Wockhardt Hospital

With age, most body organs begin to deteriorate in their function. This happens to the brain also, thereby reducing the overall speed of functioning of most organs. While slowing of bodily movement is visible, the internal organs functioning also slows down, which is not that obvious. Memory loss or dementia is one of the main manifestations of this degeneration of the brain.

Alzheimer’s is the most common form of dementia, and the associated symptoms includes reduced reasoning abilities and cognitive defects. Though it is seen only in the elderly, not all elderly people will have Alzheimer’s. The overall quality of life of the affected person is reduced with difficulty remembering things that were recently learned. It is a progressive disease and as it gets more severe, a full-time caretaker may be required.

Causes: The brain cells are affected by protein masses known as plaques and tangles. These hamper the way communication between the brain cells happens as well as affect nutrition from reaching all parts of the brain. This leads to shrinking of the brain, eventually leading to memory loss and other problems. There is also a strong genetic linkage, as most people with Alzheimer’s have the lipoprotein A gene.

Symptoms: Though memory loss is the most common symptom, there are other symptoms:

1. Being confused about places, people, and times
2. Inability to find the right words during conversations
3. Regular objects are misplaced
4. Becoming irritable, (in someone who was not so previously)
5. Mood swings
6. Personality changes
7. Inability to organise thoughts
8. Not able to make the right decisions
9. Repetitive talks and actions
10. Forgetfulness (not something the person always does)
11. Difficulty with numbers (again, not something calculations
12. Difficulty managing everyday tasks and minor problems
13. Suspicion of others (like immediate family members and friends)

Risk factors: While age is definitely a risk factor, the fact that not all aged people develop Alzheimer’s is to be borne in mind. Other risk factors include the history of stroke, high cholesterol, high blood pressure, diabetes, smoking, obesity, and poor lifestyle choices.

Diagnosis: While there is no definitive way to diagnose Alzheimer’s, symptoms along with brain scans and neuropsychological function testing are useful ways to confirm the diagnosis.

Treatment: This is aimed at two things reducing the rate of disease progression and treat (or reverse) symptoms if possible.

Cholinesterase inhibitors improve cellular communication in the brain and also manage depression and agitation. Memantine is used to slow the pace of disease progression.
In people with the disease, small changes are useful to help them with the symptoms. These include keeping essential things like keys and wallet in the same place, keep a daily diary to help them remember things, keep pictures of friends and family within visible distance.

Sleep apnea is a common and serious sleep disorder that causes your breathing to become shallow or stop completely during sleep. In some cases, this pause in breathing (called apnea) can last 10 seconds or longer and it can occur 30 times or more in an hour.
Though certain chronic health problems increase sleep apnea risk and make it more prevalent in older individuals, factors like enlarged tonsils or other structures in the throat can cause sleep apnea to develop at any age (including in childhood).
“sleep apnea is a public health problem”

And despite the condition being common, it often goes undiagnosed because many of the symptoms — such as loud snoring, gasping for air, and interruptions in breathing — occur during sleep, when individuals may not even realize what’s happening.

 Role of homeopathy-
Homeopathy reaches the root cause of apnea from stress to snoring and heavy weight where breathing gets obstructed. 
Homeopathy allows the bronchus and other obstructions to allow airway passing with giving relaxed sleep to a patient.

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them—and possibly even prevent them. The two types of migraine are- 

1. Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
2. Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.

Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.

Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

• Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
• Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
• Motor: Usually related with the movement problems like the limb weakness
• Verbal: It is related with the speech problems

Headache: In case of a migraine attack one might experience:

• Pain on both sides or one side of the head
• Pain is throbbing in nature
• Vomiting and nausea
• Sensitivity to smells, sound and light
• Vision is blurred
• Fainting and lightheadedness

Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

1. Onset of headaches >50 years 
2. Thunderclap headache - subarachnoid haemorrhage 
3. Neurological symptoms or signs 
4. Meningism 
5. Immunosuppression or malignancy 
6. Red eye and haloes around lights - acute angle closure glaucoma 
7. Worsening symptoms 
8. Symptoms of temporal arteritis

These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

1. Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
2. CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
3. MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
4. Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.

Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

• Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
• Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you.