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

Paxonil Ls 12.5Mg/0.25Mg Tablet Tips

Infantile Spasms - How To Resolve Them?

Dr.Arsha Kalra 93% (158ratings)
MBBS, MD - Paediatrics, Fellowship in Neonatology
Pediatrician, Zirakpur
Infantile Spasms - How To Resolve Them?

Infantile spasm is a seizure-related disorder that is witnessed among infants and young children. The average age for getting affected with infantile spasm is four months, but some kids might experience this disorder within a month of the birth. This disease can have a subtle appearance, and as such, it is difficult to recognize as a serious condition. While a full seizure in an adult is scary, the one observed among infants can be as little as a minor head drop, along with minor body shakes. This might appear to be that serious, but infantile spasm is more serious as compared to a full body convulsion in adults. Unfortunately, an infant suffering from infantile spasm is at great risk of developmental disability, if the condition is not detected and treated early.

Anticonvulsant Medication:
There are very few medicines that are approved by the FDA for treating infantile spasms. The two medicines that are widely used by doctors include Adrenocorticotropic hormone (ACTH) and Vigabatrin.

  • ACTH: This is the oldest approved medicine by the FDA that was first discovered in the year 1958. This injection needs to be pushed twice in a day. Children tend to gain weight and feel hungry when this injection is injected.
  • Vigabatrin: Vigabatrin is very well tolerated by young kids and has a successful track record of treating infantile spasms. Studies have proven that Vigabatrin can tackle tuberous sclerosis and plays an important role in improving developmental outcome.

Second line therapies:

  • Pyridoxine: Dependency on Pyridoxine as a cause of infantile spasm is very rare. High dosage of oral administration of pyridoxine has fetched good results for patients, who do not suffer from pyridoxine related seizures.
  • Valproic acid: Valproic acid has the best anecdotal rate of success. However, doctors do not recommend this medicine for kids less than 2 years of age because of possible complications.
  • Clonazepam: This is one of the earliest non-steroid medicine for the treatment of infantile spasm. Some of the popular medicines used are nitrazepam, benzodiazepines, and clonazepam.
  • Ketogenic Diet: This is a decade old practice that has come back to popularity again. Studies have shown that ketogenic diet can help 20-35 % patients of infantile spasm to keep the condition under control.
  • IVIG: High dosage of IVIG has been reported to be very helpful in tackling infantile spasms. The dosage ranges from 100-200 mg/kg/dose ranging for about 2-3 weeks at stretch.
  • Surgery: The final part of the therapy includes a surgery that removes the abnormal part of the brain. It should only be considered for patients who have not responded to therapies including Vigabatrin and ACTH. It should also be investigated whether the patient has any structural abnormalities of the brain.
     
1997 people found this helpful

Infantile Spasms - How They Can Be Treated?

Dr.Vineet Bhushan Gupta 88% (99ratings)
Diploma in Child Health (DCH), MRCPCH, MRCP (UK), MD - Paediatrics, MBBS
Pediatrician, Delhi
Infantile Spasms - How They Can Be Treated?

Infantile spasm is a seizure-related disorder that is witnessed among infants and young children. The average age for getting affected with infantile spasm is four months, but some kids might experience this disorder within a month of the birth. This disease can have a subtle appearance, and as such it is difficult to recognize as a serious condition. While a full seizure in an adult is scary, the one observed among infants can be as little as a minor head drop, along with minor body shakes. This might appear to be that serious, but infantile spasm is more serious as compared to a full body convulsion in adults. Unfortunately, an infant suffering from infantile spasm is at great risk of developmental disability, if the condition is not detected and treated early.

Anticonvulsant Medication:
There are very few medicines that are approved by the FDA for treating infantile spasms. The two medicines that are widely used by doctors include Adrenocorticotropic hormone (ACTH) and Vigabatrin.

  • ACTH: This is the oldest approved medicine by the FDA that was first discovered in the year 1958. This injection needs to be pushed twice in a day. Children tend to gain weight and feel hungry when this injection is injected.
  • Vigabatrin: Vigabatrin is very well tolerated by young kids and has a successful track record of treating infantile spasms. Studies have proven that Vigabatrin can tackle tuberous sclerosis and plays an important role in improving developmental outcome.

Second line therapies:

 

  • Pyridoxine: Dependency on Pyridoxine as a cause of infantile spasm is very rare. High dosage of oral administration of pyridoxine has fetched good results for patients, who do not suffer from pyridoxine related seizures.
  • Valproic acid: Valproic acid has the best anecdotal rate of success. However, doctors do not recommend this medicine for kids less than 2 years of age because of possible complications.
  • Clonazepam: This is one of the earliest non-steroid medicine for the treatment of infantile spasm. Some of the popular medicines used are nitrazepam, benzodiazepines, and clonazepam.
  • Ketogenic Diet: This is a decade old practice that has come back to popularity again. Studies have shown that ketogenic diet can help 20-35 % patients of infantile spasm to keep the condition under control.
  • IVIG: High dosage of IVIG has been reported to be very helpful in tackling infantile spasms. The dosage ranges from 100-200 mg/kg/dose ranging for about 2-3 weeks at stretch.
  • Surgery: The final part of the therapy includes a surgery that removes the abnormal part of the brain. It should only be considered for patients who have not responded to therapies including Vigabatrin and ACTH. It should also be investigated whether the patient has any structural abnormalities of the brain.

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

2850 people found this helpful

Slip Disc - Treating It With Sciatica!

Dr.Kailash Kothari 89% (59ratings)
MD - Anaesthesiology, MBBS
Pain Management Specialist, Mumbai
Slip Disc - Treating It With Sciatica!

Introduction The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc.

Symptoms -

This protrusion can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.

Causes of weak disc -

Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

How to deal with it?

- The first step to deal with a herniated or prolapsed lumbar disc is conservative management.

- Rest,

- Analgesic

- Anti-inflammatory medication

- Physical therapy.

At this point, Sometimes it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

What to do if pain does not improve?

If in a few weeks (4 weeks) these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc pathology, the space behind it (Spinal canal) and the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Diagnosis -

Using precision diagnostic & therapeutic blocks in chronic LBP, the following pain generators in lower back have been found:

- Isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients.

Treatment -

Once the diagnosis has been confirmed, there are a variety of treatment options which are non-surgical:

First Method:

  • Image-guided Epidural injection (70% of patients do very well with this)
  • Indicated in  Acute radicular pain due to irritation or inflammation.
  • Symptomatic herniated disc with failed conservative therapy
  • Acute exacerbation of discogenic pain or pain of spinal stenosis
  • Neoplastic infiltration of roots
  • Epidural fibrosis
  • Chronic LBP with acute radicular symptoms
  • Epidural Lumbar injection

ESI Treatment Plan Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.

Second Method:

If pain doesn't subside and diagnosis is in doubt we perform Provocative Discography - Coupled with CT.

A diagnostic procedure & prognostic indicator is necessary for the evaluation of patients with suspected discogenic pain. This test has the ability to reproduce pain on injection of the affected disc, to determine type of disc herniation/tear by performing post discography CT scan.

Once we know which disc is painful and what type of disc prolapse it is, we may plan further intradiscal treatments.

Third Method:

One of the best alternatives existing today is the Disc Fx and disc biculoplasty RF ablation, as the results obtained are excellent and practically has minimal to no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. The popularity of this technique is that it achives similar or better success rates in well selected patients.

Fourth Method:

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for multilevel cervical & lumbar disc herniation with radiculopathy.

The total cost of these procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Fifth Method:

Nucleoplasty and Dekompressor discectomy are other common techniques in some patients. This helps in debulking the disc and thereby reduces the nerve compression.

Sixth Method:

Epidural Adhesiolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS). A spring-loaded catheter is inserted in epidural space via caudal/interlaminar/transforaminal approach.

After epidurography, testing volumetric irrigation with normal saline/LA/hyalase/steroids/hypertonic saline in different combinations is then performed along with mechanical adhesiolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Seventh Method:

Some patients (less than 2 %) do need surgery if pain doesn't improve. In today's time, open surgery is not required in most cases. Percutaneous endoscopic discectomy is most advanced and stitchless surgery which is done under local anesthesia. Patients recover very fast and go home on same or next day.

Conclusion - In today's time, back pain due to disc herniation is managed best by pain management doctors as they offer range of nonsurgical of minimally invasive surgical options with better success rates and minimal complication rates. The patients do recover very fast without the need to be in the hospital.

4809 people found this helpful

How To Treat Slip Disc With Sciatica?

MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Anaesthesia, PDCC - Pain Management, Fellow of Interventional Pain Practice
Pain Management Specialist, Delhi
How To Treat Slip Disc With Sciatica?

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.

Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in – Acute radicular pain due to irritation or inflammation.

  • Symptomatic herniated disc with failed conservative therapy
  • Acute exacerbation of discogenic pain or pain of spinal stenosis
  • Neoplastic infiltration of roots
  • Epidural fibrosis
  • Chronic LBP with acute radicular symptoms
  • Epidural- lumbar injection

ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

  • There is minimal or no radiological finding.
  • Multilevel imaging abnormalities
  • Equivocal neurological examination finding or discrepancy between clinical & radiological signs
  • Postop patient with unexplainable or recurrent pain
  • Combined canal & lateral recess stenosis.
  • To find out the pathological dermatome for more invasive procedures, if needed

Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

4354 people found this helpful

Procedures That Can Help Treat Slip Disc & Sciatica!

Dr.Neeraj Jain 86% (20ratings)
MBBS, MD, FIMSA, FIPP, CIPS - Certified Interventional Pain Sonologist
Pain Management Specialist, Delhi
Procedures That Can Help Treat Slip Disc & Sciatica!

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.

Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in – Acute radicular pain due to irritation or inflammation.

  • Symptomatic herniated disc with failed conservative therapy
  • Acute exacerbation of discogenic pain or pain of spinal stenosis
  • Neoplastic infiltration of roots
  • Epidural fibrosis
  • Chronic LBP with acute radicular symptoms
  • Epidural- lumbar injection

ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

  • There is minimal or no radiological finding.
  • Multilevel imaging abnormalities
  • Equivocal neurological examination finding or discrepancy between clinical & radiological signs
  • Postop patient with unexplainable or recurrent pain
  • Combined canal & lateral recess stenosis.
  • To find out the pathological dermatome for more invasive procedures, if needed

Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

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

4501 people found this helpful

Creutzfeldt Jakob Disease!

Dr.Radhika A (Md) 89% (13ratings)
MD - Acupuncture, Diploma In Accupuncture, Advanced Diploma In Accupuncture
Acupuncturist, Delhi
Creutzfeldt Jakob Disease!

Treatment of Creutzfeldt-Jakob disease

Homeopathic Treatment of Creutzfeldt-Jakob disease
Acupuncture & Acupressure Treatment of Creutzfeldt-Jakob disease
Psychotherapy Treatment of Creutzfeldt-Jakob disease
Conventional / Allopathic Treatment of Creutzfeldt-Jakob disease
Surgical Treatment of Creutzfeldt-Jakob disease
Dietary & Herbal Treatment of Creutzfeldt-Jakob disease
Other Treatment of Creutzfeldt-Jakob disease
What is Creutzfeldt-Jakob disease
Symptoms of Creutzfeldt-Jakob disease
Causes of Creutzfeldt-Jakob disease
Risk factors of Creutzfeldt-Jakob disease
Complications of Creutzfeldt-Jakob disease
Lab Investigations and Diagnosis of Creutzfeldt-Jakob disease
Precautions & Prevention of Creutzfeldt-Jakob disease
Treatment of Creutzfeldt-Jakob disease 

Homeopathic Treatment of Creutzfeldt Jakob Disease

Homeopathy balances mood and relieves complaints like anxiety, depression, insomnia etc. It treats the person as a whole. Treatment is constitutional. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. It balances the energy system, improves immunity and body functions. It naturally cures the root cause of disorder. Some of the homeopathic medicines for treatment of Creutzfeldt Jakob disease are:

Platina
Kali br
Aurum
Ars alb
Kali ars 

Acupuncture and Acupressure Treatment of Creutzfeldt Jakob Disease

Acupuncture has worldwide reputation in treatment of degerative neurological conditions. Therapist will first make acudiagnosis to detect blockage of energy system and will then treat accordingly.

Psychotherapy and Hypnotherapy Treatment of Creutzfeldt Jakob Disease

Psychotherapy and hypnotherapy can play a good supportive role in reducing anxiety, depression, improving sleep and overall emotional state.

Conventional / Allopathic Treatment of Creutzfeldt-Jakob disease

In the allopathic treatment of Creutzfeldt-Jakob disease, Opiate drugs can help relieve pain if it occurs, and the drugs clonazepam and sodium valproate may help relieve symptoms. A catheter can be used to drain urine if the patient cannot control bladder function, and intravenous fluids and artificial feeding also may be used.

What is Creutzfeldt-Jakob disease?

Creutzfeldt-Jakob disease is a degenerative brain disorder. It leads to dementia and, ultimately, death. This disease is rapidly progressive and always fatal. Most patients die within a year.

Symptoms of Creutzfeldt-Jakob disease

Personality changes
Anxiety and Depression
Mood swings
Memory loss
Impaired thinking
Blurred vision
Insomnia
Difficulty speaking
Difficulty swallowing
lack of coordination
Sudden jerky movements

Causes of Creutzfeldt-Jakob disease

The cause of Creutzfeldt-Jakob disease is abnormal versions of a kind of protein called a prion. These proteins are harmless, but when they’re misshapen they become infectious and can wreak havoc on normal biological processes.

Risk factors of Creutzfeldt-Jakob disease

Around the age of 60
Genetics
Exposure to contaminated tissue

Complications of Creutzfeldt-Jakob disease

Infection
Heart failure
Respiratory failure 

Diagnosis of Creutzfeldt-Jakob disease

Diagnosis of Creutzfeldt-Jakob disease involves the following tests:

Medical and personal history
Neurological exam
Electroencephalogram (EEG)
Magnetic resonance imaging (MRI)
Spinal fluid tests
Tonsil biopsy

Myofacial Pain - How To Diagnose It?

Clinical Fellowship In Pain Management, MD - Internal Medicine, Master Of Public Health (MPH), MBBS
Pain Management Specialist, Hyderabad
Myofacial Pain - How To Diagnose It?

Myofascial pain syndrome or MPS refers to the soft tissue and muscle pain that is often accompanied by inflammation. This chronic condition affects the fascia, which is the connective tissue covering the muscles. MPS is also called referred pain.

Symptoms of Myofascial Pain Syndrome

The symptoms of myofascial pain syndrome are all related to pain:

  • Excruciating pain in the muscles

  • Persistent pain that worsens occasionally

  • Knotty muscles

  • Sleep disturbances due to the pain

  • Difficulty at work or any performance due to the pain

The pain usually originates at a point and spreads to the entire muscle group and surrounding muscle groups, depending on the intensity of the pain. Allowing the pain to stay without treatment might worsen symptoms.

The symptoms give way to sleep disorders and sometimes, Fibromyalgia, that will worsen the symptoms.

Causes of Myofascial Pain Syndrome

Myofascial pain usually occurs due to some kind of injury. It can be strenuous exercise or sports routine, or an injury from an accident. A tendon, ligament, or muscle group injured earlier can develop symptoms of myofascial pain syndrome. Other specific causes include:

  • General fatigue

  • Stomach irritation

  • Heart attack is a risk factor

  • Repetitive Motions

  • Lack of movement of a certain body part

  • Intervertebral disk injury

  • Stress and anxiety are the causes that don’t even need a preexisting physical injury to cause referred pain. But if MPS already exists, stress, anxiety, depression, and other mental health issues can worsen the symptoms.

Diagnosis

The doctor will ask questions about the injury (if any), the mental health condition, the lifestyle or work routine, and about the symptoms and triggers. The doctor will apply pressure on the pain regions to determine the type of pain. It can be any of the following:

  • Active trigger point

  • Dormant trigger point

  • Secondary trigger point

  • Satellite myofascial point

Treatment of Myofascial Pain Syndrome

Treatment of MPS involves a combination of medication, injections at the trigger points, and physical therapy. The doctor will decide which of the three treatment pathways, or which combination is best fitted for the case.

  • Medication: Usually there are three types of medication for referred pain. One is pain relievers containing Ibuprofen or Naproxen Sodium. Some need to be orally consumed and some need to be applied on the skin at the trigger point. The second option for medication includes antidepressants which might be helpful if the pain is chronic and worsens with depression. The third option is sedatives like Clonazepam that helps with stress and insomnia to alleviate the pain symptoms.

  • Therapy: A certified physical therapist will know suitable stretching/massage/posture training exercises to alleviate the symptoms over time. Heat and ultrasound can also be used in therapy to increase blood circulation and promote muscle healing.

  • Needle procedures: Trigger point steroid injection and acupuncture can help alleviate symptoms of MPS.

The symptoms of myofascial pain syndrome take time to reduce. With continued treatment, moderate exercise, some caution to avoid further injuries, and maintenance of healthy posture at all times, even chronic pain can be cured.

It is always advisable to consult a doctor as soon as a person notices any symptoms.



 

4298 people found this helpful

Premature Ejaculation: What Should You Know About It?

Dr.Shyam Mithiya 91% (722ratings)
MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Premature Ejaculation: What Should You Know About It?

My last article gave insight on the non-medical methods of controlling premature ejaculation Now, as a wrap up on this topic, I will highlight the options of medical treatments available for managing P.E. However, take it as a warning that you must consult your doctor before trying out any of these methods and medicines, because more often than not, such drugs and medicines have their side effects that can adversely bother your health.

By now we know that Premature ejaculation (PE) occurs when a man reaches peak of sexual excitement and ejaculates before he actually wants it to happen, thus, leaving his partner deprived of the sexual pleasure that she deserves. Even the most empathetic female partner would not like his man to leave her unsatisfied in bed.  Sooner or later this problem becomes a medical problem, reduces the warmth in their relationship.

Several factors including psychological problems such as anxiety; biological problem like penile hypersensitivity, hormonal imbalance (e.g. thyroid problem); behavioural problem like, habituation of quick sex/masturbation, etc may be held responsible for causing PE.

Medical (Allopathic) therapy for PE treatment:

Drugs used for managing premature ejaculation reduce sensitivity and anxiety, improve blood flow and even affect some chemical mediators present in the brain. These class of drugs include local anaesthetics, antidepressants and phosphodiesterase-5 inhibitors.

Anaesthetic compounds were the first medical treatment proposed for PE management. They were applied topically to the surface of skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays/ creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of penis, absorption in vagina resulting in vaginal numbness and irritation.

Earlier agents like Alpha Amino Benzoate and Phenoxybenzamine were used to prolong duration of intercourse, but they were associated with severe side effects.

It has been found that Serotonin (a chemical in brain) levels were deficient in PE patients. Treatment medications include Selective Serotonin Reuptake Inhibitors (SSRIs), which interact with a receptor (5-HT2C) present in brain and increases the production of Serotonin. They also help in reducing anxiety and depression associated with PE. Through this mechanism, they prolong the time to reach ejaculation. Several SSRIs have increasingly become used as 'off-label' for PE.

Among the available SSRIs, Paroxetine-Dapoxetine is more beneficial with lesser side effects as compared to other SSRIs. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent SSRI which acts quickly and cleared rapidly from the body. Adverse effects with SSRIs are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term use of Paroxetine.

Another potential medical treatment option for PE are class of medications which increase the blood flow by dilating the blood vessels of penile region and prolong the PE. But headache, dizziness, flushing, body-ache associated with them have limited their use in PE.

At present, clinicians need to consider all treatment modalities when evaluating a man with PE, as each patient may respond differently and experience variable side effects. Additional and more effective therapies need to be developed having least side effects.

Ayurvedic therapy for PE treatment:

Vajikaran in Ayurveda is an important treatment modality which increases sexual capacity and improves health. In Sanskrit, Vaji means horse, the symbol of sexual potency and performance thus Vajikaran means producing a horse's vigour, particularly the animal's great capacity for sexual activity in the individual. Vajikaran therapy reenergizes all the seven dhatus (body elements), and restores equilibrium and health. It also offers a solution to minimize the shukra (sperm and ovum) defects.

There are many formulations which are used in Vajikaran. Some of the commonly used formulations include Vrihani GutikaVrishya Gutika, Vajikaranam Ghritam and Upatyakari Shashtikadi Gutika.

Vrihani Gutika is one of the potent formulations while Vrishya Gutika is highly potent aphrodisiac used in treatment of PE. Vajikaranam Ghritam enhances the strength of penis. Upatyakari Shashtikadi Gutika is useful for the enhancement of the fertility.

Also, Chapdraprabha Vati and Kaunch Pak are known to increase sexual vigour and semen consistency helping in increase in sexual timing.

So, with this concluding article, I wrap up my knowledge and experience in treating patients suffering from premature ejaculation. Take care, and stay healthy!

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

7145 people found this helpful

How to Manage Premature Ejaculation? Medical Treatment Options

Bachelor of Ayurveda, Medicine & Surgery (BAMS), MS-Ayurveda
Sexologist, Delhi
How to Manage Premature Ejaculation? Medical Treatment Options

As discussed earlier, premature ejaculation (pe) occurs when a man reaches the peak of sexual excitement and ejaculates before he wants it to happen. When pe interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors such as psychological problems (eg. Anxiety), penile hypersensitivity, habituation of quick sex / masturbation, alcohol abuse, hormonal imbalance (e. G. Thyroid problem), and even genetic problems may cause pe.

Medical (allopathic) therapy for pe treatment:

Drugs used for the management of pe reduce sensitivity and anxiety, improve blood flow or even affect some chemical mediators present in the brain. These classes of drugs include local anaesthetics, antidepressants, and phosphodiesterase 5 inhibitors.

Anaesthetic compounds were the first medical treatment proposed for pe management. They were applied topically to the surface of the skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays / creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of the penis, absorption in vagina resulting in vaginal numbness and irritation.

Treatment medications include selective serotonin reuptake inhibitors (ssris), which interact with a receptor (5-ht2c) present in brain and increases the production of serotonin. They also help in reducing anxiety and depression associated with pe. Through this mechanism, they prolong the time to reach ejaculation.

Several ssris have increasingly become used as" off-label" for pe. Among the available ssris, paroxetine and dapoxetine are more beneficial with lesser side effects as compared to other ssris. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent ssri which acts quickly and cleared rapidly from the body. Adverse effects with ssris are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term paroxetine.


Another potential treatment option for pe are classes of medications which increase the blood flow by dilating the blood vessels of the penile region and prolong the ejaculation time (phosphodiesterase 5 inhibitors). But a headache, dizziness, flushing, body aches associated with them have limited their use in pe.

At present, clinicians need to consider all treatment modalities when evaluating a man with pe, as each patient may respond differently and experience variable side effects. Additional and more effective therapies need to be developed having least side effects.

Ayurvedic therapy for pe treatment:

Vajikaran in Ayurveda is an important treatment modality which increases sexual capacity and improves health. In Sanskrit, vaji means horse, the symbol of sexual potency and performance thus vajikaran means producing a horse's vigor, particularly the animal's great capacity for sexual activity in the individual. Vajikaran therapy reenergizes all the seven dhatus (body elements) and restores equilibrium and health. It also offers a solution to minimize the shukra (sperm and ovum) defects.

There are many formulations which are used in vajikaran. Some of the commonly used formulations include vrihani gutika, vrishya gutika, vajikaranam ghritam and upatyakari shashtikadi gutika. Vrihani gutika is one of the potent formulations while vrishya gutika is highly potent aphrodisiac used in the treatment of pe. Vajikaranam ghritam enhances the strength of penis. Upatyakari shashtikadi gutika is useful for the enhancement of the fertility.

Also, chapdraprabha vati and kaunch pak are known to increase sexual vigor and semen consistency, thereby helping to prolong ejaculation time and sex pleasure.

3592 people found this helpful

Knowing Premature Ejaculation - PART 4: Treatment Options

Dr.Yuvraj Arora Monga 92% (1742ratings)
MD-Pharmacology, MBBS
Sexologist, Delhi
Knowing Premature Ejaculation - PART 4: Treatment Options

How to manage premature ejaculation - part 4, medical treatment options

As discussed earlier, premature ejaculation (pe) occurs when a man reaches the peak of sexual excitement and ejaculates before he wants it to happen. When pe interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors such as psychological problems (eg. Anxiety), penile hypersensitivity, habituation of quick sex / masturbation, alcohol abuse, hormonal imbalance (e. G. Thyroid problem), and even genetic problems may cause pe.

Medical (allopathic) therapy for pe treatment:

Drugs used for the management of pe reduce sensitivity and anxiety, improve blood flow or even affect some chemical mediators present in the brain. These classes of drugs include local anaesthetics, antidepressants, and phosphodiesterase 5 inhibitors.

Anaesthetic compounds were the first medical treatment proposed for pe management. They were applied topically to the surface of the skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays / creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of the penis, absorption in vagina resulting in vaginal numbness and irritation.

Treatment medications include selective serotonin reuptake inhibitors (ssris), which interact with a receptor (5-ht2c) present in brain and increases the production of serotonin. They also help in reducing anxiety and depression associated with pe. Through this mechanism, they prolong the time to reach ejaculation.

Several ssris have increasingly become used as" off-label" for pe. Among the available ssris, paroxetine and dapoxetine are more beneficial with lesser side effects as compared to other ssris. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent ssri which acts quickly and cleared rapidly from the body. Adverse effects with ssris are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term paroxetine.


Another potential treatment option for pe are classes of medications which increase the blood flow by dilating the blood vessels of the penile region and prolong the ejaculation time (phosphodiesterase 5 inhibitors). But a headache, dizziness, flushing, body aches associated with them have limited their use in pe.

At present, clinicians need to consider all treatment modalities when evaluating a man with pe, as each patient may respond differently and experience variable side effects. Additional and more effective therapies need to be developed having least side effects.

Ayurvedic therapy for pe treatment:

Vajikaran in Ayurveda is an important treatment modality which increases sexual capacity and improves health. In Sanskrit, vaji means horse, the symbol of sexual potency and performance thus vajikaran means producing a horse's vigor, particularly the animal's great capacity for sexual activity in the individual. Vajikaran therapy reenergizes all the seven dhatus (body elements) and restores equilibrium and health. It also offers a solution to minimize the shukra (sperm and ovum) defects.

There are many formulations which are used in vajikaran. Some of the commonly used formulations include vrihani gutika, vrishya gutika, vajikaranam ghritam and upatyakari shashtikadi gutika. Vrihani gutika is one of the potent formulations while vrishya gutika is highly potent aphrodisiac used in the treatment of pe. Vajikaranam ghritam enhances the strength of penis. Upatyakari shashtikadi gutika is useful for the enhancement of the fertility.

Also, chapdraprabha vati and kaunch pak are known to increase sexual vigor and semen consistency, thereby helping to prolong ejaculation time and sex pleasure.

'consult'.

Related Tip: Knowing Premature Ejaculation - PART 3: Management and Techniques (Non-medical methods)

In case you have a concern or query regarding sexual health ask a doctor online, you can consult the best sexologist doctor online, & get the answers to your questions.

 

4022 people found this helpful