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Treatment of Neurological Problems
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I have migraine specially in daytime and when sm out under scorching heat of sun the migraine is tremendous.
Sir my problem I cannot feel stable any time my feeling is something is moving and something which moves jerk but not show no any other symptoms this symptoms occur every time. I have done my brain MRI and ear test the report is normal please say what can I do?
I sister has went through brain tumour surgery 2 years back. But she is still disabled with her right hand and right leg. She is improving but with very much slower rate. Post surgery she had been expected to recovery after 6 months but she still can not walk or write properly. I am really worried could you please suggest me.
My son aged 13 years, an autistic and epilectic patient, doctor prescribed him to take famocid 40, addwize, lamitor dt, velparine syrup to prevent seizures for 3 and 1/2 years. Please advise me how to cure completely my son forever ? pradip lahiri, siliguri, west bengal, india.
I am 28 years old male, suffering from migraine since 6 years. I have consulted many neuro doctors and gone thru all types of head scanning and found nothing in scan report. I'm taking the prescribed medicines regularly but didn't see any improvement. Request you to suggest me what should I do next.
I am 50 years old male. I am having numbness problem in my both feet. I have consulted a neurologist and diagnosed the spinal cord disc problem. He suggested a surgery. But I do not want to go for surgery. Looking for a alternative solution.
I am 30 (female). I don't know what is my issue called in medical terms but my brain doesn't stop thinking. It thinks continuously even when I am asleep. Due to this I can't get good sleep. I feel sleepless. I have over thinking issues. I have some gynaecological issues and thyroid too. Can't handle pressure and leave jobs frequently. Do I need medicinal help?
I am on medication for more than 15 years for Epilepsy. (Juvenile Myoclonic Epilepsy). Dosage: Encorate Chrono 500 MG. (Sodium Valporate. Valporate Acid)
Migraine is a severe form of headache wherein, the excruciating pain is accompanied by an extreme sensitivity to sound and light; you also experience nausea. The headaches usually affect either side of the head and are throbbing in nature. Hot flashes, numbness of limbs and blind spots in the eye; these are often considered as warnings. In certain cases, migraines can cause blackouts that can range from a few seconds to a few minutes.
Migraine occurs in four stages:
- Pro-drome (symptom indicative of an onset of an illness)
- Aura (visual auras including blurred vision)
- Post-drome (the residual effects of migraine characterized by fatigue and lethargy)
But the occurrence of these stages varies across individuals. The causes of migraines aren’t specifically understood. It may be due to the interaction of the brain stem with the trigeminal nerve, which is an important pain pathway of the brain. Imbalances in hormonal levels or in the levels of neurotransmitters such as serotonin may also prove to be a causal factor.
Migraine may be triggered due to stress, physical exertion, and excess intake of alcohol or food additives such as MSG (Monosodium Glutamate). Changes in the environment and sleeping patterns may also be probable culprits.
Migraine can be easily distinguished from regular headaches, given the fact that migraines last longer and are rather severe in nature with pain felt in one part of the head. Most people experience the ‘Aura’stage where they have visual flashes right before headache. Nausea, eye pain or sensitivity to light and sound are other factors helpful in distinguishing migraine from other headaches.
Symptoms can occur a while before headache, immediately before headache, during headache and after headache. Although not all migraines are the same.
Typical symptoms include:
- Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
- The pain is usually a severe, throbbing, pulsing pain
- Increasing pain during physical activity
- Inability to perform regular activities due to pain
- Feeling sick and physically being sick
- Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
- Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.
Complications in migraine may include:
- Chronic migraine which last up to 15 days or more
- Status Migrainosus where the attacks last for over 3 days
- Migrainous infarction where the aura lasts longer than it should, cutting blood supply to the brain.
If you wish to discuss about any specific problem, you can consult a neurologist.
Traumatic brain injury (brain injury triggered by an external event such as a fall or a road accident) can be quite a harrowing experience for the patient and their loved ones. While most people recover from the injury, the duration and extent of recovery may vary from individual to individual.
Some patients may simply suffer from a temporary amnesia, while others may remain comatose for months. The recovery time and extent of neurological deficits in traumatic brain injury is determined by the severity and location of the brain injury. The traumatic brain injury can be
Open or closed
- Open injury: There is an opening up of the skin and other layers leading to direct contamination of the brain from external debris and the risk of brain infection is high in such a case.
- Closed injury: here, the brain is not contaminated, but the impact may cause various degrees of injury to parts of the brain.
Primary or secondary injury:
Primary injury: it is damage caused to the brain at the time of the injury. The damage can be
- A crack or fracture in the skull.
- Bleeding into the layers between skull and brain, like a EDH (Extra Dural Hematoma), SDH (Subdural Hematoma) or SAH (Sub-Arachnoid hemorrhage). These are potential emergencies, especially an EDH, where timely Neurosurgical intervention can decide between life and death.
- Due to violent shaking of the brain inside the skull cavity, there can be a damages to the entire brain including the axons and neurons without any visible hemorrhage on CT scans (Diffuse Axonal Injury). The outcome can be quiet unpredictable. It is dangerous if the brain starts swelling up excessively after a DAI.
- A person can also suffer from brain hemorrhages and contusions within the brain matter. Large contusions may need surgical evacuation to control brain pressure. Smaller ones are treated without surgery. Deep seated contusions towards the centre of the brain cause more morbidity even if small in size.
The secondary brain injury may develop gradually (within few hours or days from the primary brain injury), further aggravating the brain tissues. This is brought about by inflammation, altered blood supply, high brain pressure, brain edema or swelling, and programmed cell death. Sometimes, even though the primary insult is small, patients may succumb due to secondary injuries which are highly unpredictable and difficult to treat.
Estimating the extent of the brain damage
The damage inflicted to the brain is assessed by the combined assessment of the following:
1. The mode of injury, especially velocity of impact.
2. How long the person has been unconscious.
3. How bad are the visible external injuries. Is it an open or closed injury?
4. Whether there was any convulsions, vomiting, ear or nose bleeding?
5. Assessment of eye opening, verbal response and movement. This is assessed and recorded by the GCS (Glasgow coma scale).A score of 15 implies the person is fully conscious, a score of 9 indicates the person is in a semi-alert state, while a score of 3 indicates a deep state of coma.
6. Brain imaging through CT or MRI. This gives a more direct information about the physical damages to the brain, and guides the decision about Neurosurgical intervention.
Treatment of traumatic brain injury:
- Medical : medicines are administered to control brain pressure and limit the secondary injuries. It also attempts to control events like convulsions and infections.
- Surgical: surgery becomes necessary when there are depressed fractures impinging into the brain, or large hematoma or brain swelling causing rise of brain pressure or a shift of the brain to one side. Other indications are uncontrolled CSF (cerebrospinal fluid) leakage from nose. Sometimes shunts need to be put to drain out CSF in hydrocephalus (accumulation of excess water in the brain ventricles). During surgery, parts of the skull may need to be removed (Craniectomy) temporarily to allow brain expansion and control brain pressure.
- Accessory surgeries: smaller procedures like a tracheostomy (bypass of the windpipe) or PEG (stomach tube) may need to be done for long term care in comatose patients.
- Rehabilitation: tireless care by nursing and physiotherapy are necessary to help patients recover faster and avoid complications like bed sore, deep vein thrombosis, spasticity and weakness of limbs.
- Recovery: Recovery from traumatic brain injury may be time taking (weeks, months to even years). In addition to the initial treatment and medications, patients may need Brain Injury Rehabilitation. The rehabilitation aims at enabling the person to lead a normal life as early as possible. There are medications, activities, and exercises to improve one's cognitive power.