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

Dr. Jaydit Roy Choudary

Neurologist, Hyderabad

Dr. Jaydit Roy Choudary Neurologist, Hyderabad
Submit Feedback
Report Issue
Get Help
Feed
Services

Personal Statement

My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Jaydit Roy Choudary
Dr. Jaydit Roy Choudary is a trusted Neurologist in Somajiguda, Hyderabad. You can visit him at YASHODA HOSPITALS in Somajiguda, Hyderabad. Book an appointment online with Dr. Jaydit Roy Choudary on Lybrate.com.

Lybrate.com has a nexus of the most experienced Neurologists in India. You will find Neurologists with more than 37 years of experience on Lybrate.com. Find the best Neurologists online in Hyderabad. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Info

Languages spoken
English

Location

Book Clinic Appointment

YASHODA HOSPITALS

SOMAJIGUDA, HyderabadHyderabad Get Directions
...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. Jaydit Roy Choudary

Your feedback matters!
Write a Review

Feed

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

M suffering from migraine everyday I feel like dyiñg cause of pain I need a advice what should I do for relief.

MBBS, cc USG
General Physician, Gurgaon
I am giving some health tips for Migraine headache •1.You can turn off light for some time •2.Apply hot or cold compresses to your head or neck. •Ice packs have a numbing effect, which may dull the sensation of pain. •Hot packs and heating pads can relax tense muscles. •3.Warm showers or baths may have a similar effect. •4.You can take Tea or coffee( but not excess) 5.Sleep well Here are some tips to encourage sound sleep Establish regular sleep hours. •Minimize distractions. •Your eating habits can influence your migraines. •Be consistent. Eat at about the same time every day. Don't skip meals. Fasting increases the risk of migraines Avoid foods that trigger migraines Meditation This problem can be solved by Meditation, i can give you address of rajyoga meditation center near your house Consult Physician/me for further management
Submit FeedbackFeedback

How can you describe a scar epilepsy? Very confused with this variant! Please can anyone help!

MBBS
General Physician, Faridabad
Sometimes, epilepsy can be caused by scar tissue or a brain infection that can interfere with the brain's electrical signaling. Scar tissue in the brain can be caused by head injury, tumor, stroke or surgery.
1 person found this helpful
Submit FeedbackFeedback

What is the cause of parkinson deseas in women in india. Pl explain in age group 48 to 50 years.

MPTh/MPT
Physiotherapist,
Cause are unknown. Its a degenerative disorder. Symptoms like tremors, difficulty in writing, drooling of saliva, rigidity will be present, difficulty in speech, festinating gait are also seen
Submit FeedbackFeedback

I am 47 years old get floaters since April 2016. I also have epilepsy problem. But I found floaters is not any way connected to epilepsy. I consulted the ophthalmologist in Chennai. They said there is no treatment for the floaters. My question is sometimes it is less and sometimes I feel it is more in a day. The ophthalmologist whom I consulted said that my position is not that laser treatment is needed. So will the floaters increase with age and till what stage I can ignore? Also will it affect my vision in due course of aging?

MBBS, MS - Ophthalmology
Ophthalmologist, Delhi
I am 47 years old get floaters since April 2016. I also have epilepsy problem. But I found floaters is not any way co...
The floaters are due to vitreous degeneration inside the eye causing cells to float in the liquid media of the eye. When these cells pass through visual axis they can be seen as floaters. More clear when seeing towards the sky. Usually they tend to occur in small number, non pathological and increase with age, but are tolerable (doesn't hinder your vision). But if it occurs as a shower of floaters and affects your vision, then it can be pathological as in case of some retinal disease or trauma to the eye and requires immediate attention and management. As such there is no specific treatment for floaters, but washing the eyes frequently and use of some antioxidant and multivitamin (specific for the eye and retina) tablets have shown to reduce the floaters. To know some antioxidant and multivitamin tablet specific for the eyes ask me.
1 person found this helpful
Submit FeedbackFeedback

I have headache problem from few years But I don't know is it migraine How should I do come to know that I have migraine?

MBBS, cc USG
General Physician, Gurgaon
Hello, i am giving you common symptom of migraine Headache eye pain. (most commonly one-sided pain; less frequently both sides of the head are affected) pain located near the eye on affected side. pain that worsens with exertion or physical activity. Nausea/ Vomiting sensitivity to light and/or sound. consult again for further management
1 person found this helpful
Submit FeedbackFeedback

I am having hand shivering and sometimes in some positions body shivering also happens regularly. If I will not eat even one time it will shiver a lot. Can anyone help me in suggesting. Thanks.

Diploma in Venerology & Dermatology (DVD)
Alternative Medicine Specialist, Pune
I am having hand shivering and sometimes in some positions body shivering also happens regularly. If I will not eat e...
Just show to a physician get admitted and do all investigations as this is something quite serious. Alsop it could bed eficnecies of many things and excess Bp or sugar flctuations.
Submit FeedbackFeedback

I am suffering parkinson disease .what can I do I am feeling tired and my head like breathing heart beat plzz give me solution. Thank you.

MBBS
General Physician, Mumbai
I am suffering parkinson disease .what can I do I am feeling tired and my head like breathing heart beat plzz give me...
Dear lybrateuser, -Your tiredness is due to parkinsons disease, have a nutritious well balanced diet, do regular aerobic exercise for 30 min like walking, swimming, stretching as this will improve your muscle strength, flexibility & balance -get investigations done & start medication, consult a doctor, medication helps improve symptoms rapidly & you will feel much better.
1 person found this helpful
Submit FeedbackFeedback

Hi. My mom is feeling partial numbness (or whatever you call it in medical terms) in hands. (It is just like when someone's hand or any other body part is pressed for a long time and the blood circulation stops. Then you feel that numbness.) It happens after doing a lot of work. Is it just a weakness or some other kind of problem? Help me plz.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
Hi. My mom is feeling partial numbness (or whatever you call it in medical terms) in hands. (It is just like when som...
Although it seems like the numbness is due to weakness either due to stress or Vitamin B-12 deficiency but we cannot rule out something more serious and this can be known only after physical examination. 1.Since when is she feeling this problem 2.The numbness is partial or complete in that hand . 3.How about her sleeping and eating habits. 4.Regarding her menstrual history.
Submit FeedbackFeedback

Treatment of Migraine and Improving Metabolism

MD(EH)/AM/Accupressure
Acupressurist, Chandigarh
Take herbal tea for migrane.
And for metabolism take half tea spoon turmeric powder early morning with water.

Hello sir I am anxiety patent and also my digestion power is not good whatever i eat can't digest and and my hand shaking, do not feel strength in my body.

Reparenting Technique, BA, BEd
Psychologist, Bangalore
Hello sir I am anxiety patent and also my digestion power is not good whatever i eat can't digest and and my hand sha...
You must immediately seek help from a counselor. Your fear is creating an obsession and that is leading to anxiety. The stress of this anxiety is causing the indigestion and therefore weakness. Before it gets out of control and difficult to deal with seek help earlier, especially about this fear. If the fear is of recent origin, you could perhaps identify it and deal with it. But if it is from a long past, then much work has to be done to sort that out. If medication is required please cooperate with both the therapies to get the best results. Sometimes this kind of nervousness could be genetic too. In the meantime you must do certain things to build your constitution physically, spiritually, emotionally, and mentally. Mental stability can be achieved by learning a few skills in handling emotions in an appropriate manner. Stress management skills, which have a lot to do with expressing emotions, will need to be a major part of your recovery program. Emotionally you need the help of a counselor and that will help you tremendously to move from anxiety to normal fear. Please persevere and cooperate through all the support you need and you will come through successfully. Develop your body’s health by physical fitness through exercise, good rest (sleep), and a proper diet. Any way what you need to focus on is to do vigorous exercise of the aerobic kind for the heart’s fitness; meditation for the brain’s fitness; sleep for a well rested mind and body; a sound spiritual well being for good confidence and stability; and a diet with lots of vegetables, fruits, and whole grains. Vigorous exercise, especially of the callisthenic kind, will make your heart, which is a muscle, grow larger; and then your heart will need to beat less often and you will respond to the anxiety with a calmer disposition. If your mind, constitution, and your emotions are in check and fit, you will never be disturbed again.
2 people found this helpful
Submit FeedbackFeedback

I am 16 years old but today my right hand was shivering while holding the glass? What is the reason?

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine, Post Graduate Diploma in Healthcare Management (P.G.D.H.M)
Ayurveda, Phagwara
I am 16 years old but today my right hand was shivering while holding the glass? What is the reason?
There may be several reasons behind the problem, from the inputs you had provided there may b malnutrition, so eat plenty of organic fruits & vegetables and increase the amount of protein. Wishes.
1 person found this helpful
Submit FeedbackFeedback

Dark circle on eye due to scared to sleep early it get 2.30 while sleeping migraine head pain gas Healthy body not even walk 1 km a day . Getting lazy ness day by day and taking medicine of bed rest . What should I do.

MD - Homeopathy
Homeopath, Aurangabad
Dark circle on eye due to scared to sleep early it get 2.30 while sleeping migraine head pain gas Healthy body not ev...
Yes migraine headache can be cured by homeopathy take natrum mur 30 30 ml liquid sbl 1 drop daily on tongue for x 7 days and revert me back you may contact me on this site. And check my package and get customized medicines.
Submit FeedbackFeedback

Wat to do with migraine headache. Is there a permanent solution to it, if I start getting a migraine attack it will continues till I get a night sleep, sound not concentrate on work, if I see light it's more irritated.

MBBS
General Physician, Mumbai
Migrane- It is characterised by one sided headache which is pulsatile in nature and with a throbbing pain usually with an aura and we can start with tablet propranolol after personal examination
4 people found this helpful
Submit FeedbackFeedback

I am suffering from insomnia. What can I do to sleep well during night? And work actively during day time.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), DYA (DIPLOMA IN YOG & AYURVED), D.I.H.M (DIPLOMA IN INDUSTRIAL HEALTH MANAGEMENT)
Ayurveda, Nashik
I am suffering from insomnia. What can I do to sleep well during night? And work actively during day time.
Massaging to your head with suitable oil it clears the block in the energy channels that cause a build -up negative energy. It increases energy level, alertness and concentration. Wonderful relaxing therapy. It gives relief from pain, stress, insomnia, tension and tiredness. Helps to reduce the stiffness of muscle reduces physical and mental fatigue. Improve the circulation to head, neck, scalp, face shoulder area. Relieves a headache and migraines. Stimulate healthy hair growth. Prevent hair fall and graying of hair. Anti ageing -relax facial and eye muscles to make you look younger and healthy. Key to increasing eyesight.
Submit FeedbackFeedback

All About Parkison's Disease

MBBS, Master In Health Science
Neurologist, Mumbai
All About Parkison's Disease

* Should I be afraid of talking to the doctor?
No. Every doctor wants his/her patient to recover as soon as possible. If patients have the right knowledge, they are able to interpret and report their symptoms better. Having this knowledge prevents unnecessary anxiety and greatly facilitates diagnosis and treatment.

It is the duty of every doctor to provide the right information to the patient, and every doctor tries to do this to the best of his/ her ability. Sometimes it is not possible to provide thorough information and answer all questions of a particular patient, because then the doctor will not be able to give adequate time to the next patient. Th is is the main reason behind writing this book. In many cases, patients do not want to talk to their doctor because they are afraid of knowing more about their illness. This is the wrong approach. Knowledge is power. I assure you that having the right knowledge will decrease your anxiety and help you get better.

I do have one suggestion: before going to the doctor, write down all your questions on a piece of paper. Almost all doctors will be very happy to answer your questions if you ask them efficiently.

* Why should I pay attention to my symptoms? just run some tests and you will know what disease I have...
Tests can be helpful, but they cannot diagnose all diseases. Often, no test can detect the small short-circuits in the brain that are responsible for causing seizures. Until very recently, there was absolutely no test that could diagnose parkinson's disease. Tests cannot tell the doctor how you are responding to the medication. For example, in parkinson's the doctor may ask you how you feel in the morning, how long the eff ect of medication lasts, do your arms or shoulders jerk after you take medication, and so on. Each symptom is important for the correct diagnosis and treatment of your condition. You and your immediate family members can provide the doctor with this essential information. If you have difficulty remembering your symptoms, you should note them in a notebook. If you have difficulty describing some of your symptoms, you should make a video recording for 3-5 minutes using a smartphone or digital camera (android, Iphone etc). Such recordings are tremendously helpful for diagnosis and treatment.


* What are the common tests used to diagnose brain diseases?
The three tests most commonly used are:
Mri, ct scan and eeg. Other specific tests have been described in the relevant chapters.
(i) Mri (magnetic resonance imaging) scan:
An mri scan is probably the most important test for diagnosis. It can diagnose many diseases such as a stroke, tumor and inflammation. Mri scanning is done in a big tube shaped machine which is attached to a bed. Th e patient sleeps on the bed for 30-45 minutes. Th e bed slowly moves back and forth through the machine. During this time the machine clicks very detailed pictures of the patient's brain.

Please note that during the scan you may hear some loud whooshing and clicking sounds. Th ese are just the sounds of

Magnets and motors inside the machine, and there is no need to be concerned by these noises. Some people may feel anxious because of the small space within the scanner, and a few people may need medications to decrease this anxiety. Mri scanning is extremely safe; there is usually no health risk. Before the scan, please inform the doctor about any metal inserts or implants (e. G. Heart defi brillator) In your body.

Mri test machines are of various strengths such as 1.5 tesla, 3 tesla and so on. Mri machines with a higher number (for example 3 tesla) take better pictures. This book was written in 2015, at this time the highest resolution mri available in india was 3 tesla.

(ii) Ct (computerized tomography) scan:
The CT Scan machine looks just like the mri machine. It has a bed that moves back and forth slowly while the machine takes a picture of your brain.

CT scan has a few advantages over mri:
(i) It is less expensive. An mri may cost around 5000-7000 rupees, while a ct scan usually costs around 1000 inr (indian rupees).
(ii) It can be done very quickly. An mri may take 1 hour or more, but a ct scan can be completed in 10-15 minutes.

Unfortunately, CT scanning has some significant disadvantages:
- The picture obtained by a ct scan is not as clear as that obtained by an mri. The difference in quality is striking: it is like the diff erence between a black-and-white tv from the 70s and the new lcd televisions available today.

- CT-Scan exposes your body to radiation.
Radiation is bad for your body, and especially a baby's body. Therefore, pregnant women should never have a ct scan. Ct scan is commonly used during emergencies. When a patient comes to the emergency room, a rapid ct scan may be done to look for emergencies which may need immediate surgery such as bleeding inside the brain. An mri is usually done the next day, when the patient is more stable.

If you have already had an mri, then usually you do not need a ct scan. Th ere are a few rare conditions (e. G. Calcification in brain) which are seen better on a ct, but these are very uncommon.

(iii) Eeg (electro-encephalo-graphy):
Our brain functions because of electric currents traveling from one place in the brain to another. An eeg measures this electric current.

To do this test, small pieces of wire are stuck to the head using glue. These wires are then connected to an amplifi er and the electrical activity in the brain is recorded. The machine itself does not send any current to the brain. It only records current. Therefore, there is no pain or discomfort, and this is an extremely safe test. Anyone can have this test, including pregnant women, babies and very sick patients. Th is test is most often used for evaluating seizures. An eeg is also used in cases where the patient is unconscious for a long time, without a clear reason.


1. Doctor, my hand keeps shaking. It stops shaking only at night. Why is this happening?
The shaking of your hands is called a tremor. There are many causes of hand tremor. Th e most common causes are essential tremor and parkinson's disease. If you have essential tremor, your hands will shake more when you try to do something. For example, writing may become very diffi cult or water may fall down when you try to drink form a glass.

If you have parkinson's disease, the tremor is maximum when your hands are resting and doing nothing. For example, when you are sitting on a chair and watching tv comfortably, the hand starts shaking. Besides these common causes, there are other causes. For example, shaking of the hand (s) can begin after a small stroke near an important part of the brain called the red nucleus or in a condition called dystonia which causes contraction of the hand muscles without any clear reason some medications (see list), severe anxiety and very excessive tea/coff ee can cause hand shaking. Finally, there are diseases that have symptoms exactly like parkinson's disease.

Therefore, I need to examine you carefully. Based on observing you so far, I think there is a possibility that you may have parkinson's disease.


2. Parkinson's! I have heard this is an extremely serious illness! is this disease fatal?
No. Parkinson's disease is not fatal. Yes, but it is important to treat parkinson's disease promptly. Th e diagnosis of parkinson's disease is often missed. If not treated on time, patients with parkinson's disease are significantly restricted in their day-to-day activities, practically becoming disabled if treatment is delayed for a long time.

Secondly, if left untreated, patients with parkinson's disease can have frequent falls causing serious injuries including fractures and head injuries. Hence the diagnosis and treatment of parkinson's disease should be done as soon as possible.


3. What causes parkinson's disease?
Our brain runs on electricity and chemicals. If there is too much or too little of a particular chemical in your brain, it causes a disease. Parkinson's disease is caused by the reduction of a chemical called dopamine in our brain.

Dopamine is produced in the back of our brain, in a part called the mid-brain. It is then transported forwards and is widely distributed throughout the entire brain. It fi res up the movement centers of our brain, and helps them communicate better with one another. In parkinson's disease the cells in the midbrain producing dopamine gradually

Die. No one quite understands why this happens. Then effect is that the movement centers of the brain don't Communicate well with one another, and this produces the various symptoms of parkinson's disease.


4. Ok so what are other symptoms of parkinson's?
You already know one symptom shaking of the hands while resting. There are many other symptoms in patients with parkinson's disease and recognizing them is often very easy:
- Their muscles are often stiff and become inflexible, but they often do not complain about it. Th ey may complain that they are not able to do some things such as comb their hair.
- They are very slow in doing everything. They walk very slowly. They often bend forward while walking.
- They have difficulty turning around when they are walking.
- Sometimes they can get stuck in one position. Often this happens while walking, but may happen while doing something else.
- In later stages, they can fall frequently.
- Their friends may notice that their face has become expressionless and they just appear to stare off without blinking into distant space.

All patients do not have all of these symptoms. Some patients experience just the shaking of hands; other people experience just the muscle stiffness and so on. Often as people get older, more and more of the dopamine producing cells are destroyed and patients start developing more symptoms. But it takes years for this to happen and it may not happen in all people. In some patients, parkinson's disease remains restricted to just a few symptoms.


5. Ok doctor, thankfully I seem to be having just the hand shaking at this time. But other than the symptoms you just described, I am having other symptoms. I am always constipated, I cannot sleep well, and my saliva keeps dribbling from my mouth. Is it possible that these symptoms are also related to parkinson's disease?
Yes. It is not just possible but very likely that all these symptoms are due to parkinson's disease. Parkinson's disease is recognized by all doctors as a disease affecting movement. But in addition to movement problems, patients can have many other problems.

These are frequently not recognized, even by physicians, and therefore left untreated. If recognized and treated (and simple treatments are available for many of these symptoms), their resolution can significantly improve the patient's quality of life. It is important that your doctor should think about other diseases too. For example

If you have back pain, it is important that the doctor should think about arthritis of the back, if you have impotence your doctor should think about diabetes etc. But in many cases, no other cause can be found - these problems are due to parkinson's disease. About 10-20 years ago, even doctors did not know about these complications of parkinson's disease. It is a matter of great pride for me that I had the opportunity to receive training from the world-famous indian professor who is at the forefront of research regarding these symptoms: Dr. Kallol ray chaudhuri at king's college hospital in london.


6. How can you be sure that I have parkinson's disease?
A better patient history and examination will help me to confirm my diagnosis. We need to rule out other problems which look like parkinson's disease. Certain drugs may produce symptoms that are very similar to parkinson's disease (see list). Make sure you are not taking these medications, and avoid these medications in the future.

There are a few other diseases which have almost the same symptoms at parkinson's disease. Their names are complicated! these include diseases such as progressive supranuclear palsy (psp), multiple systems atrophy (msa) and cortico- basal degeneration (cbd)! th names are not very important the important thing is that there are other diseases that look just like parkinson's disease. Some of these diseases are identified by your doctor by looking for small clues on your exam: such as your blood pressure and the way your eyes move. Now let me tell you something very frankly even after a very detailed history and meticulous examination, the diagnosis may not be clear in some patients, even to the best of doctors in the best of institutions.


7. So isn't there a test for parkinson's disease?
Unfortunately, there is no test for parkinson's disease which can prove it with 100% accuracy. An mri (see information for everyone section) can be helpful to rule out some other diseases e. G. Multiple strokes, and 
Therefore many doctors get an mri in patients with parkinson's disease. There is one test that can be helpful. It

Is called the dat scan. The dat scan is abnormal in parkinson's disease, but it is also abnormal in some other diseases that look like parkinson's disease! therefore it is helpful only in certain cases. There are a few other tests like a cardiac scan (mibg scan), but these are only available at a few research centers, and again, do not help to completely rule out other diseases.


8. But. That is very concerning. What you are saying is that in some patients the diagnosis remains unclear?
You are correct. In most cases, the diagnosis of parkinson's disease can be made with certainty. But about 10% of patients have an uncommon mixture of symptoms so that no doctor, no blood test, no investigation can confidently determine if the patient has parkinson's disease or if he/she has another, similar disease. In such cases, most doctors explain the situation to the patients, and give them anti- parkinson's medications such as levodopa. Usually, a dramatic improvement is seen if the patient has parkinson's disease. If a patient takes an adequate quantity of Levodopa for 4-6 weeks and there is no clinical improvement, it is very unlikely that he has parkinson's disease.

These medications cause clinical improvement in about 1/3rd of all patients with the other diseases such as msa, psp etc. However, this improvement is not as dramatic as the improvement seen in parkinson's disease and frequently does not last as long. As the years go by, other symptoms develop (such as urinary problems, eye movement problems and falling) and a more definite diagnosis can be made on the basis of repeat examination.

9. Hmm. Doctor, there must be several medicines for parkinson's. If the parkinson's is caused by a lack of dopamine, shouldn't consuming dopamine help to reduce the symptoms of the parkinson's?
Yes, there are many medications and yes you are correct providing extra dopamine to the brain is one of the best ways to make the symptoms better. I have provided a list of these medications, but it is worth highlighting two of them: levodopa is the oral form of dopamine. It is converted into dopamine when it goes inside the brain. Th is is usually the fi rst medication that is started. It is available in standard, dispersible and extended-release

Preparations. Young patients with very mild symptoms of parkinson's disease are given a diff erent kind of medication initially. These medications are called dopamine agonists. Th ere are 3 dopamine agonist medications: pramipexole, ropirinole, and rotigotine. Th ey are available in standard and extended release preparations.


10. So, what you are saying is that the dose of parkinson's medications does not stay constant throughout life?
You are correct. Parkinson's disease often progresses as patients grow older. Some symptoms change and become less prominent but on the whole the symptoms become more severe. Th is progression is probably caused by gradual death of more and more cells producing dopamine. Very few people have side eff ects due to these based on the symptoms that develop, the medications. Often, parkinson's disease dose of parkinson's medication may need progresses as patients grow older and new to be changed, or new medications may be given. For example, if you have trouble sleeping at night, then the doctor can ask you to take an extra levodopa pill at night or an extended release ropnirole pill. If the benefi cial effect of levodopa is not lasting for as long as it used to, the doctor may ask you to take entacapone with the levodopa. If you have constipation the doctor will prescribe a laxative and so on. Sometimes it may take a few trials of different medications over 1-2 weeks to find the right combination that works for you. Parkinson's is not a deadly disease. Th ere are many medications for parkinson's. Th e doctor needs to have precise information about the patient's symptoms in order to prescribe the right medications. In parkinson's disease, the doctor needs help from his/her patient. It is essential to record your symptoms accurately and visit your doctor regularly, every 3 to 6 months.


11. Doctor, you are saying that frequently the dose of levodopa needs to be increased. But what happens if too much levodopa gets into the person's brain?
Yes, this can happen but it is not life-threatening. When there is excessive dopamine in the brain, the body starts moving too much. Often there are small jerks in the neck, shoulders and sometimes in the leg. If you are a fan of michael jackson, you have seen break-dancing. Th ese excessive movements look like break-dancing. Th e medical term

For these excessive movements is dys-kinesias. It is very important for you to be aware of them and remember the word: dys-kinesias. Often, dys-kinesias are at their maximum 1-2 hours after you take levodopa. If you have trouble recognizing these movements, you should take a video of any suspicious movements on your smartphone and show it to your doctor. In the early stages of parkinson's disease, dys-kinesias are only seen when the

Levodopa dose is very high. But in more advanced stages, they may be seen at lower doses and giving the patient an adequate dose of levodopa without producing dyskinesias may become diffi cult. At this stage, some dyskinesias may need to be tolerated. If you are suff ering from dyskinesias, you can reduce the dose of levodopa that you are

Taking. But this may result in some of the symptoms of parkinson's disease (slowness, rigidity, freezing etc) to reappear. Another way in which dyskinesias may be reduced is by giving you amantadine.


12. I am getting it now, doctor. This is like a weighing scale isn't it? too little levodopa causes the parkinson's disease symptoms to come back, and too much levodopa action causes dyskinesias.
Yes! th at is absolutely right. In the initial stages, balancing this weighing scale is very easy. But after 10, 15 or in some cases 20 years, balancing this scale becomes diffi cult. After taking levodopa, many patients improve but also get dyskinesias. It becomes impossible to fi nd a levodopa dose that causes improvement without producing dyskinesias. Th erefore, at this stage, some dyskinesias may need to be tolerated as long as you are able to function satisfactorily.


13. So doctor, you told me what happens when there is too much dopamine action in the brain. What if the there is too little dopamine action in the brain? What if levodopa just stops working?
Levodopa never stops working. But it may become less effective, and its effect may become short-lived. Th ere could be many reasons for levodopa to become less eff ective. These are listed separately the most important reason is that the patient may not be taking the levodopa on an empty stomach. As parkinson's disease advances, the eff ect of levodopa lasts for a shorter duration of time. Here is a somewhat typical story from such a patient. Remember, this happens only in few cases:
Taking the tablet helps me only for a short time. When I wake up in the morning, my feet contract, twist and become painful.


14. I understand. It must be difficult at that stage to find the right combination of medications. What if the situation worsens further?
Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to find the right combination; sometimes even 3-4 trials of diff erent combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health.

Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's

Patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. Th en I take my morning dose of levodopa

And feel good. Sometimes I get some dyskinesias, but I don't complain about them because I am feeling good. But only an hour or 1.5 hours later, the symptoms of parkinson's disease start coming back. I become slower and slower, and then freeze. I get better again when I take levodopa, but I can't keep taking levodopa every hour!

I understand. It must be difficult at that stage to fi nd the right combination of medications. What if the situation worsens further?

Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to fi nd the right combination; sometimes

Even 3-4 trials of different combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health. Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. A proper mixture of medications may help this situation as well. I had given you an
Example of this earlier: entacapone can prolong the eff ect of levodopa.


15. Doctor. Brain surgery? are you kidding me? this is a big deal. By the way, what is this surgery called?
I know brain surgery is a big deal. This surgery is called deep brain stimulation, or this is a brain surgery, but a relatively dbs

If your symptoms are well controlled with medications, no doctor in their right mind would recommend you to have surgery. But in a few patients, medications no longer produce adequate improvement. Either the improvement lasts for a very short time, or the medication produces such dramatic dyskinesias that giving an adequate dose is impossible.

Approximately, 70% of such patients benefit from this surgery. The improvement is very significant, but dbs does not make all symptoms of parkinson's disease magically disappear. It is very important to have realistic expectations from the surgery. The improvement seen after surgery is batteries last for about 5 years, and can be Replaced when required.


16. Well. How is this surgery done?
This is a brain surgery, but a relatively minor one. A metal frame is usually attached to the patient's head. A very small hole (approximately 1 cm in diameter) is made in the head, and a thin (1 to 1.5 mm thick) wire is inserted through it. The wire is pushed into a very particular part of the brain called the sub-thalamic nucleus. Th e same process is repeated on the other side and another small wire is inserted. These wires are then connected to a small battery (a square of approx. 3 inch) that is kept in the skin below the chest. No part of this device can be seen from the outside, and any scars on the head are usually covered by hair in a few weeks. Th e device is usually turned on 4 weeks after the surgery. On an average, most.


17. I see. Doctor, does DBS cure all symptoms of parkinson's disease?
No. DBS surgery improves only those symptoms which improve after levodopa.

- Dbs surgery prolongs the eff ect of levodopa, decreases dyskinesias, improves slowness of movement, hand shaking, muscle stiff ness and in general makes the patient much more functional. However, symptoms that do not get better after levodopa such as freezing and falling usually do not get better after dbs.

- Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body. Other symptoms that we talked about e. G. Sleep problems may get better after dbs. I conducted an audit of sleep symptoms after dbs during my time in london at king's college hospital, and found that there is

Significant, but non-dramatic, improvement in many patients.

Two problems can become worse after DBS:
(i) Severe psychiatric problems such as severe depression and hallucinations and
(ii) Severe diffi culties of thinking and memory. If any of these problems are severe, dbs is usually not off ered to the patient. If a patient has severe psychiatric problems and is under treatment, dbs may be considered in the future if they completely resolve.


18. Okay doctor, what are the risks of this surgery?
Th ere is a small amount of risk involved in any surgery. Since dbs surgery is relatively minor, the risk is low but is not non- existent.
- The risk of death is less than 1%
- Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body.
- A few patients have minor problems such as problems in wire connections or a non-functioning battery. Th ese are easily corrected. In short, about almost 90-95% of patient do not have any complications during or after the surgery, and the risk of death or permanent problems is very small (lts 2%).


19. Can the doctor guarantee a significant benefi t after DBS surgery?
No. No doctor in the world can guarantee Improvement after dbs. Th at being said, improvement happens in most patients as long as they are carefully selected. Before off ering you option of surgery, the doctor will give you a large dose of levodopa and make sure that your symptoms improve significantly. He/she will tell you that this is the maximum benefit that you may get after dbs, and try to set realistic expectations so that you are not disappointed after the surgery. Often the surgery is followed by a period of temporary improvement, even before the battery is switched on. This improvement Goes away in a few weeks. Th is is expected and you should not be disappointed - this is a good sign. After the battery is switched on, it may take between 3-6 months to achieve the optimal balance between your dbs and medications. During this time, your symptoms will improve gradually. But you should be patient if your symptoms

Have not improved within 1-2 months there is a good chance they will improve with further dbs adjustments. Most patients improve after dbs surgery, but a few people do not improve. Th e reason why these people do not benefit from dbs surgery is unknown, and this is being vigorously researched in the us, uk and other countries. Read more here

3 people found this helpful

Hi! Im 26years. I have a shivering problem. My hands shake at times even I have healthy food. Cloud please suggest me any home remedy. Thanks.

MBBS
General Physician, Cuttack
. 1. It could be due to essential tremor. The cause of the tremor is unknown. In some cases it is hereditary and runs in families. There is no definite treatment unless it is severe 2 other causes of tremor could be stress, anxiety, panic, nervousness, inadequate sleep, physical exhaustion, strong emotion, hyperthyroidism, hypoglycemia, smoking/tobacco/alcohol abuse/withdrawl, excess tea/coffee, drugs like steroid/amphetamine, neurological disorder, 3. Investigate yourself to exclude the above causes of tremor after consulting neurologist 4. Avoid stress/anxiety/nervousness/ panic etc 5. Avoid excess tea/coffee/ smoking/alcohol 6. Take good nourishing diet 7. Have adequate sleep. 8. Do a thyroid function test to exclude thyroid problem 9. Consult neurologist for further advice.
1 person found this helpful
Submit FeedbackFeedback

In my left hand numbness started after my crt implantation. I consult nuero & concern cardiac, but no result.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
It could be due to cervical spondylosis this is quite a common condition rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Use no pillow under the head. Any way take ibuprofen 200mg od & sos x 5days do neck & back (spine) exercises contact me again if need be. Use of cervical collar will give you relief. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take you will need other supportive medicines also.
Submit FeedbackFeedback

I am 32 years old female having a huge amount of hair fall and migraine problems with joint pain can you suggest some remedies which can be easily made at home.

MD - Homeopathy
Homeopath, Aurangabad
I am 32 years old female having a huge amount of hair fall and migraine problems with joint pain can you suggest some...
Natrum mur 30 take 1 drop 3 times x 7 day above is homeopathic medicine and available in homeopathic store also safe to take and no side effects do not take more days without my consent.
Submit FeedbackFeedback

Sir I am suffering from Seizures, sir can you tell me about this and suffering from last 5yrs, please sir.

MBBS,J.R. Neurology
General Physician,
Suffering from seizures for the past 5 years makes you an epilepsy patient. The causes can be numerous, starting from infection to local lesions. It is mandatory that you get yourself diagnosed properly for the underlying cause and strictly follow the antiepileptic medications that have been prescribed to you. Patients do recover completely and can live a normal life without depending on drugs. Seizures are indeed a cause for concern as it can be life threatening at times. Sometimes there are triggering factors that induce seizures. So I would advise you to look for such factors and avoid them. Consult a neurologist if you haven't. Take care.
2 people found this helpful
Submit FeedbackFeedback

Respected doctors, I am a male of 29 years of age, I am suffering from generalized anxiety disorder feeling like I am in a like state, light headed, foggy vision, stiff head, head feeling numb, depersonalization, tough to carry on life since 1 and half year. One of psychiatrist tell me that I had taken lots of medicine as I was hospitalized 3 times in a year and therefore depersonalised has taken place and feeling numbness in head due to heavy medicine. Eat healthy sleep healthy will create stamina and slowly your anxiety will be improved. Please suggest.

Reparenting Technique, BA, BEd
Psychologist, Bangalore
Respected doctors, I am a male of 29 years of age, I am suffering from generalized anxiety disorder feeling like I am...
Your doctor is right about many things but I recommend that you meet with a counselor too. That person will teach you a lot of skills and techniques to deal with yoru problem along with the help of the medication. Anxiety has all to do with fear and your inability (or so you would tend to think) to handle the same. Fear is based on looking too much into the future and imagining things that usually do not tend to happen (usually 90% of your fears will not happen). You need to change your perception of the fearful stimulus then you can change your response to the fear. The first one is the best and will preempt the need for the second. If you are already far gone into the reaction mode, then you need both responses to counter the attack. The way we see things in life (like half empty or half full glass) is very dependent on our attitude. Attitude may have developed over many years but fortunately can change in a matter of sustained choices made and acted up on now. Accordingly you choose to see things as either threatening or as an opportunity. The opportunist will be positive and work with the situation to make good out of it. The individual who sees it as threatening, will, out of fear, try to avoid/run away from the situation or react with anxiety. Yes, self-belief does impact it too, but you can see that prior to that, perception will tarnish the belief system too. Here, you can see that all the resolution lies in just changing your perception/attitude, even if it is against odds. Changing your response, despite the perception, is building up of your reserves and resources to handle any contingency that life throws up at you. And life throws up situations quite regularly and heavily. For this you need to develop a fit mind and body: The former, by meditation and mind exercises; and the later, by exercises and proper diet. You need good sleep too. Included in the development of the mind is the handling of emotions, in your case, fear. These changes will give you a handle on life and your perceptions and responses. Prayer is really powerful, if you are a spiritual person. Repeat some personally framed affirmations that are geared to calming you down and building confidence. Do a personality course too. Anything that develops you personally will be of great assistance in building resilience.
Submit FeedbackFeedback
View All Feed