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Dr. Y. Bala Raja Sekhar

Neurosurgeon, Hyderabad

500 at clinic
Dr. Y. Bala Raja Sekhar Neurosurgeon, Hyderabad
500 at clinic
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To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. Y. Bala Raja Sekhar
Dr. Y. Bala Raja Sekhar is a renowned Neurosurgeon in Koti, Hyderabad. You can consult Dr. Y. Bala Raja Sekhar at Kamineni Hospital - Koti in Koti, Hyderabad. You can book an instant appointment online with Dr. Y. Bala Raja Sekhar on Lybrate.com.

Lybrate.com has a nexus of the most experienced Neurosurgeons in India. You will find Neurosurgeons with more than 39 years of experience on Lybrate.com. Find the best Neurosurgeons online in Hyderabad. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Kamineni Hospital - Koti

#4-1-1227, Abids Road, Bogulkunta, Koti. Landmark: Near To Taj Mahal Hotel, HyderabadHyderabad Get Directions
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Hi. I'm 19years old n I have migraine problem. Can it ve reduced? I've been using no medicines. I can't bear wen it starts. Help me doc.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Navi Mumbai
First of all you should follow some basic thing 1. Avoid=hot and cold at time 2. Less the sugar as much as possible if you want to eat sweet take juggery which is black 3. Do not drink water after meal drink at the time of meal sip by sip up to 150 ml 4. Avoid late night sleep 5. Shir shuladi vajra ras vati 1 tab after lunch and dinner 6. Audumbaravleha 2 tsp before lunch and dinner.
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Sir my brain is very paining in night when I am going to sleeping night. Any esrly morning. Please solve my problem.

MBBS
General Physician, Mumbai
Few things related to headache so that we can plan the treatment accordingly - if pain is associated with blurred or decreased vision than check your eye sight for refractive error - if the pain is associated with cold and fever than we have to rule out sinusitis as the cause and if the pain is pulsatile in nature and with a throbbing pain usually with an aura than we have to rule out migrane as the cause - if the pain is associated with neck problems than we have to rule out cervical spondylosis as the cause - if the pain is associated with either low or high bp or due to hyperacidity than we have to treat the cause after examination.
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What are the symptoms of migraine? My son will have severe head ache twice in a month (2-5days)

MBBS, cc USG
General Physician, Gurgaon
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.
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Good morning Sir I have migraine I don't know how to cure with it please suggest me.

BHMS
Homeopath, Faridabad
Hello, Self-care measures can help ease the pain of a migraine headache. Try muscle relaxation exercises. Relaxation techniques may include progressive muscle relaxation, meditation or yoga. Get enough sleep, but don't oversleep. Get an adequate amount of sleep each night. It's best to go to bed and wake up at regular times, as well. If possible, rest in a dark, quiet room when you feel a headache coming on. Place an ice pack wrapped in a cloth on the back of your neck and apply gentle pressure to painful areas on your scalp. Medication: Take Bakson's Mig Aid tablet/ 1 tablet 3 times a day.
1 person found this helpful
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Is there any prevention tablet for migraine? Usually I will get some symptoms to get migraine. So is there any preventing tablets? Does migraine is dangerous.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Do take balanced diet and hyderated Do regular physical activity with breathing exercises for about 20 minutes regularly avoid stress anxiety and do focus one thing at a time Best Wishes.
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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

I want to last long in bed. I have heard about some instant pills that helps to stay long in bed. Which pill should I take. And also does taking pill will create numbness as created by some of long lasting condoms Please advise I want to stay long for my first time and also it should not take away the pleasure.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
I want to last long in bed. I have heard about some instant pills that helps to stay long in bed.
Which pill should I...
Homoeopathic medicine DAMIAPLANT ( SCHWABE) Drink 20 drops in 20 ml fresh water 3 times daily for 2 months and report thereafter,
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Last 1 months onwards I am suffering from one side headache (male 27. I am taking antimigrain medicine. If headache is ther? there is any serious issue?

MD - Pathology
General Physician, Amritsar
Get your bp, hb, vision checked in this hot weather dehydration can also cause headache, keep yourself well hydrated. Take tablet suminat 100 rapid release for pain relief if you are taking treatment for prevention of attack, wait for 1-3 months before you will have results.
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Mai last year se hand shake krta h is se koi side effect to ni hai h agar hai to please advice but Hindi language .

PDDM, MHA, MBBS
General Physician, Nashik
Mai last year se hand shake  krta h is se koi side effect to ni hai h agar hai to please advice but Hindi language .
Masturbation is regarded as a normal, healthy sexual activity. In general, the medical community considers masturbation to be a natural and harmless expression of sexuality for both men and women. It does not cause any physical injury or harm to the body, and can be performed in moderation throughout a person's lifetime as a part of normal sexual behavior. It will not affect you or your ability to have children in the future. If you wish to reduce the frequency of masturbation: It originates from brain, due to thinking about sex. Hence: ·     Do not watch adult material. ·     Concentrate more on your studies or work. ·     Exercise regularly.
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My sister age is about 55 years. She has got problem in morning hand shivering, weakness. We had done almost all test. All are normal had b12 injection. Take all medicine. But its not after few hours in morning it will all right. Now what to do.

Master in Psychology, MD - Ayurveda, Dems, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda,
No need to worry Mr. Paresh, just ask your sister to avoid fried oily and junk food. Avoid aerated drinks. Take proper sleep. Do pranayama in the morning for half an hour. Take tab, neurobion forte once a day. Apply n massage mahanarayan tail on both upper limbs for fifteen minutes every alternate day in the morning.
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Epileptic Women of Childbearing Age

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai

Special care and strategic treatment are necessary for a woman with epilepsy with respect to control of epileptic seizures the effects of sex hormones on the seizures, short and long term effects of Anti-Epileptic Drugs during pregnancy as well as on the quality of life.

What are the basic symptom of migraine? I am felling so much trouble all the time.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda
Sexologist, Pune
primary headache disorder,recurrent headaches that are moderate to severe, Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours, Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell,The pain is generally made worse by physical activity, Up to one-third of people have an aura: typically a short period of visual disturbance which signals that the headache will soon occur.Occasionally, an aura can occur with little or no headache following it.
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What is real medicine for seizure. I am taken ox maxetol medicine. I want 2 b allri8 forever. Wt can I do pls give me solution .how can I do my other treatment 2 b allright forever.

MD - General Medicine, DM - Neurology
Neurologist, Kochi
You can slowly taper and stop- but some of the epilepsy is life long and needs life long tretament. I do not know what type you have Get a consulataion.
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I am suffering from migraine for the last 3-4 years. I have been using Zerograin plus. But of late it has stopped being of much help.

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
1 person found this helpful
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My age is 23 years old. At this age I take suminat 25 or 50 mg for severe migraine 8 to 10 times a month. Is it safe?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Udupi
Dear reduce migraine by *diet: good dietary habits would help an individual maintain good health and offer immunity from recurring bouts of headaches. Consuming cooked vegetables without oil should be encouraged. Have a diet rich in fruits and vegetables. Vegetable juices and soup, fruits and fruit juices including apple, mango, should be taken in ample quantities. Highly-fruit based diet for a day or two can relieve pain. Grapes, lemons, cabbage juice are especially important. Rice, salad and buttermilk can always be consumed. *yoga: simple yoga treatments have been found to serve both as an alternative and as a supplement for dealing with migraine and headaches. Yoga is known to offer both cure and immunity from headaches. Headaches caused due to tension and worry can be alleviated through deep breathing and relaxation, especially in a lying down position in a quiet place. Inverted postures, or those where the head is lowered briefly, increase oxygen to the brain and can reduce headache-causing strain. However, for those suffering from severe headache like migraine, any type of exercise can be injurious. *useful herbs -- ginger, brahmi, jatamansi.
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My wife has migraine related to head. Her half portion starts paining sometimes. What should we do to Decrease her pain? Please suggest any remedy.

MBBS
General Physician, Cuttack
Take Paracetamol 500mg one Tablet sos after food, drink plenty of water and take rest.. Check your BP, avoid stress and anxiety since it precipitates migraine attack If You have chronic migraine, you have to take migraine prophylaxis after consulting neurologist
1 person found this helpful
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I am 76 old and having backache and nummness (jhannjanahat) in the right arm and vertigo and taking medicine kalmia and lachlenthis.

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 caldikind plus (mankind) 1tab odx10days paracetamol 250mg od & sos x 5days do neck & back (spine) exercises contact me again if need be. Use of cervical collar will give you relief. Make sure you are not allergic to any of the medicines you are going to take.
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I can't sit down in floor for more mins because I can't feel my leg its like numbness. After I donated blood 1 month ago its spreading all over my body (numbness)

BHMS
Homeopath, Faridabad
I can't sit down in floor for more mins because I can't feel my leg its like numbness. After I donated blood 1 month ...
Hello, Could be due to general weakness of the body. Would advise you to take homoeopathic medicines - Alfaalfa Tonic and Five Phos. - both thrice daily, and let me know about your condition after a month.
1 person found this helpful
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I am 24 year old. I have migraine problem. What are the preventions for it? What can I do whenever my headache is increased? Is there any long term solution for it?

MBBS
General Physician, Cuttack
1.Take Paracetamol 500mg one Tablet sos after food up to a maximum of three tablets daily at the time of attack 2.Drink plenty of water and take rest. 3.. Avoid stress, anxiety, depression, agitation,exposure to loud noise, bright light since it precipitates migraine attack 4.. Go for regular exercise 5. practice yoga, meditation, deep breathing exercise to calm your mind, control your emotion and relieve you from stress 6. If You have chronic migraine, you have to take migraine prophylaxis after consulting physician
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