Dr. Deepak Kumar

Alzheimer's disease (AD), otherwise called Alzheimer's, is a chronic neurodegenerative disease that gets progressively worse over time. This condition may start with acute anxiety and dementia, for certain patients. It begins gradually and becomes worse after some time. It is the reason behind almost sixty to seventy percent of the dementia cases. The most well known early indication is trouble in remembering recent events and occasions also known as short-term memory loss.

As the disease progresses, indications can include issues with speech, confusion (effortlessly getting lost), mood swings, loss of inspiration, overseeing self-care and behavioural issues. As the patient’s condition worsens, they regularly pull back from family and society. Over time, bodily functions are lost. Despite the fact that the speed of progression of the disease can differ, the average life expectancy is three to nine years.

• Immunity Matters: Immune cells that ordinarily help us battle off bacterial and viral infections may assume a far more prominent part in Alzheimer's disease than expected. A number of immune system particles have been connected to Alzheimer's disease. Many of them having been identified in the brain tissues of Alzheimer's patients.
• Neuroinflammation: Neuroinflammation is, by definition, irritation of the sensory or nervous tissue. This term is generally connected with endless aggravation and chronic inflammation. In spite of the fact that we realise that the immune system is in charge of setting off this inflammation, how this happens has not been totally understood yet. The immune system has been seen as the first line of defence to threats and dangers to the brain. It is quickly activated and takes care of the danger with an inflammatory response which causes the condition of Alzheimer’s to worsen.
• Microglia: Irritation in a neurodegenerative disease like Alzheimer's is driven essentially by immune cells living in the central nervous system, to be specific microglia. With regards to Alzheimer's, microglia cells can detect the presence of protein totals and react to them. It is believed that the development of Alzheimer's disease may originate from the microglia’s lost capacity to react to A-beta accumulation, therefore allowing its aggregation to continue. This view is upheld by genetic studies in patients with Alzheimer's disease portraying transformations in immune molecules that can trade off microglia's responsiveness.
• Other Signs: Other than genetics, there are different signs that indicate an association with the immune system in the advancement of the disease. These include, for instance, a few immunological links found in the cerebrospinal liquid of Alzheimer's patients from the beginning or epidemiologic proof showing that the prolonged treatment with nonsteroidal mitigating drugs lessens the danger of creating Alzheimer's. Hence, where the immune system acts as a defence mechanism, it can also act as a trigger in some cases that could cause or enhance the Alzheimer’s disease even further.

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The tissue in the brain does not heal in the same way as the tissues in the rest of the body. A traumatic incident such as an accident involving the head, a fall or a gunshot can damage and destroy brain tissue. The extent of this damage depends on the force exerted on the head. Recovering from such accidents can take anywhere from a few months to a few years. No two people recover in the same way and hence it is difficult to set a universal timetable to this recovery. Some people make a full recovery and go back to living their normal lifestyle while others may need help throughout their lives.

• In the first few weeks after the injury, the tissues inside the brain are likely to be swollen and the patient may have internal bleeding. As a result, the person may be in a coma and unaware of the happening around him or her. In this state, the patient will not be responsive to external stimuli of any kind and will be unable to communicate with others.
• As the swelling subsides, the brain tissue functioning will improve. Though the patient’s eyes may still remain closed, he or she may begin to show signs of responsive behavior. With time, he or she may open their eyes and they may begin to experience irregular sleep-wake cycles. At the point, the patient may be said to be in a vegetative state.After some time, the person may also begin to respond to family members and display an ability to follow simple commands. This is known as a minimally conscious stage.
• Caregivers will need to be very patient with the person as at this stage as inconsistent behavior is very common. The person may appear nervous and restless and may often feel frustrated with his or her inability to do things they were able to before the accident. Some days could be very productive while on others, the person may not be able to pay attention to commands or complete actions that they could do on the previous day. The patient may also turn aggressive or overreact to stimuli.
• These first few stages of recovery usually happen within six months of the accident. Between six months and two years from the accident, the brain will slowly regain its functionality. Improvements slow down after two years but may still continue for many years. It is important to remember that the rate of recovery varies from person to person.

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The brain contains numerous nerve cells which help in its normal functioning. Epilepsy or seizures occur when there is a disruption in the activity of the nerve cells in the brain. A neurological disorder of the CNS (Central Nervous System), epilepsy can affect all and sundry, irrespective of their age, sex and ethnicity. However, children and aged people (above 60 years) are more susceptible to the condition. A study suggests approximately 10 million people in India suffer from epilepsy.

Types of Epilepsy
Based on the activity of the brain that causes an epileptic attack, Epilepsy can be of two types - Focal or Generalized
Focal Epilepsy: An epileptic attack triggered by unusual activities restricted to a particular area of the brain.

• In some cases, focal epilepsy may result in unconsciousness. A person may also lose awareness and become unresponsive (keeps staring into space), a condition termed as Focal Dyscognitive Seizures. A person with this condition may behave strange, such as walking in circles, chewing or rubbing their hands.
• In another type of focal epilepsy known as Focal seizures without loss of consciousness, a person does not lose consciousness. In such cases, there may be sudden and involuntary jerking of the arms or the legs. There may also be dizziness or a tingling sensation.

Generalized Epilepsy: Here, the seizures or epilepsy result from unusual activities throughout the brain. Generalized epilepsy, may, in turn, be of the following subtypes

• Tonic seizures: This affects the muscles of the legs, arms, or the back, causing them to stiffen and tighten up.
• Atonic seizures: Here, a person may suddenly fall down due to loss of muscle control. The condition is also known as Drop Seizures.
• Absence seizures: Mostly affecting children, the affected person may lose awareness (temporary) and behave strangely such as staring into spacing, smacking their lips, or blinking their eyes continuously.
• Clonic seizures: They are characterized by sudden and continuous jerking movements of the arms, face, and neck muscles.
• Tonic-clonic seizures: Here, a person may suddenly lose consciousness. There are violent shaking and stiffening of the body. Some people may even be seen biting their tongue.
• Myoclonic seizures: In this arms, and legs of a person suddenly twitches and jerks.

What triggers an Epilepsy?
Epilepsy may be an outcome of the following factors

• Medical conditions such as stroke or even brain tumors may affect the normal activities of the brain, thereby resulting in epilepsy. Diseases such as Viral Encephalitis, AIDS or Meningitis act also act as a trigger, accelerating the chances of epilepsy.
• Developmental disorders such as Neurofibromatosis or Autism can also trigger epilepsy.
• In some cases, epilepsy may be a genetic predisposition. Thus, a person with a family history of epilepsy may suffer from the condition.
• Epilepsy may also be an outcome of a prenatal brain injury due to oxygen deficiency or an infection to the mother.
• People with dementia may also suffer from an epileptic attack.

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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.

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It is common belief that alcohol consumption is a social menace and is injurious to health. It is the third leading lifestyle causes of death in the United States and takes a toll on the health care costs of the country. Many organs like the liver, kidney, heart, and brain are affected in people who are addicted to alcohol. However, it has been proven that alcohol consumption in minor amounts can have beneficial effects on the human body including the heart.

The side effects depend on a number of factors listed below.

• Type of alcohol consumption (social or habitual drinker)
• Amount of alcohol consumed
• Frequency of drinking
• Age, gender, and genetic predisposition of the person to develop alcohol-related diseases
• Family history of alcoholism and its related diseases
• Age at which the person started drinking
• The number of years that a person has been consuming alcohol
• Overall health condition of the person
• Exposure to alcohol as a fetus

Like the adage goes, anything in excess is bad. It is not necessary that a habitual or social drinker who consumes a drink or two per week would end up with these issues. In fact, if recent studies are to be believed, mild to moderate intake of alcohol does have a benefit to overall health.

• The cardiovascular benefits are the most prominent. Red wine and beer, in particular, are shown to provide benefits against cardiovascular damage in the long run. This could be due to the antioxidant properties of red wine. Alcohol itself (ethanol or ethyl alcohol) also has a positive effect. Some varieties of beer, porter and stout varieties in particular, are also shown to be beneficial. The anti-inflammatory properties and antiatherogenic (effect on plaque formation in the blood vessel) are what contribute to these positive effects.
• There is evidence to show that cholesterol profile is improved (good cholesterol increase) and clotting function is improved in people who have mild alcohol consumption.
• The insulin sensitivity is also better, leading to better control of sugar levels.
• Light alcohol consumption also is believed to reduce the risk of hemorrhagic stroke. However, heavy alcohol consumption is believed to increase the risk of stroke and other cerebral events.
• Limited alcohol use is also linked with reduced risk of dementia. Heavy consumption leads to faster memory decline.
• The key to note is that these benefits are only when the alcohol consumption is mild to moderate. In excess, the negative effects of alcohol are well established and numerous. Some of the most significant ones being cirrhosis of the liver and cancers of various organs including mouth, liver, larynx, oesophagus, colon, breast, pancreas, etc. To reduce these effects, alcohol screening and brief counselling to reduce habituation are helpful. If you wish to discuss about any specific problem, you can consult a Neurologist.