Adgaba Gel

The primary aim of the treatment in patients suffering from seizure is leasing a seizure-free life without giving way to any adverse effects. This goal can be accomplished in over 60 percent people with the help of anticonvulsants. Some patients also experience adverse effects since they suffer from a seizure which is refractory to medical therapy. Here are some of the common treatment options for seizures:

1. Monotherapy: Sometimes, monotherapy is given as it reduces the chance of all sorts of adverse effects and even avoids drug interactions. Moreover, this type of treatment approach is much less expensive than polytherapy since many older generation of the anticonvulsant agent comprises of hepatic enzyme which is responsible for reducing the serum level of the concomitant drug which leads to an increase in the dosage level of such medicines.
2. Social And vocational rehabilitation: People suffering from problems in psychosocial adjustments after the diagnosis may also need social and vocational rehabilitation. Many physicians do not pay enough attention to the consequences that an epilepsy diagnosis may leave on the patient. For instance, people with epilepsy may have a fear of experiencing next attack of seizure and they may be unable to work at heights or drive.
3. Consulting an expert: It is important to refer patients with intractable spells to epileptologist or neurologist for subsequent workup. A neurosurgical consultation may also be needed when the patient has to be treated surgically.

Importance of anticonvulsant therapy

Patients who have had already suffered from recurrent attacks of unprovoked seizure may need treatment with an anticonvulsant. This treatment is not recommended until the person has risk factors for suffering from the problem yet again. The primary means of treating seizure is anticonvulsant therapy where the most suitable drug is chosen based on accurate diagnosis of the syndrome as a response to specific anticonvulsants may vary from one patient to another. The difference in response may reflect the various pathophysiologic mechanisms in different types of seizures.

Types of anticonvulsant therapy
Some of the anticonvulsant therapy medication may have multiple action mechanism while some have an only single mechanism of action. Some of the most common variants of the therapy include:

1. Neuronal potassium channel referred to as KCNQ opener
2. Blockers of unique binding sites such as perampanel, gabapentin, and levetiracetam
3. H-current modulators such as lamotrigine and gabapentin
4. Carbonic anhydrase inhibitors such as zonisamide and topiramate
5. Alpha-amino 3-hydroxy 5-methyl 4-isoxazole propionic acid receptor blockers like topiramate and perampanel.
6. N and L-calcium channel blockers like zonisamide, valproate, topiramate, and lamotrigine

Even though there are so many types of drugs available, all of them cannot be used for the treatment of seizures. Doctors would evaluate the condition thoroughly before prescribing a medication that can be helpful in reducing the severity of the condition.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The primary aim of the treatment in patients suffering from seizure is leasing a seizure-free life without giving way to any adverse effects. This goal can be accomplished in over 60 percent people with the help of anticonvulsants. Some patients also experience adverse effects since they suffer from a seizure which is refractory to medical therapy. Here are some of the common treatment options for seizures:

1. Monotherapy: Sometimes, monotherapy is given as it reduces the chance of all sorts of adverse effects and even avoids drug interactions. Moreover, this type of treatment approach is much less expensive than polytherapy since many older generation of the anticonvulsant agent comprises of hepatic enzyme which is responsible for reducing the serum level of the concomitant drug which leads to an increase in the dosage level of such medicines.
2. Social And vocational rehabilitation: People suffering from problems in psychosocial adjustments after the diagnosis may also need social and vocational rehabilitation. Many physicians do not pay enough attention to the consequences that an epilepsy diagnosis may leave on the patient. For instance, people with epilepsy may have a fear of experiencing next attack of seizure and they may be unable to work at heights or drive.
3. Consulting an expert: It is important to refer patients with intractable spells to epileptologist or neurologist for subsequent workup. A neurosurgical consultation may also be needed when the patient has to be treated surgically.

Importance of anticonvulsant therapy
Patients who have had already suffered from recurrent attacks of unprovoked seizure may need treatment with an anticonvulsant. This treatment is not recommended until the person has risk factors for suffering from the problem yet again. The primary means of treating seizure is anticonvulsant therapy where the most suitable drug is chosen based on accurate diagnosis of the syndrome as a response to specific anticonvulsants may vary from one patient to another. The difference in response may reflect the various pathophysiologic mechanisms in different types of seizures.

Types of anticonvulsant therapy
Some of the anticonvulsant therapy medication may have multiple action mechanism while some have an only single mechanism of action. Some of the most common variants of the therapy include:

1. Neuronal potassium channel referred to as KCNQ opener
2. Blockers of unique binding sites such as perampanel, gabapentin, and levetiracetam
3. H-current modulators such as lamotrigine and gabapentin
4. Carbonic anhydrase inhibitors such as zonisamide and topiramate
5. Alpha-amino 3-hydroxy 5-methyl 4-isoxazole propionic acid receptor blockers like topiramate and perampanel.
6. N and L-calcium channel blockers like zonisamide, valproate, topiramate, and lamotrigine

Even though there are so many types of drugs available, all of them cannot be used for the treatment of seizures. Doctors would evaluate the condition thoroughly before prescribing a medication that can be helpful in reducing the severity of the condition. In case you have a concern or query you can always consult an expert & get answers to your questions!

A Herniated disc also known as a slip disc or prolapsed disc and it refers to the problem where one of the discs located in between the bones of the vertebrae(backbone) gets damaged and stacks itself upon the nerves. The tender inner portion of the disc gets protruded over the outer ring. Herniated disc causes severe neck pain and back pain. It occurs when the outer ring gets weak and tears down. The most common symptoms include pain and numbness, especially on one side of the body. The pain extends down to the arms and legs. It worsens during nighttime. The muscles become weak. Overweight people are likely to have this disease, as the discs carry extra weight. Old people are vulnerable to a slip disc.

Effects of Herniated Disc:

1. An untreated case of Herniated disc may cause permanent damage to the nerves.
2. In certain cases, a Herniated disc is capable of cutting off nerve impulses to the "caudal equine"nerves, present in the lower back and legs. This leads to loss of bladder control or bowel control.
3. Saddle anaesthesia is another long-term effect. Nerves are compressed by the slip disc, causing loss of sensation in the inner portions of your thighs, the back of your legs and surrounding the rectum region.
4. Symptoms may improve or worsen.

Diagnosis of Herniated Disc:
Treatment or diagnosis of Herniated disc or slipped disc can be either conservative or surgical in nature. The nature of treatment is determined according to your discomfort level and the kind of pain you are experiencing, or how much the disc has slipped out.

1. The pain caused by Herniated disc can be relieved by undertaking an exercise schedule, which includes stretching and strengthening the spine and its surrounding muscles.
2. A physiotherapist should be appointed for recommending the types of exercises.
3. Taking pain relievers also soothes the pain.
4. Stronger medicines prescribed by doctors include-muscle relaxants, narcotics to deal with the pain, medicines for nerve pain such as "gabapentin"  or "duloxetine".
5. In case of the symptoms not subsiding within a span of six weeks, a surgery may be recommended by your doctor. The surgeon may have to remove the damaged part of the disc. This surgery is called a microdiscectomy.

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain.

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

1. Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

2. Patient Controlled Analgesia (PCA): This method is also known as ‘Pain Pump’. An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

3. Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

4. Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

5. Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

6. Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery. If you wish to discuss about any specific problem, you can consult an orthopedist.

Spinal Stenosis is basically the narrowing of the spaces in the spine that further causes pressure on the spinal cord as well as nerves. It has been observed that nearly 75% of cases, mainly occur in the low back that requires lumbar spine treatment. The type of spinal stenosis treatments received for this problem may vary, as it totally depends on the location of the stenosis and the severity of your signs as well as symptoms.

Here are some treatments offered by a spine specialist:

1. Medications 
Sometimes, medications are prescribed by spine physicians to control the pain associated with spinal stenosis. Some of the common medicines prescribed are mentioned below.

• NSAIDs (Onsteroidal anti-inflammatory drugs that help to ease the pain and reduce the inflammation. These mainly include ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve), that are easily available without prescription.

• Muscle relaxants help to calm the muscle spasms that occasionally occur and these medicines includes cyclobenzaprine (Amrix, Fexmid).

• Antidepressants like amitriptyline are recommended to be given as tricyclic nightly doses to ease chronic the pain.

• Anti-seizure drugs are commonly used to reduce pain caused by damaged nerves and these medicines include names like gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica).

2. Therapy 
People suffering from stenosis tend to become less active to reduce the pain caused by physical activities. This further leads to weakness in the muscles that is even more painful. Therefore a physiotherapist teaches some exercises to build up the strength, maintain stability as well as flexibility in the spine and improvement in maintaining balance.

3. Steroid injections 
Because of this ailment nerve roots become a little irritated the spots that are pinched gets swollen. Thus injecting corticosteroid around that constriction that reduces the inflammation and gives relief to the pressure. Theses injections sometimes don't work for everyone and if they are repetitive, they can cause weakness in the nearby bones as well as the connective tissue. Therefore, only a few injections per year are suggested.

4. Surgery 
Surgery is considered, only if the other treatments don't work or a patient is disabled by its symptoms. The main aim of a surgery is to relieve the pressure on the spinal cord or nerve roots which is done by creating more space within the spinal canal. The main examples of surgeries suggested includes Laminectomy, Laminotomy and Laminoplasty.

In most cases, these space-creating operations help in the reduction of the symptoms of spinal stenosis. But sometimes the symptoms do not fully disappear or even get worse after surgery. Surgery even includes some risks like infections, blood clot in a leg vein, neurological deterioration or even a tear in the membrane that covers the spinal cord.