WHO IS THE REAL “HERO” OF STROKE CARE_

Who Is The Real “Hero” Of Stroke Care

Who Is The Real “Hero” Of Stroke Care?

We know more about our clothes and cars than we know about our health and body. It is astonishing that we spend more time to research about which laptop to buy, but when it comes to our own health most of us take a passive approach. This deficiency of knowledge is even more evident when it comes to dealing with emergencies.  “Ït is too late now, I am sorry!”  Unfortunately, we have heard this line more often in the real-life than in films. 

The question arises, what can we do to change this? How do we tackle this deficiency? Dr Chandril Chugh, Senior Consultant, and Head, Interventional Neurology, explains this with an example.

We had a 70-year-old female brought to the emergency room by her granddaughter for confusion and difficulty walking due to weakness on the right side. The granddaughter was sure that the symptoms had started right after breakfast. It took them 45 minutes to drive, so they were in the hospital within the first hour of the symptoms. The patient was evaluated and head imaging was done which showed occlusion of the left middle cerebral artery (largest blood supply to the brain).

An Interventional Neurologist intervention was necessary, who recommended Mechanical Thrombectomy. The patient underwent the procedure successfully and was discharged without any deficits. The entire family was happy and satisfied with the treatment. Now my question is: who deserves the credit for this good outcome- The Interventional Neurologist, Neurologist or the emergency physician?  I personally believe that the “Hero” of this scenario is neither of the above but, the granddaughter. If she had not recognized the symptoms and brought her grandmother to the hospital in time, then we would not have been able to achieve what we did. She was aware of the stroke symptoms and took the right decision of coming to the hospital. When it comes to dealing with emergencies like Stroke or Brain attack, information and knowledge are life-saving.

Below mentioned are the important aspects of stroke diagnosis and care.

How do you recognize a stroke?

STROKE: REMEMBER THE 6 S METHOD TO DIAGNOSE STROKE

  • SUDDEN (symptoms usually start suddenly)
  • SLURRED SPEECH ( speech is not clear, as if drunk)
  • SIDE WEAK ( face, arm or leg or all three can get weak)
  • SPINNING (Vertigo)
  • SEVERE HEADACHE
  • SECONDS (note the time when the symptoms start and rush to the hospital)

Can stroke be really serious?

If I were to say stroke is really bad, you will probably not believe me. Luckily, some studies have made my job easier. According to a study done by researchers in 2006 in the USA, a patient with ischemic stroke loses 190,00,00 brain cells every minute, about 14000,000,000 nerve connections are destroyed every minute and 12 km (7.5 miles) of nerve fibres are lost every minute. The end result is the patient gets paralyzed for life and becomes dependent. That's pretty scary!!!

Is there a treatment available for stroke?

Yes. The Stroke treatment depends on which kind of stroke the patient has. Up to 85 % of all strokes are ischemic (blocked blood vessel). For ischemic brain attack, there is an option of intravenous medication called tPA (recombinant tissue plasminogen activator) available which can be given to the patient within the first 3 to 4.5 hours of the symptom onset. The patients who have a blockage in a large blood vessel can be offered a procedure called mechanical thrombectomy, which involves removing the blockage in the blood vessel and restoring the blood supply.  This procedure is done through a small nick in the groin and there is no open surgery involved. Recent trials have shown that patients do exceedingly well post mechanical thrombectomy and have a greater chance to live life independently.

Till what time can you do mechanical thrombectomy?

Mechanical Thrombectomy can now be offered up to 24 hours from the onset of the symptoms but, sooner it’s done better the patient does.

What is the single most important factor in stroke care?

The most important part of stroke care is not the doctor or the hospital, it’s the patient! As most of the strokes are painless, patients tend to ignore their symptoms and hence delay the treatment. If the patient and the family are aware of stroke symptoms they can reach the hospital in time and can get treated.

 

Originally Published On Max Health Care - Who Is The Real “Hero” Of Stroke Care

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by Dr Chandril Chugh

Here's a blog talking about the role of the nervous system in bipolar disorder. Learn more about it and get the right treatment.

Role Of The Nervous System In Bipolar Syndrome: Know All About It

Bipolar disorder is a brain-based disorder with many clinical manifestations and comorbidities, leading to severe disabilities in the patient. Mixed episodes characterize this condition, i.e. its symptoms swing between mania and depression. It is important to note that while depression has commonly been associated with the disorder, a bipolar diagnosis need not necessarily include depressive episodes, though it can.

Bipolar disorder is a complex medical state whose etiology involves genetic and epigenetic factors acting alongside environmental components in causing manifestation of the disease. Bipolar disorder affects virtually all areas of the human body, from energy levels and appetite to muscles and even libido.

What causes Bipolar disorder?

Millions of people in the world are affected by manic depression , however, it can take years to be properly diagnosed with the disease, depriving people of the assistance that they have . As the name reflects, people with bipolar disorder experience two extremes, or poles, with their mood: depression and mania.

Mania is the polar opposite of depression. A manic person can have an uplifted mood or experience feelings of grandiosity. They might be relentlessly talkative, hyperactive, or may claim to have special powers or express paranoia, anger, or anguish.

Bipolar disorder has traditionally been viewed as a purely biological one, but in reality the episodes of this complex condition are best understood within a biopsychosocial framework, which is interactions between genes, neural pathways, and socioenvironmental influences.

Pathophysiology of bipolar disorder

The behavioral and physiological manifestations of Bipolar disorder are complex, showing itself not only as profound changes in mood, but also in the form of a range of neurovegetative and psychomotor features. The pathophysiology is undoubtedly moderated by interconnected limbic, striatal and fronto-cortical neurotransmitter neuronal circuits, and the interacting cholinergic, catecholaminergic and serotonergic neurotransmitter systems thus represent very attractive candidates. Thus, it’s not surprising that clinical studies over the past 40 years have for the foremost part rested upon the conceptual foundation that monoamine signaling and hypothalamic-pituitary-adrenal (HPA) axis disruption are integral to the pathophysiology of both depression and mania .

A true understanding of the pathophysiology of manic depression must address its neurobiology at different physiological levels, i.e. molecular, cellular, systems, and behavioral. Abnormalities in organic phenomenon undoubtedly underlie the neurobiology of the disorder at the molecular level and this may become evident as we identify the susceptibility and protective genes for Bipolar disorder in the coming years.

Hippocampus and bipolar disorder

Interest in hippocampal volume stems from neuropsychological and neuropathological studies that implicate this structure within the pathophysiology of bipolar disorders. For instance, enlarged right hippocampal volume is claimed to be related to poor neuropsychological functioning in manic depression , and findings from a neuropathological study have indicated a discount and dysgenesis of varied neuronal cell lines in entorhinal and hippocampal cortex of bipolar patients.

Also, in people with bipolar disorder, certain parts of the hippocampus are smaller than they are in both people with major depressive disorder and in people without mood disorders.

Bipolar disorder and neurotransmitter imbalance

The brain uses a variety of chemicals as messengers to speak with other parts of the brain and systema nervosum . These chemical messengers, referred to as neurotransmitters, are essential to all or any of the brain’s functions.

There are many various sorts of neurotransmitter chemicals within the brain. The neurotransmitters that are said to be involved in manic depression include dopamine, norepinephrine, serotonin, GABA (gamma-aminobutyrate), glutamate, and acetylcholine.

Measuring neurotransmitters, their chemical variations, and their effects is central to the study of bipolar disorder. For example, GABA is lower within the blood and cerebrospinal fluid of patients with manic depression while oxytocin-active neurons are more in those with manic depression .

Which hormone causes bipolar disorder?

Neurotransmitters aren’t the only chemical messengers within the body. Hormones are also used by the body as chemical messengers. The thyroid is an endocrine organ located within the neck that produces hormones . It has been the main target of much mood disorder research. Depression is usually related to low levels of hormone , a condition referred to as Hypothyroidism. Mood elevation is usually related to high levels of hormone (Hyperthyroidism). Treating hypothyroidism by supplementing or replacing hormones may sometimes alleviate depression. Similarly, reducing levels of high hormone with lithium may ease manic symptoms. Given that up to half patients with a rapid cycling sort of bipolar disease even have hypothyroidism, the involvement of the thyroid in producing or enabling bipolar disorders for some patients is a strong possibility.

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by Dr Chandril Chugh

Neurosarcoidosis

Neurosarcoidosis: Symptoms, Treatment And Causes

Sarcoidosis is a chronic disease that involves a collection of inflammatory cells in an abnormal quantity. These cells together form a lump which is also known as a granuloma. This disease can affect any part of the body; however, its most common in lungs and lymph nodes. Lymph nodes have a bean-shaped structure and are present all across the body. They carry lymphocytes or more commonly known as white blood cells which helps us to fight any infection or disease.

Neurosarcoidosis is a Neurological manifestation of sarcoidosis affecting the central nervous system, i.e., spinal cord, brain and optic nerve. It is uncommon but a severe kind of sarcoidosis. While it most commonly occurs in facial and cranial nerves, other parts of the nervous system are equally at the risk of inflammation or abnormal cell deposits.  

Causes of Neurosarcoidosis Disorder:

The Cause of Neurosarcoidosis is unknown. But some infections, immune system disorders or genetics can contribute to it. Also, approximately five to ten percent of people who have sarcoidosis in other parts of the body have chances to develop it in their nervous system. Only 1 per cent of people are likely to acquire Neurosarcoidosis, without having sarcoidosis in any other part of the body. Speaking of demographics, people between the ages of twenty to forty are seen developing this disorder, and it is more common in Swedish and African-American people; however, it can occur in anyone.

Symptoms of Neurosarcoidosis:

Symptoms of Neurosarcoidosis vary as per the part of the brain that has been affected by the disease. In some cases, it may exhibit symptoms similar to Multiple Sclerosis, a condition where the immune system attacks the covering sheath protecting nerve fibres and thereby disrupts the communication between the brain and rest of the body. The reason behind the similarity of symptoms is that Neurosarcoidosis also weakens the myelin coat around the nerve fibres.

To tell the difference, doctors perform a set of diagnostic tests including CT scan, Chest X-ray, blood tests and biopsy to ascertain if the symptoms are from Multiple Sclerosis or Neurosarcoidosis. 

Following are the symptoms of Neurosarcoidosis based on the area of the brain that has been affected by it.  

Brain or cranial nerves:

  • Dementia
  • Loss of hearing
  • Speech difficulties
  • irritability
  • hallucinations
  • Seizures
  • Confusion
  • Loss or alteration of ability to smell or taste
  • Headaches
  • Vision issues
  • Facial paralysis

Peripheral nerves:

  • Numbness and tingling
  • Weak and vulnerable muscles
  • Partial or incomplete paralysis in some body parts

Pituitary gland:

  • Frequent urination
  • Fatigue
  • Excessive thirst
  • Changes in the menstrual cycle for women

Neurosarcoidosis diagnosis

The diagnosis of Neurosarcoidosis can be a complicated procedure. There is always a room for diagnostic error in this disease as the primary examination involves the finding of granulomas. Still, the same can easily be the result of any other illness. For the proper diagnosis of the sarcoidosis, following three criteria are required as per the statement jointly passed by the WASOG (World Association of Sarcoidosis and Other Granulomatous Disorders), the American Thoracic Society and the European Respiratory Society:

  • Clinical and Radiologic manifestation
  • Granulomas not exhibiting caseation
  • No indication or proof of alternative disease  

Once the disease is suspected, the diagnosis is further continued to obtain histological verification of the same, and estimate the degree & severity of organ involvement. Additionally, to determine the course of treatment, it is also evaluated during the diagnosis of whether the disease is stable or progressing.

Neurosarcoidosis treatment

Treatment varies based on the symptoms and severity; however, there is no cure for the disease. Currently, available medications/treatments help achieve symptomatic relief from pain without treating autonomic dysfunction. And they also sometimes lead to side-effects, seldomly severe, which is why one needs to discuss the potential side-effects of recommended medications beforehand and to decide if they are worth the possible benefits.  

Some of these treatments are - 

  • Occupational therapy
  • Pain management medications or therapy
  • Immunosuppressive and immunomodulatory medications
  • Physical therapy

Conclusion

Neurosarcoidosis does not have any standard prognosis as the severity, and the symptoms vary from person to person. And only two-thirds of people suffering from it achieve temporary or permanent diminution of pain & other symptoms and can go back to living their lives normally. However, those who do not experience remission need to continue the treatment and manage their symptoms throughout life. And to do so, a multidisciplinary approach is advised, which demands considerable participation of patients to work on somatic along with psychosocial aspects of this capricious disorder. Participation can be in the form of regular visits to the neurologist, coordination with doctors and therapists and a proper medication routine - right drug, right dose at the right time!

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by Dr Chandril Chugh

anxiety

How Can Anxiety Cause Neurological Symptoms?

Anxiety is a natural human emotion that everyone experiences at some point in their lives. But when stress levels get too high, anxiety can turn into a medical disorder that seriously affects both mental and physical health. For those with anxiety disorders, the stress response can be extreme, leading to neurological symptoms that impact daily life.

How Can Anxiety Cause Neurological Symptoms?

When anxiety becomes chronic, it affects how your brain works. Can Anxiety Cause Neurological Symptom like excessive worry, fear, and physical reactions such as increased heart rate and nausea. These reactions can cause neurological symptoms like dizziness, headaches, and tingling sensations in severe cases. While anxiety doesn't damage the nerves, it puts a heavy strain on the brain and often leads to mental health conditions like depression.

Common Neurological Symptoms of Anxiety:

  • Tingling or numbness
  • Dizziness and Cluster Headaches
  • Muscle tension
  • Difficulty concentrating or remembering things

Can Anxiety Cause Neurological Symptoms

Neurological anxiety happens when anxiety either stems from or worsens due to a neurological disorder. People with conditions like Epilepsy Symptoms or Multiple Sclerosis Symptoms often experience heightened anxiety. Even though anxiety itself is not a neurological disorder, its symptoms can look and feel similar to those caused by brain or nerve issues.

Critical Signs of Neurological Anxiety:

  • Uncontrollable fear or worry
  • Panic attacks with chest pain and trouble breathing
  • Trouble focusing or thinking clearly
  • Sleep problems, including nightmares

Different Types of Anxiety Disorders

Anxiety disorders come in many forms, each affecting the brain and body in unique ways:

Post-Traumatic Stress Disorder (PTSD):

PTSD develops after a traumatic event. Common symptoms include flashbacks, nightmares, and severe anxiety. People with PTSD often experience depression and neurological symptoms like shaking or sleep issues.

Obsessive-Compulsive Disorder (OCD):

OCD causes unwanted, repetitive thoughts and behaviors. People with OCD feel the need to perform certain tasks in a specific way to ease their anxiety. This constant stress can cause muscle tension and other physical symptoms.

Panic Disorder:

Panic disorder involves sudden, intense bouts of fear known as panic attacks. These attacks often cause chest pain, dizziness, and shortness of breath, which can mimic neurological symptoms.

Social Anxiety Disorder:

Social anxiety disorder creates intense fear and self-consciousness in social situations. Although it’s not a neurological condition, the stress it causes can lead to physical symptoms like shaking, sweating, or dizziness.

Diagnosing Anxiety and Neurological Symptoms

If anxiety leads to neurological symptoms, it's important to get a proper diagnosis. Doctors will conduct tests to rule out other causes, such as medication side effects or other medical conditions.

How Doctors Diagnose Anxiety:

  • Physical exams to check for other health issues
  • Blood tests to look for any underlying conditions
  • A review of symptoms, medications, and medical history
  • Questionnaires to assess the severity of anxiety

Managing Anxiety and Its Neurological Effects

To prevent anxiety from affecting your brain and body long-term, it’s important to manage it properly. Recognizing anxiety triggers is the first step. Common triggers include work stress, new responsibilities, childhood trauma, or even side effects of certain medications. Once you identify your triggers, you can take steps to manage them.

Natural Ways to Manage Anxiety:

  • Practice mindfulness activities like yoga, meditation, or stretching
  • Engage in enjoyable activities that distract from stress (like dancing or painting)
  • Take regular breaks from stressful routines to recharge.

If anxiety symptoms become overwhelming, it’s essential to seek medical help. Cognitive-behavioral therapy (CBT), psychotherapy, and medications can all help manage anxiety and its neurological symptoms.

When to Seek Medical Help:

  • Persistent headaches or dizziness
  • Chest pain or difficulty breathing
  • Ongoing sleep problems like nightmares or insomnia

Conclusion

While anxiety is a normal stress response, excessive anxiety can cause neurological symptoms that affect daily life. Proper treatment and management can help reduce both the mental and physical effects of anxiety. With the right plan, including therapy, medication, and lifestyle changes, you can overcome anxiety and regain control of your life.

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by Dr Chandril Chugh

The Struggles Of Coping With PTSD During Social Isolation

The Struggles Of Coping With PTSD During Social Isolation

Social Isolation 

The term which we looked at as the preventive measure from an outbreak of a novel disease may have given rise to another pandemic. It may have helped considerably in the prevention of COIV19, but it certainly has an adverse impact on the psychological profile of people. The medical survey conducted in India in August 2020 on a small group of people to gauze the mental impact of coronavirus induced lockdown showed 28.2% of the respondents have PTSD, and the rest may not have been diagnosed with PTSD yet but have developed similar symptoms. Like excessive sweating, breathing troubles, sleeping & eating disorders, etc.

Why social isolation is a trauma?

The isolation was forced and was not practised willingly. One day all of a sudden, the entire world was shut down to prevent the disease we never heard of before. And then it turns out the situation is more severe as we started calling it a pandemic. So, as people were confined to their places, they experienced a feeling of no control over the circumstances, the fear of contracting the disease or losing loved ones, sense of despair as not seeing things turning back to their default state, etc. And coupled with all the significant personal and work-life alterations it led to, social isolation became the number one reason for PTSD in 2020. 

Why is PTSD treatment necessary?

PTSD exerts a damaging impact on mental and physical health and can lead to trouble in sustaining relationships. Besides, the risk of developing depression or indulging in deliberate self-harm is six times higher in people with PTSD. And they are also five times more vulnerable to other anxiety disorders compared to a person without PTSD. So coping up with this disease is essential. 

PTSD treatment can be anything from a simple change of habit to seeking professional help. It is different for every individual based on their coping mechanism and severity of the disease. 

PTSD treatment

  1. Reach out - People with PTSD often struggle in isolation as they find it challenging to open up and share their difficulties. They are scared of having people not able to comprehend their situation. In fact, in many cases, people themselves don't realize that they are struggling with PTSD until symptoms become unendurable. We all need to understand that PTSD is not uncommon and that if it is hard to explain it to family and friends, then there is always an option of seeking professional help, but leaving it untreated is not an option.
  2. Heedfulness - PTSD patients relive the traumatic event, again and again, and are overwhelmed with stress and anxiety in every minute of it. But by just spending two minutes a day practising meditation, prayer or any other mindful technique with a goal to focus on the present without the fear of past or future, can help in calming the body and mind. Although it may just lead to a moment of relaxation, it will bring back the taste of normalcy and hope that sanity is achievable. And before you know, these small regular victories will make a huge difference. 
  3. Exercise - Exercise has commendable results in stress-relieving by regulating mood and emotions. It pumps up the production of feel-good neurotransmitters, known as endorphins. So, sweat out the PTSD. Make your own exercise regime. All you have to do is pick a physical activity that amuses you like yoga, dance, cycling, running, walking, swimming, etc. and practice it every day maybe just for 10 minutes to start with. Remember, the goal is to enjoy and relax, not to overwhelm yourself. Be consistent, set small goals and decompress. 
  4. Psychotherapy/ PTSD Therapy: There are several therapies designed to help people cope up with the disease. The aim of this write up is not to tell you about the treatment you should go for. As the course of treatment will be decided once a thorough diagnosis is performed under medical supervision. However, we aim to let you know that there is more than one option for you to fight the disease. And that the treatment is customized as per psychological profile.
  • Cognitive Therapy: This is a type of talk therapy that indulges you in deep thinking and initiates conversations. It helps you to put into words the thoughts that are seemingly inexplicable and thereby encourage you to pin out negative feelings or mental patterns that are keeping you stuck. 
  • Exposure therapy: This PTSD therapy as the name suggests exposes you to the situation or the memory that frightens you, but without compromising your safety. It lets you re-enter the traumatic event that led to PTSD at the first place, and gives you an opportunity to process it, understand it which you might not have received when the actual event occurred. This therapy is suitable for patients who are in denial and fear to let their emotions out. 
  • (EMDR) Eye movement desensitization and reprocessing: This is an interactive psychotherapy technique that combines exposure therapy with a set of guided eye movements. Along with letting you re-enter the traumatic situation safely, it also helps you to change your reaction to it for processing it better. 

Now you may think that the world is coming to an end, but remember this too shall pass and it's only after the darker cold nights, the sun feels brighter and warm.

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by Dr Chandril Chugh

Research Paper of Dr Chandril Chugh Expert Neurologist

Here’s Why PTSD Gets Worse Before It Gets Better

Here’s Why PTSD Gets Worse Before It Gets Better

“It gets worse before it gets better”- this is a statement often quoted by people who’ve undergone or overcome a psychological disorder. Well, it holds true for PTSD too. PTSD is a disorder that hits you like a wrecking ball - it is a wholesome that affects your mind and body, usually for a long period of time. 

 

Many a time the patient themselves take a long time to acknowledge the disorder or to even notice the symptoms before going for therapy. The person is in a state of shock and a kind of mental numbness. Trauma therapy can be mentally exhausting and can inflict more pain. The road to cope up with PTSD can be unpredictable. However, it is not impossible to navigate through it. In therapy, a patient usually goes through 4 stages. Going through these stages is like going deeper into an ocean where you don’t know what comes next. It can be scary and you may also be triggered at times, and things may get worse but eventually, you will get to the other end, much stronger. 

 

The first stage being of ‘impact’ that encompasses reactions such as shock, guilt, fear, etc. These are the first impressions after the traumatic event has taken place. A person may find it difficult to muster the whole event and is in a state of shock. This may last for a few hours or even days, depending upon the person and the severity of the trauma. An individual may experience helplessness, anxiety, shock, fear, or hypervigilance. 

 

The next stage is usually the denial phase where the person consciously or unconsciously denies the flashes, or memories of the terrifying event. However, if you’re consciously trying to avoid the event, you should know that it is only going to harm you furthermore. Suppressing emotions and bottling up your feelings will eventually lead to an outburst. It is not necessary that everyone with PTSD may experience this phase. Some individuals come to terms with the trauma and acknowledge what happened. In either of the above cases, it is important that you start finding a solution to the main issue. 

 

You can start by finding a short term recovery solution. This is known as the intermediate recovery phase, where one tries to get back to normalcy.  The individual may face several adversities but still, efforts are made to find immediate solutions to primary problems. There are two ways a person can respond to this stage. 

  1. Altruism- the person may be amazed by the love and support of the people around and accepts it gratefully. The care received from others pushes you to take a step forward in healing. 
  2. Disillusionment- here a person acts totally opposite to the previous one where the person may feel disappointed by the lack of support or feel intruded by it. Although, they still acknowledge the traumatic and take steps to overcome it, all by themselves.  

 

It’s very common to experience nightmares, flashbacks, and intrusive thoughts at this point. However one should learn to tame these symptoms. There is no timeline for healing; it entirely depends on the individual receiving treatment to be comfortable and accepting of what has happened and finally moving forward from there. However, one should always seek proper neurocritical care. Your mental health is of prime importance.  With self-care techniques, meditation, mindfulness, grounding, and breathing techniques you can control these symptoms and lessen their impact. 

This is the right step to initiate a process of dealing with daily life situations and not slipping back, since after you’ve acknowledged the trauma and try to heal, it gets worse. Nightmares, negative thoughts, emotions, and flashbacks.  If you feel like your therapist is moving too fast in the process, it is completely fine to ask them to go slow and let you deal with trauma in an enhanced and efficient manner. Image rehearsal therapy and several others can help you get a long term solution for recovery. One of the reasons why trauma therapy gets worse with time is because you’ve to deal with the inner demons by confronting them. 

 

The long term recovery stage is where one finds a permanent solution to trauma. While the person still might be dealing with the post-trauma effects, this is the stage that focuses on rebuilding oneself while dealing with personal problems. This is the stage where things get absolutely worse, your symptoms may get even stronger and wild. They can hit you at your worst. There is a possibility where you may be super upset with the phase you’re in and feel like giving up. At times you may even depend on stimulants like alcohol, drugs, or cigarettes. 

 

However, running away from these symptoms will leave you in a more deplorable and miserable condition. One should try to come to grips with the reality, give that one final push, and deal with the problem.  It is necessary to go through some tough questions and realizations to feel free and have hope for healing. 

 

After a storm comes the calm. PTSD may break you at first, but overcoming it will only make you stronger. Never lose hope in you and don’t let the inner demons control or hurt you. Remind yourself that these scary nights are going to pass and there shall be a beautiful dawn soon. 

by Dr Chandril Chugh

Demystifying Neurology: Learn About The Medical World

What Makes Neurology Complex: Learn About The Medical World

What Makes Neurology Complex: Learn About The Medical World

Neurology is that branch of medicine which deals with Neurological disorders of the nervous system, which includes the brain, blood vessels, muscles and nerves. A Neurology specialist is a doctor who is trained to diagnose and treat these disorders.

When a patient seeks consultation with a neurologist, they foremost evaluate whether there is a problem in the nervous system of the patient or not and only after determining the problem, continue with the treatment. 

If you are planning to see a neurologist, you might have a lot of questions in your mind about what will be required of you and therefore, here we will address each of your queries specifically.

1) Would I be referred to a neurologist?

If the general physician believes that the patient has a neurological problem and needs special attention, they may refer the patient to a neurologist. In such a case, they would refer the patient to a specialist who can effectively examine the patient and also provide proper treatment when necessary. 

2) Why would you need to see a neurologist?

A neurologist is trained to diagnose and treat a range of conditions. Here are some reasons to see a neurologist: 

  1. Neuropathic pain occurs due to any damage that leads to nerve injury and may be sharp, shooting or burning. You may also have neuropathic pain from damage to your brain or spinal cord and occur after a stroke. 
  2. Parkinson's disease: Parkinson’s is caused by the loss of brain cells which produces the chemical dopamine, which is necessary for body moment. 
  3. Seizures: It's a sensation in the brain accompanied by uncontrolled moments and at times, may also lead to unconsciousness.
  4. Migraine: A migraine is a severe form of headache that is very disturbing.
  5. Nerve injury: Any nerve injury to the Spinal cord or brain caused by an accident can also lead to a Neurological disorder.

 

These symptoms can lead to memory loss, loss of sensation and visual changes may occur in some patients. Therefore, it is important to get the proper treatment to treat these medical conditions, for which one needs to see a Neurologist.

3) What does a neurologist treat you for? 

A Neurologist treats you for Disorders and Diseases of the nervous system. What to tell your Neurologist depends upon how an individual feels.

Suppose your primary care doctor refers you to a Neurologist. During the first appointment, the neurologist will check out your previous medical reports and have conversations with you to know more about your medical history.

After that, they scrutinize the information in front of them which helps them make decisions. If necessary, a physical examination and neurological exam can also be conducted to know the depth of the problem.

The doctor may also try to reach for the right diagnosis by testing the moments and study the effects of these exams. It can include body moments, breathing, and sense of touch.

During a physical exam, the doctor looks at body movements, studies the posture, sense of balance and any difficulties that the patient may be having in performing a specific task or activity in the exam.

Types of Neurological tests 

  1. Electroencephalogram (EEG): Measuring the electrical activity in the brain from the Electrodes applied on the scalp.
  2. Electromyography and nerve conduction studies (EMG/NCS): Nerves and muscles are tested through Electrodes and fine needles placed on the skin.
  3. Lumbar Puncture: A Spinal fluid sample is taken to determine any serious problems. 
  4. CT, MRI, and PET scanning are some other diagnostic tests. 

The treatment can be dynamic and totally depends upon the patient body and also their past medical history.

by Dr Chandril Chugh

All You Need To Know About Parkinsons Disease

All You Need To Know About Parkinson’s Disease

All You Need To Know About Parkinsons Disease

Parkinsons disease falls under the gamut of neurological diseases and is a disorder of the nervous system which affects that part of the brain which controls movement. For best treatment of nerves you can refer to the neuro physician in Jaipur , neurologist  in Jaipur along with the neurosurgeon in Patna.. You can also consult the top neurosurgeon in Patna , they can provide you with the best food for strengthening nerves.  It is also known as Idiopathic or Primary Parkinsonism, which is a progressive movement disorder that causes problems like stiffness, tremors, difficulty in walking, maintaining balance and coordination problems among people suffering from the disease. In Idiopathic or Primary Parkinsonism, the progression of the disease tends to be slow and variable. Doctors often use the Hoehn and Yahr scale to gauge the progression of the disease over time. For any brain problems you can refer to the brain specialist doctor in Faridabad and even can consult about what causes brain haemorrhage. Even doctors can make you understand the brain attack symptoms in hindi.

The beginnings of Parkinson’s disease usually begin with a shaking in the hands, which is not noticeable in the beginning but gradually progresses over time. The onset of symptoms usually starts when a person reaches 60 years of age and may include a tremor in the hand, stiffness and slow movement. Sometimes, in some patients, it may start at an early age. Till now, there is no cure for this disease but one can seek treatment and support to help manage the symptoms. For further spondylosis problems, you can consult a doctor and ask about what mattress is good for spondylosis dural , what pillow can be used for ankylosing spondylitis and whether a neck massage causes a stroke. You can also consult about the aspartame side effects on the brain.

Parkinsons Disease Causes

While the causes of Parkinsons disease remain unknown, it is believed that many factors like genes and certain environmental triggers play a role. Many researchers have identified certain precise genetic mutations which can cause Parkinsons Disease . Moreover, it has also been stated that exposure to specific toxins or certain environmental factors may also increase the risk of development of Parkinson’s in an individual.

Parkinsons Disease Symptoms 

During the early stages of the disease, the patient’s face may stop showing any expression, their arms may not swing during a walk or the speech may turn soft and slurred. Gradually, with time the symptoms can get worse. And while there is no cure for this disease yet, certain medications, if started at the right time may aid in improving symptoms in a significant manner. On certain occasions, the doctor may suggest surgery to regulate certain regions of the brain to improve the symptoms. The other kinds of Parkinsons disease symptoms include:

  • Tremor: A person suffering from

    Parkinsons Disease

    may notice that their hands, arms, legs, lips, jaws and other body parts start to tremble or are shaky. 

  • Impaired posture: In some people, the arms do not swing freely when they walk. Or their posture may become curved and they may experience balance issues as a result of Parkinson’s disease.
  • Stiff muscles: A patient may experience muscles in the body going rigid and this may cause pain and limit their movement. In some cases, doctors may misdiagnose signs of early Parkinson’s on the basis of muscle problems as arthritis. 
  • Bradykinesia or slow movement: A patient with Parkinson’s disease may have slow movement, which makes even the simplest of tasks very time-consuming. They may have difficulty while buttoning their shirt or getting out of a chair, which are symptoms of this disease.
  • Loss of involuntary movement: A person may experience a decreased ability to perform unconscious tasks and movements like blinking, smiling or even swinging the arms while walking.
  • Changes in speech and handwriting: A person may start speaking more softly, quickly or have a slur in speech while talking. Their speech may also be more in the form of a monotone without the usual modulations in voice. A person may also have trouble having written anything and the handwriting may appear small, all of which when clubbed together with other symptoms are grounds for a Parkinson’s disease diagnosis.

Parkinsons Disease Diagnosis 

It is difficult to make an accurate description of Parkinsons disease in the early stages and there are no specific tests to determine this disease, but an experienced neurologist can reach a conclusion after conducting a detailed examination on the basis of a person’s medical history, along with a review of their symptoms, and a detailed physical examination. They may also recommend regular follow-up appointments in order to evaluate the patient’s condition and symptoms over time to be able to reach a conclusive diagnosis.

Parkinsons Disease Treatment

Till date, there is no one drug for Parkinsons disease treatment and the options to handle the disease mostly includes drugs prescribed to manage the symptoms for each patient separately, depending on their symptoms. The other forms of treatment may include medication and surgery, along with modifications in lifestyle and options like more rest and exercise. It is also quite common for people with Parkinsons Disease to take a mix of medicines to manage symptoms but there is no medicine to reverse the effects of this disease. 

A few complications arising from Parkinsons disease can be in the form of depression, anxiety, changes in blood pressure, the problem in the bowel movement, cognitive problems, trouble in sleeping, fatigue among other issues. However, most people suffering from this disease usually live a normal to a nearly-normal life but it can certainly be life-changing for both the patient and their family. However, while there is no proper medicine for a holistic Parkinsons disease treatment, it is still possible to have a good quality of life for a person suffering from this ailment. The most important thing to do is to continue working with your doctor and following the recommended treatment options in dealing with symptoms like tremors, stiff muscles and slow movement. 

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All You Need To Know About Migraine | Dr Chandril Chugh

All You Need To Know About Migraine

HydrocephalusAll You Need To Know About Migraine

After having spent nearly 7 months indoors, it appears that social distancing and hygiene are going to be an integral part of our lives for some time. During this period, as most of us stay inside, mobile phones and laptop screens have replaced outing with friends and this new normal has had a tremendous impact on all aspects of our life. Many people are also stressed and anxiety levels are at an all-time high, owing to the uncertainty surrounding the present and worries about what the future may hold. Moreover, the virus has forced many to go into isolation, which has taken a toll on their mental health. It has also impacted those who suffer from chronic migraine, who are now complaining of frequent and painful episodes. This brings us to the question: What is a migraine and how to manage it during the pandemic? 

A migraine pain is a type of headache that usually comprises more than 10 percent of all headaches. A person suffering from migraine experiences headaches and along with it, some of them may develop sensitivity to light and sound. For severe migraine you can contact the migraine doctor in Jaipur. Migrane can also be caused by aspartame slows metabolism. A few other migraine pain symptoms are headache, accompanied by pulsating and throbbing pain, along with nausea, vomiting and visual manifestations. In the present times, a migraine causes headache and it should not be confused with a Covid-19 headache, which is moderate in nature and a person experiencing it may have bilateral pain, which may increase when you bend down, cause a pulsing sensation, and may occur with a fever. 

Causes of Migraine

In many cases, a migraine headache may be genetic. Usually, a person with migraine experiences headaches which get triggered with changes in weather, upon experiencing a strong odour, sleep deprivation, stress, smoking, hunger, bright lights and loud noises. Migraines can also be caused by complex ptsd and sleep   . In some cases, certain medicines may also cause a migraine headache. It has been observed that migraines are three times more common in women as compared to men and these episodes of migraine pain usually start sometime between childhood and early adulthood. You can contact a neurologist who is the best doctor to treat migraine. You can also contact an online neurologist in this pandemic situation. Most migraine pain relief by  migraine treatment or migraine medicine can be managed without medicine by following a few simple lifestyle changes. Migraines can be a reason to see a neurologist. For this you can consult the best neurologist in Faridabad.

Migraine management tips

  • Know your triggers 

If you know what activates your migraine, you can prevent the effects of migraine by controlling your triggers. The first step is to observe what causes your pain to trigger and by doing so, you will be able to monitor when your migraine is most likely to occur, what triggers it, how many times a day it occurs and when it may develop.You have to also analyse the nervous system facts of your body. A few common migraine triggers are stress, changes in the weather and environment, hormonal changes, change in sleep pattern or sleep deprivation and physical factors like exertion. You have to also keep the facts about the cns into consideration .It can also be a Reason of complex ptsd and sleep . For that you can consult an online neurologist and learn about the nervous system facts. You should always have food that heal nerve damage .Moreover, processed foods like aged cheese, food additives, preservatives like monosodium glutamate can also trigger your migraine.Therefore you must always have the best food for nerves repair.  As the best food for nerve repair will always make your nerves strong  . If your nerves are strong enough, there will not be any reason to see a neurologist.Also for any mind issue you can contact a mind doctor in Delhi or mind doctor in Agra. Many migraine cure patients complain that their headaches tend to get worse with a strong odor and may get some brain haemorrhage symptoms. Then there will be a reason to see a neurologist.You can consult an online neurologist too and he can systematically scan the nervous system facts of your body  . And thereby doctors always refer you to have the best food for nerve repairs .Many are allergic to even certain perfumes and smells. Also for better nerve treatment, you can contact the top neurologist in Jaipur.

  • Migraine management at home

During this time, it is advised that one should avoid going to a hospital and therefore, the best thing you can do is to try treating your migraine at home. The nervous system facts are very essential. You should never ignore the brain hemorrhage symptoms if accidentally it happens.  Most of the time, migraine management can be carried out at home with lifestyle changes and without any medicines. You can start with a few simple breathing exercises, yoga and acupressure. Another remedy is dimming the lights and turning on soft music before going to sleep. Moreover, eating foods like almonds, cashews, sesame seeds, peanut butter, eggs, milk, which contain magnesium can also help in migraine management. Ginger is another food that you can try to prevent migraine. Apart from this, you should also focus on staying hydrated, getting adequate sleep, exercising regularly and limiting the intake of alcohol. 

However, if the home remedies do not work out, or in some cases where the patient is resistant to medication, the effects of migraine on your life can be managed by consulting a neurologist.

  • Get enough sleep and eat healthily

Sleep deprivation is one of the major causes of migraines. And given the changes in our lifestyle during the pandemic, our sleep patterns have been affected. During this period, we have witnessed people spending long hours in front of electronic gadgets, which disturbs the circadian rhythm and causes sleep deprivation and can give rise to brain hemorrhage symptoms. Therefore, for proper migraine management, sleep is important and one should try sleeping early to avoid a migraine. You can also try meditation before going to bed to prevent the effects of migraine. 

  • Manage stress levels 

The onset of the pandemic has been stressful for a lot of people who were coping with fear and anxiety of the disease along with home isolation can be quite overwhelming. This is another concern as situations like these can aggravate stress and cause migraine. Therefore, one needs to manage the stress levels and prevent things that cause you stress. 

Exercise, yoga and deep breathing are excellent ways that provide immediate relief and lower the stress levels. 

  • Book a telemedicine appointment  

Telemedicine is an exchange of medical information and health services via technology. And you can try booking a telemedicine appointment and try getting a professional’s advice without actually having to step out of the house. At present, there are many doctors you can consult through telemedicine, who will be able to diagnose you and prescribe medicines on migraine management.  

 

Managing your migraine amidst a pandemic is a challenging task. However, don’t let this burden you. Try to keep calm and stay positive. Know your triggers and try to avoid them. You can always seek medical help from doctors online by booking an online appointment. 

For any queries or questions regarding migraines or other related health issues, one shouldn’t hesitate to consult a reputed neurologist or brain doctor.

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by Dr Chandril Chugh

PTSD And Intimate Relationships - Problems and Solutions

PTSD And Intimate Relationships - Problems and Solutions

PTSD And Intimate Relationships - Problems and Solutions

PTSD is one of the severe mental disorders that has a debilitating effect on you and the people around you. People don’t understand how to avoid PTSD after trauma hence the trauma from PTSD takes a toll on every aspect of your life. It becomes challenging to carry out the basic functions in life. Apart from this, PTSD comes with the added baggage of guilt, anger, frustration, and symptoms such as nightmares, flashbacks, negative thoughts, etc. Dealing with such symptoms can be overwhelming for the individual. 

It can be difficult to see someone you love struggle with PTSD, especially when you’re unable to help. When it comes to PTSD trauma response, the person is in a state of shock and his relationship with others is at stake. 

What impact does PTSD have on intimate relationships? 

PTSD is bound to cause strains in your relationship. Here’s how PTSD affects a relationship. Some of the common problems faced by people are – 

  • Detached from other

It is quite natural for the person suffering from PTSD trauma symptoms to feel detached from others. Patient s the relationship should try PTSD trauma therapy, and they may withdraw themselves from engaging in a conversation or the normal things they did before the traumatic event. They may distance themselves from the activities at the house and isolate themselves in the room. Among couples, the person suffering from PTSD may experience a lack of interest in sexual activity and be in a state of shock or numbness. The family members, friends, or partners on the other hand may feel alienated and hurt by such behaviour. It may also result in them leaving you. 

  • Moodiness 

Being hyper-aroused can interfere with your sleeping patterns and your mood. They may feel irritable, anxious, sad, frustrated and a dozen of other negative emotions. It is possible that people with PTSD feel neglected and cynic due to PTSD relationship trauma. Opening up or having a conversation can be a challenging task for them. They may feel annoyed if you try to help them. Consciously or unconsciously they may try to avoid companionship. Feelings of distrust, insecurity creep in and create a further strain in the relations. On the other hand, significant others may experience helplessness, guilt, tension and pressure. The inability to help your loved one can be very disturbing and inflict emotional and mental pain. 

  • Inability to be vulnerable

One of the insidious effects of PTSD is the feeling of powerlessness and not being able to control your life. PTSD is accompanied by flashbacks, nightmares, and intrusive thoughts which can be triggered anywhere, anytime. A simple reminder of the traumatic event and one of the above symptoms can easily be triggered. This leaves the person helpless and weak. Hence, being vulnerable puts them in a position of being weaker. Hence they avoid talking about the trauma, their experience, or what’s happening to them. Opening up can be menacing. 

  • Lack of communication

Talking can be very consuming and difficult for trauma survivors. Especially in the start few days, where they’re in the impact stage and still in shock. Generally, the immediate reaction to trauma can be isolating oneself and suppressing all the feelings. However, communication is essential for enhancing the symptoms and getting back to normal. Through communication, many problems can be solved and misunderstandings can be avoided. 

PTSD trauma treatment

Some solutions to deal with PTSD and relationships. However difficult it may seem for the person to recover from PTSD it is important that they never lose hope or fall back to being demotivated. Through proper care and support, one can cope with PTSD. Here are a few tips that can be used to overcome problems in relationships. 

Tips To Help People Suffering From PTSD - For Self Care

  • Establish proper communication

for a healthy relationship, communication is very important. Even if you feel that you’re not ready to open or need more space, clear it out with your family members. Misunderstanding can create a strain in your relationship and have an adverse effect on your mental health. In order to avoid misunderstandings, communication is the key. Conversing with your loved ones will also help you vent out your bottled feelings. 

  • Self-care

Self-care is the key to a successful recovery. Only by loving yourself, you will be able to spread the love around you. Pamper yourself with everything you love. Self-care means prioritizing your needs before others and caring for your mental, physical and spiritual health. Meditation, exercise, yoga, healthy food, etc. help in enhancing your health. 

  • Find the courage to cope up

In the end, what is important is recovering from the disorder. If you don’t want PTSD relationship issues, find the courage to recover. Proper treatment for PTSD, such as neurological care and therapy will help you find a way through your struggles. 

Tips To Help People Suffering From PTSD - For Family, Friends, and Partners

  • Make them comfortable

Acknowledge the ordeal faced by the person with trauma and not making a hue and cry in front of them. At times, showing extra care makes them feel weak. The cue is to act normal and does normal things in front of them. 

  • Give them space

Forcing your loved ones to talk or showering them with extra care, will only make them go away and isolate themselves. Give them their space, and don’t intrude much. Let them take as much time as they wish

  • Love and support them

Always love and support them. Support their choices, however, if they seem to divert or resort to bad activities such as intake of stimulants, correct them. Be gentle and calm. With the love and support of loved ones, healing can be made easier.

One should definitely contact a neurologist or online neurologist consultation with them for treating further complications. You can also find him as a neurologist in Punjab, the best neurologist in Faridabad or brain specialist doctor in Faridabad , a top neurologist in Jaipur or neurologist doctor in Jaipur, the best neurologist in Saket, best neurologist in South delhi, neurologist in Agra, mind doctor in Delhi, top neuro physician in Patna and a top neurologist in Gwalior or neurologist doctor in Gwalior. He is also amongst the top 5 neurologist in Patna and top 10 neurologist in Delhi,ncr, and is also famous for his long distance senior care services.

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by Dr Chandril Chugh