep deprived off late. There is also a fallacy you need to sleep early and wake up early, whcih is medically untrue. The duration of sleep is of paramount importance for a healthy life. An average of 8 hours of sleep prevents stress, obesity, cardiac illness, immune related disorders, and many more. Minimum one needs 6 hours of sleep, maximum 10 hours. The benefits of dieting, workouts are all negated in the absence of adequate sleep leading to higher morbidity and mortality. Sleep well and be healthy." - Dr. Jagadeesan. (Psychiatrist)

3 people found this helpful
View All Feed