Dr Chandril Chugh

5 Ways to Help a Loved One Diagnosed with Multiple Sclerosis

Introduction

People generally have a similar reaction when a loved one is diagnosed with multiple sclerosis. What does this mean? How do I cope?

Multiple sclerosis is a chronic disease handicapping the central nervous system (including the cerebrum, optic nerves, and spinal line). Multi-zone scarring is a sign of multiple sclerosis. In Multiple Sclerosis, the immune framework goes after the myelin sheath that covers nerve filaments and causes correspondence issues between the human cerebrum and the rest of the human body. Myelin permits the nerves to direct electrical signals rapidly and productively. Myelin sheaths that deteriorate or weaken in multiple places can leave scars or sclerosis behind. Specialists call these regions lesions. As these areas of spots multiply, there are major to never fibres due to which the patient's body can not carry out certain functions.

In the long run, the infection can cause long-lasting harm or deterioration of the nerves. Patients with Multiple Sclerosis can lose their ability to walk independently or even at all.

This illness is more often diagnosed in females than in males. Globally, the National MS Society reports more than two million patients suffering from the disease.

Even though it tends to be hard to take in right away that your loved one or someone close to you has been diagnosed with Multiple Sclerosis, you are their caretaker and have to make them realize they should continue living their life to the fullest.

As of now, there is no proven remedy for Multiple Sclerosis.

There are no particular tests for multiple sclerosis diagnosis. Diagnostic tools like spinal taps, MRIs, multiple sclerosis blood tests, or evoked potentials are often used instead.

5 ways to multiple sclerosis patient care

1. Understand that there is a great deal of vulnerability with Multiple Sclerosis

As a caregiver, you have this unpredictable illness that may affect different patients. One day your loved one who has multiple sclerosis will feel fine, and the next day, they might have various complications. The vital factor in beating this is arranging, laying out schedules, planning, and having the capacity and eagerness to be adaptable as a guardian. Even when it comes to multiple sclerosis causes and symptoms, specialists say that never make assumptions that what you read or hear about numerous sclerosis patients will also be the case for your loved ones.

2. Be consistent with your treatment.

As a general rule, the best methodology is to treat any individual with a physical, neurologic issue as a solid and free individual equipped for navigation and taking care of oneself. Doing as such for your adored one to be freer is excellent for both of you. You might have to research gears like a ramp and wheelchair. A physical advisor can come to your place to recommend explicit changes. Design your house so that it becomes easy for them to get around. In this way, they will continue to serve in the role of confidant and socially active.

3. Keep yourself updated about the disease.

Few of the symptoms are easily visible, while other changes might be felt exclusively by the individual encountering multiple sclerosis. Therefore, listening to multiple sclerosis patient stories is necessary to educate yourself about the illness. Frequently ask your loved one who has multiple sclerosis about what they are going through and what all they wish that people taking care of them might be aware of the illness. It might be impossible for you to know the exact thing somebody with multiple sclerosis is going through. However, putting forth the attempt to attempt can have an enormous effect. Also, read articles and listen to the caregivers of other multiple sclerosis patients as they are experienced.

4. Assist them with the ordinary routine stuff.

It becomes a big challenge for patients with multiple sclerosis to do basic routine stuff like strolling, utilizing the restroom, cooking, and cleaning. Most Multiple sclerosis patients can facilitate care; however, they may eventually need assistance with transportation and household upkeep. Contingent upon your loved one's Multiple Sclerosis stages, you might need to assist with fundamental considerations like dressing them up, cooking and helping them to feed, toileting, and cleaning them from time to time. In the early stages, your loved ones might not require your assistance, but the gesture will significantly affect them. Keep them in the loop, so they know you are available if they need you in the future.

5. Always try to be adaptable and understanding.

Individuals with Multiple Sclerosis have great days and awful days, and these might even change in the middle of the day. The patients might even feel exhausted after a deep eight-hour sleep. Realizing that weariness can make it challenging for somebody you love to participate in exercises you had arranged, try to be OK if they drop on you.

Multiple Sclerosis patient care always requires being ready with a plan B if a terrible day happens.

Dr. Chandril Chugh is one of the most popular US-trained Neurologists. He has 16 years of experience in this field. He was the head of the Department of Interventional Neurology at Max Hospital, Saket, and is a prime supporter of Dr. Good Deed. He is also a member of AAN & SCCM. He is popularly known for his kindness and excellent assistance demeanor among his patients. Besides the fact that he takes incredible thought of his patient's wellness, additionally, he is awesome to talk with at each gathering.

Conclusion

When you're a caregiver, it's critical to deal with yourself. Work out consistently, eat well, and get a decent night's rest. Keep track of your and your loved one's medical care. Always be understanding and cooperative with them, and ensure that you are always with them whenever they need assistance. Have conversations with other caregivers to gain knowledge on the illness. Your help and care are the best treatment for your loved person with multiple sclerosis.

by Dr Chandril Chugh

Having Children After a Multiple Sclerosis Diagnosis

Introduction to Multiple Sclerosis

A person suffering from Multiple Sclerosis experiences damage to the central nervous system by affecting the nerves located in the brain and spinal cord. Multiple Sclerosis is a chronic and handicapping sickness that generally begins in youthful adulthood and is twice as typical in females than males. This illness happens when the immune system assaults nerve strands and myelin sheathing. This assault causes aggravation, which annihilates nerve cell cycles and myelin.

Multiple Sclerosis is a deep-rooted infection, generally advancing to genuine and long-lasting incapacity, even though it can incidentally have just gentle side effects. Moreover, multiple Sclerosis is erratic and can go from harmless to handicapping.

Multiple sclerosis life expectancies of approximately twenty-five to thirty-five years after the finding of Multiple sclerosis is observed.

The disease is more common in countries of the Northern hemisphere.

Multiple sclerosis causes

A wide range of causes can lead to Multiple Sclerosis, including viruses, autoimmune disorders, environmental elements, and hereditary variables. Each of the potential causes shares the common component of the body's immune system going after sensory tissue. Myelin protects the electrical signs the sensory system uses to transmit. When obliterated, communication will have interference and delay. Specific sensory systems may be damaged permanently.

Multiple sclerosis symptoms and diagnosis

Different symptoms and signs of multiple sclerosis may arise based on where the affected nerve fibers are located and how far the disease progresses. They might be depending upon the sensory system impacted. They show up in different mixes, might include problems like Judgment, Consideration, Memory, and Focus. To determine how multiple sclerosis affects the body in general, the following points should be noted:-

• Exhaustion
• Wooziness
• Issue with coordination
• Paralysis
• Obscured vision or twofold vision, etc.

You should seek medical attention if you notice any of the symptoms listed above. You may be advised to consult a neurologist or healthcare provider for a diagnosis. Multiple sclerosis cannot be diagnosed with a specific test. Instead, a differential diagnosis is used to analyze the disease. The medical services supplier will do a careful clinical history and an actual test as the initial moves toward finding Multiple Sclerosis. The neurologist may suggest you go to certain tests like MRI, lumbar puncture, blood tests, etc to know more about the spread of illness.

Multiple sclerosis treatment

Multiple sclerosis does not have a cure. However, treatment options can slow its progression and provide benefits. Additionally, you can get treatment to manage symptoms, deal with flare-ups or relapses, improve your safety and function. Restoration treatments, including active recovery, muscle relaxants, occupational treatment, discourse and gulping help, mental treatment, or assistive gadgets like supports, may likewise be helpful. Corticosteroids and plasmapheresis are considered treatments for Multiple sclerosis attacks.

Multiple sclerosis and pregnancy

Luckily, there is no appearance of speeding up the course or worsening the effects of Multiple Sclerosis in pregnancy. From a few pieces of research, doctors have observed that Multiple Sclerosis side effects decline in pregnancy. However, the impacts of the illness might make it physically challenging to convey a pregnancy. MS and pregnancy fatigue, weakness, and coordination issues may increase the probability of falls. Parents will need to closely monitor the mother's infection to the disease and the fetus's health during this period. If a mother has unrecognized Multiple Sclerosis, there are high chances of her being diagnosed with MS after pregnancy as during pregnancy be more likely to start having symptoms.

Issues that a woman with MS will have over one with not are:-

• Small-for-gestational-age baby.
• Difficulty in pushing out the baby during labor and birth.
• Mosty to give a cesarean birth.

Doctors have observed that women with Multiple Sclerosis mostly have c section delivery. Some theories suggest that labor is delayed due to muscle problems.

No settled treatment modifies the direction of multiple sclerosis. In any case, you might be given medications like steroids and anti-inflammatory medicines. So do consult your neurologists for more information. Pregnant women who have multiple sclerosis may need to undergo rehabilitation programs. This will depend on the symptoms of the mother. Some of them are listed below for your help:-

• Keeping up your freedom
• Restoring coordinated abilities
• Utilizing assistive gadgets
• Socializing
• Setting a suitable activity program to advance muscle strength, perseverance, and control.
• Overseeing bladder incontinence
• Getting mental retraining
• Adjusting the home climate for security and ease of use
• Getting friends and family involvement.

Dr. Chandril Chugh has been in the Neurology field for sixteen long years and is regarded as one of the top US-trained Neurologists. He was the head of the Department of Interventional Neurology at Max Hospital, Saket, and is one of Dr. Good Deed's most vocal supporters. He is also elected to be a member of SCCM & AAN. His kindness and excellent assistance demeanor make him popular among his patients. Furthermore, he is lovely to converse with at every meeting since he listens to his patient's problems. Dr. Chandril Chugh completed his MBBS and won a gold medal. His vision is to assist people improving their lives and, bit by bit arise as thought forerunners in the field of the health board.

Conclusion

According to research, women with multiple sclerosis do not have a significantly different rate of birth defects from those without numerous sclerosis in pregnancy, delivery, and conceiving. The only problem comes during labor, as the mother might not have pelvic sensation and may not feel torment with contractions. This may likewise make it difficult to tell when work begins. The side effects of MS might be dispatched for quite a while. Pregnant women with MS should inform their doctor as soon as possible for timely diagnosis and treatment. Getting the proper clinical consideration can lead to having a healthy pregnancy and a sound child if the mother has Multiple Sclerosis.

by Dr Chandril Chugh

Is It Important To Take a Second Opinion Before Spinal Surgery?

When do you need to undergo spinal surgery? Is undergoing one necessary? Dr. Chandril Chugh, American trained stroke and Aneurysm Specialist discusses all the factors that come up in all our minds.

REASONS FOR SPINAL SURGERY

If a patient comes up with lower back or neck pain, we observe him for a while and suggest maintaining physical activity, in case it resolves on its own. If the pain does not resolve on its own, you should see a doctor for further evaluation.

Spinal problems can also be treated in a non-surgical way as well. Options like physical therapy, exercises, medication, and sometimes spinal injections are also recommended before surgery is resorted to. If a patient is not responding to non-surgical options and still experiencing a lot of pain then, we recommend surgery, especially for those who go through a weakness in limbs due to spinal cord or nerve root compression.

TYPES OF SPINAL SURGERY

Lumbar Decompression Surgery for Spinal Stenosis: Lumbar decompression surgery, also known as, lumbar laminectomy, is performed to correct the narrowing of the spinal canal, called spinal stenosis. The surgeon removes the lamina in the spine that is causing pain.  

A lumbar discectomy involves removing an injured disc in the lower back. An arthroscopic discectomy and an open spine surgery are both types of lumbar discectomy. Open spine surgery is more common.

Herniated Disc Surgery : In herniated disc surgery, the surgeon removes an injured part of the disc. In order to stop the pain from the disc, the surgeon may remove the disc and fuse the vertebrae together. Take the decision after getting a second opinion since spinal fusion makes it difficult to move the part that was operated on. The second opinion doesn’t hurt, ever. 

Spinal Fusion Surgery: As discussed above, it involves fusing two adjacent vertebrae together to avoid pain caused due to their movement against each other. The surgeon uses small screws and rods to fuse the vertebrae and then leave them to naturally heal and fuse. The surgeon can also use a bone graft from another part of the body to help the vertebrae to fuse.  

RECOVERY TIME

Recovery after discectomy is usually quicker, although you may feel numbness, pain, or weakness around the affected area.

When it comes to fusion surgery, it may take longer. It will take 3 to 4 months at least for the bones to recover and the process of healing will go on for a year. The length of surgery also depends upon your condition before surgery.

RISKS ASSOCIATED WITH SPINAL SURGERY

Anaesthesia risks: Spine surgeries are usually performed under general anaesthesia, intravenously to avoid pain during the surgery. Risks are rare but serious like death, heart attack, stroke, and brain damage. Complications may be caused because of other medical conditions. Please tell the medical team about tobacco use or if you or your other family members have ever had a reaction to anaesthesia. 

Bleeding: The surgeon employs techniques that minimise blood loss however, blood loss can still happen.  

Blood clots: After the surgery, the body’s clotting mechanism is super active to stop the bleeding caused by the surgery. Injury to the blood vessels around the affected site can cause clotting. Clots can occur during the first few weeks of surgery. Signs of a blood clot include swelling, tenderness or redness, and pain. 

Dural tear: It occurs when the thin protective covering around the spinal cord gets torn during the procedure. Most dural tears heal without incident. In case, the tear doesn’t heal the spinal fluid can leak out through the tear and can cause a spinal headache. If you feel a headache after surgery, tell your surgeon, chances are you might need a second surgery.  

Infection: The risk of infection after surgery is small. If the infection develops it is superficial, but it can spread to the deeper areas around the spinal cord and vertebrae. Common symptoms of infection include a red hot and swollen wound, pain, fever and chills, clear liquid or yellow pus coming out from the cut, a foul smell coming out from the wound site. Go to your doctor if you notice any of these symptoms.  

TAKE SECOND OPINION

The complications mentioned are rare but still, you should ask the surgeon about the risks associated with the surgery. In fact, take a second opinion as well. Knowing the risks beforehand allows you to weigh the pros and cons of whether undergoing surgery would be right for you. Taking a second opinion is best when the first surgeon wants a confirmatory opinion before going for the second surgery. When this is the case, let the surgeon choose the surgeon as he would choose the one whose opinion he would value the most. If the surgeon is unable to explain to you why you need surgery, his explanation seems vague or your personal goals don’t match, when it comes to the treatment, you should surely take a second opinion. Taking a second opinion is important when the first surgery did not work and the doctor is recommending another one. If the first surgery is not beneficial, then the second one would be helpful in very specific circumstances.

Online second opinion services are also an option especially when the doctor you want to consult is at a distance. The doctors look at your X-ray scan, MRI reports and then provide a second opinion. But there is one drawback, they do not get to evaluate you and your condition in person.

HOW TO CHOOSE A SPINE SURGEON

1. The surgeon should enlighten you about the pros and cons of undergoing surgery, and educate you about the process. He should describe to you what is technically possible about the potential benefits.

1. Patients often ask about whether the orthopaedic surgeon or neurosurgeon should do their surgery. Each specialty has a different focus in training although both are equally trained to do the surgery. The orthopaedic surgeons are better suited for deformity and neurosurgeons are better in handling tumour cases. Both of these surgeons often work together in the operating room.  Your surgeon should be board certified in orthopaedic surgery or neurosurgery.

1. Last but not least, the number of years of experience that the surgeon has in the field of spinal surgery. A surgeon more experienced is going to have a way better technique while handling such a case than the one who does a spinal surgery occasionally.

In a nutshell, never ignore the symptoms and never avoid taking a second opinion.

by Dr Chandril Chugh

What is Guillain-Barré Syndrome ?

Guillain - Barre is a condition wherein your body's immune system  assaults your nerves. It can cause muscle weakness, loss of reflexes, and numbness or shivering in the body. These symptoms can progress, in the end incapacitating the whole body. A lot of people with the condition need to be hospitalized for treatment.  Guillain-Barre can be treated and limit the term of the sickness. The duration of this syndrome is  around a fortnight to a month.

There are a total of three types of Guillain barre syndrome. Scroll down to learn more regarding the kinds :

• Acute inflammatory demyelinating polyradiculoneuropathy
• Acute motor axonal neuropathy - impacts the axons of the nerves going to the muscles.
• Acute motor and sensory axonal neuropathy - affects the axons of the nerves.

Now let us have a look at the causes of the Guillain-Barre syndrome :

This health problem is not age-specific but it is most typical in individuals 50 years old or more geriatric. Although science has not come up with the exact cause of the disorder yet, it is believed that barre syndrome is caused by a few sicknesses that modify your nerve cells, so the resistant framework of your body begins to see them as dangers. Others think that one of the Guillain barre syndrome causes is the failure of your immune system to remember which cells it shouldn't assault. The problem generally seems days or weeks after respiratory or intestinal system contamination. The immune system of the body is the major GB syndrome cause. To know various reasons by which the immune system can get incapacitated which lead to Guillain barré syndrome is as follows :

• HIV / AIDS
• Flu
• COVID-19 OR ZIKA VIRUS
• Cytomegalovirus
• trauma
• Surgery
• Mycoplasma pneumonia
• Childhood vaccinations
• Hepatitis A, B, C, and E
• campylobacter

Know about Guillain barre syndrome symptoms :

People with Guillain barre syndrome usually experience weakness within two weeks of onset. The symptoms are as follows :

• Prickling, tingling sensation in your fingers, toes, lower legs, or wrists
• The shortcoming in your legs that spreads to your chest area
• Precarious strolling or failure to walk
• The trouble with facial developments, including talking, biting, or gulping
• Twofold vision or failure to move eyes
• Extreme torment that might feel throbbing, shooting, or cramp-like and might be more awful around evening time
• The trouble with bladder control or inside work
• Fast pulse
• Low or hypertension
• Trouble relaxing

Apart from those mentioned above, the patient may experience other symptoms of GBS. For example, the affected person may face breathing difficulties or lack of reflex movements. He or she may also complain about Lagging bowel operation and urine retention, Blood pressure oscillations, erratic heartbeats, or developing blood clots.

Dr. Chandril Chugh is a dedicated stroke specialist. He went to extensive medical training in the United States of America. With over 16 years of experience in this field, he is well known for his Empathy, honesty, and wonderful service attitude among his patients. He is currently positioned as a

Senior Consultant & Head – Interventional Neurology at Max Super Speciality Hospital situated in Saket, New Delhi. He is the best neurologist in the capital. The services offered by his team are at par.

Guillain barre syndrome diagnosis :

Guillain - Barre disorder is a very serious medical condition that requires quick hospitalisation since it can deteriorate quickly. The sooner suitable treatment is begun, the better the opportunity of a healthy and a better result. The signs and symptoms of Guillain barre syndrome relate to those of the nervous system breakdowns making it difficult for the medical practitioner to come to a conclusion. Certain tests can be conducted at the discretion of the doctor to confirm the GBS syndrome. Certain nerve conduction velocity tests and electromyography may also be suggested by the neurologist.

GB syndrome treatment :

At times, to speed recuperation, the specialist will take blood from your body, clean it, and thereafter return it to your body. This cycle is called plasmapheresis. Your primary care physician might give you antibodies. You will also be advised to take high doses of solid cells through an IV. These assist with decreasing your immune system's assault on your body. Certain individuals with GBS should be hospitalized for a couple of days. Others stay for a very long time. Physical therapy or physiotherapy can also do wonders on the patient's body to recover from the GBS. Guillain barre syndrome medication is intravenous immunoglobulin or blood transfusion.

FAQs

How do you catch Guillain-Barré syndrome?

Disease with Campylobacter, which causes looseness of the bowels, is one of the most well-known danger factors for GBS. Individuals likewise can foster GBS after a few different contaminations, like influenza, COVID - 19, Epstein Barr infection, and Zika infection.

What is the most common cause of Guillain-Barré syndrome?

GBS can be seen in any individual but it is more prominent in people who have lived fifty years or more. Most commonly, this deadly syndrome can be easily caused by Campylobacter, which is widely circulated in most warm-blooded creatures.

Can you fully recover from Guillain-Barre?

Affirmative, the patients have reported that they recovered fully from this life-threatening syndrome within a year. Some individuals may have symptoms and signs again years afterward, but this is occasional.

Can alcoholism cause Guillain-Barré syndrome?

Yes, definitely. Studies have found that alcohol when found with malnutrition in the patients caused severe acute axonal polyneuropathy.

What happens in Guillain-Barré syndrome?

The capacity to talk gets impacted in extreme instances of Guillain-Barré disorder. The chest muscles are impacted, making it difficult to inhale and exhale. Patients pass on due to difficulties, which can incorporate loss of motion of the muscles that control breathing, blood disease, or lung clumps.

by Dr Chandril Chugh

Everything you need to know about Ataxia

Ataxia gait can be described as the absence of muscle control or coordination of intentional actions, like walking, swallowing, balance, speech, and any kind of muscle coordination. Ataxia usually evolves as a result of injury to a portion of the brain called the cerebellum which is responsible for the coordination of muscle. The cerebellum is situated at the bottom of the brain just above the brainstem. You can be affected by Ataxia at any stage of your life. Inherited defective genes from your parents also can cause the illness. You will be amazed to know that Friedreich's ataxia, the most typical type of the said illness, affects roughly 1 in 50,000 humans in the USA. Ataxia is typically progressive, signifying it can get more threatening with time.

Let us grasp some knowledge about different types of Ataxia:-

1. Spinocerebellar Ataxia:

Classified into dozens of different types, this is a genetic Ataxia. Cerebellar ataxia is common to different types, nonetheless, further signs and symptoms, as well as the age of onset, differ depending on the specific gene mutation.

2. Ataxia-telangiectasia:

This uncommon, moderate youth sickness causes degeneration in the cerebellum. Telangiectasia is the development of smaller than normal red veins that could arise toward the edges of your youngster's eyes or on the ears and cheeks. It incapacitates the immune system of the young ones which may lead to illnesses including infections and cancers.

3. Episodic ataxia:

Episodic ataxia creates recurring disorder with activity and balance. These kinds of episodes can vary from several times to just one or two times annually.

4. Friedreich’s ataxia:

This common inherited ataxia includes harm to your cerebellum, spinal line, and fringe nerves. In Friedreich’s ataxia, the person experiences stiff muscles and gradually loses strength and feeling in their arms and legs, and even weakening of heart muscles.

5. Sensory ataxia:

When you have sensory ataxia, you have minor sensations in the feet and legs because of damaged nerves. This illness weakens the feedback that comes from the brain

6. Cerebellar Ataxia:

Cerebellar ataxia symptoms are wobbling, dropping down while walking or being precarious on stairs.

7. Truncal ataxia:

Also known as Ataxic gait is distinguished by uncertain starts and stops, lateral divagations, and unequal steps. It is a fluctuation of the trunk and is often seen while an individual is sitting position. It is most prominent while shifting postures or walking heel-to-toe.

Causes of Ataxia

There are miscellaneous causes for ataxia either due to a critical hurt or infection, or a regular degenerative cycle. We have listed some of them down below for you.

• Stroke, blockage, or internal bleeding in the brain.
• Infections
• Deficiency of vitamins like B-12, E, etc
• Thyroid problems
• Brain trauma.
• External or internal injury to head
• poisoning by lead, mercury, or other solvents

Let us now know the symptoms of Ataxia

Ataxia can develop several neurological disorders, overtime or can come on suddenly. Ataxia Symptoms can include:

• reduction in coordination while doing activities
• Having concern walking
• Incapacitated balance
• Heart issues
• Muscle twitching
• Garble while speaking
• Eyesight issues
• Tendency to stumble
• Hardship in swallowing

How do physicians analyze ataxia?

Generally, the Neurologist performs a physical exam and a neurological exam. But besides that specialists even check the patient's recollection and attention, eyesight, hearing, balance, and reflexes. Even laboratory tests might be conducted. These tests could include:-

Genetic testing: to determine whether the patient has the gene mutation that causes one of the inherited ataxic disorders.

CT scan - to determine possible casualties.

MRI - MRI can sometimes display shrinkage of the cerebellum and other brain parts in individuals with ataxia.

Lumbar puncture: to remove a sample of cerebrospinal fluid to examine it further in the laboratory.

Blood tests- to determine underlying reasons such as a stroke, tumor, or infection.

Ataxia treatment

There is no specific cure for ataxia. In some circumstances of cultivated ataxia, treatment is the underlying reason of cultivation, such as an infection, certain medications, or a vitamin deficiency. In certain scenarios, the specialist will treat the patient for the cause such as depression, stiffness, tremor, or will suggest adaptive devices or therapies to

cure ataxia. Medicines can assist in battling against symptoms and causes such as tremors, dizziness and can also treat muscle cramps.

Adaptive devices- Ataxia caused by cerebral palsy which leads to cerebral ataxia or ataxic cerebral palsy might not be curable. In such circumstances, neurologists recommend the patient with adaptive practices such as walking with the support of hiking sticks or walkers, having a meal in modified utensils, and communication aids for speaking.

Neuro specialists can also recommend therapies such as Physical therapy occupational therapy and Speech therapy.

Dr. Chandril Chugh is a trustworthy stroke specialist. He experienced comprehensive medical training in the United States of America. With over sixteen years of understanding in this field, he is reasonably known for his Kindness and fantastic service attitude among his patients. Not only does he take great consideration of his patient's fitness, but also he is delightful to speak with at every meeting. It’s rare to encounter a doctor that combines such personal touches and care for a patient as an individual with an outstanding quality of medical care.

FAQs

Q. What triggers ataxia?

ANS. Many circumstances can trigger ataxia, including too much liquor, certain prescriptions, cerebral palsy, stroke, tumor, and genes.

Q. What are the 3 types of ataxia?

ANS. The three variants of this disorder are vestibular ataxia, cerebellar ataxia, and proprioceptive ataxia.

Q. How long can you live with ataxia?

ANS. Life expectancy is generally limited than typical for individuals with innate ataxia, although some people can live well up to 50 plus. In serious cases, the condition can be lethal in adolescence or early adulthood.

Q. How quickly does ataxia progress?

ANS. Rapid progression may vary from weeks to months.

Q. What vitamin is good for ataxia?

ANS. VITAMIN E, VITAMIN B-12, and thiamine are good if you suffer from ataxia.

by Dr Chandril Chugh

Everything you need to know about Cluster headaches

Cluster headaches are one of the severely painful types of headaches on either side of the head, typically around the eye. A bunch of Cluster migraines generally stirs you in the night with remarkable torment in or around one eye on one side of your head. It occurs in cyclical patterns or bouts of frequent attacks (cluster periods). The recurrence of headaches during these cycles might go from one headache every other day to several headaches per day. Luckily, cluster headaches are not common and not perilous. Medicines are available in the market for cluster headache treatment which can make cluster headache assaults more limited and even less severe. Likewise, medications can lessen the number of cluster headaches you may suffer. Studies have shown that cluster headaches were more usually revealed by men than ladies, and between adolescence and middle age, however, can happen at whatever stage in life. Cluster headaches can be episodic and chronic, distinguished by their frequency of occurrence.

The most common cluster headache causes are:-

• Nerves- Two nerves are remembered to have a significant part in cluster headache are the trigeminal nerve and the facial nerve.
• Hereditary qualities - Cluster headache might run in certain families in an autosomal prevailing legacy pattern
• Tobacco smoking - Approximately 65% of people with CH are or have been, tobacco smokers.
• Hypothalamus - cluster headache patterns recommend that irregularities in the body's biological clock play a role.

Other potential triggers incorporate the utilization of medication, for example, nitroglycerin, a medication used to treat cardiac illness.

Unlike migraine and pressure headache, cluster headaches are mostly not related to triggers, like food varieties, hormonal changes, or stress.

Tips which will help to Prevent Cluster Headaches

• hot baths
• strenuous activities
• cocaine
• high altitudes
• alcohol
• tobacco smoking
• hot weather
• dishes with large amounts of nitrates

Few home remedies for cluster headaches:-

• Magnesium
• Capsaicin cream
• Melatonin
• Deep breathing exercises and yoga.

So that were a few cluster headache reasons of trigging now let us have a look at the Symptoms of Cluster Headache.   `

• Pain is generally situated in, behind, or around one eye, however may emanate to a different region of your face, head, and neck. One-sided pain
• Drooping eyelid on the affected side
• Excessive tearing from eyes
• Restlessness or agitation
• Forehead or facial sweating on the affected side
• Nausea or vomiting
• Redness of eye on the affected side
• The runny nose on the affected side
• Pale skin or flushing on your face
• Swelling around your eye on the affected side

Cluster Headache DIAGNOSIS

Cluster headache has a trademark kind of torment and pattern of attacks. An analysis relies upon the patient's description of the headache, including the patient's aggravation, the area and severity of your headaches, and related symptoms.

A neurological assessment might be helpful for the specialist with distinguishing actual indications of a neurological problem. The test is generally common in patients with cluster headaches. The doctor will utilize a progression of systems to evaluate the patient's brain function including testing your faculties, reflexes, and nerves.

If the patient has strange or complicated headaches or an unusual neurological assessment, the doctor may prescribe brain imaging tests which may include:-

• MRI.-  utilizes a strong magnetic field and radio waves to create detailed pictures of your brain and blood vessels.
• CT scan. utilizes a progression of X-beams to make itemized cross-sectional pictures of your brain.

KNOW ABOUT Cluster Headache remedies and treatment

 In the case of Cluster headache, one's treatment involves relieving and preventing your headache symptoms using medication. In intriguing cases, when relief from discomfort and preventive treatment doesn't work, your primary care physician might suggest a medical procedure. Torment medicine diminishes your headache torment whenever it has started. The remedy includes breathing 100% pure oxygen which will result in relives from the symptoms. Another way to ease the headache is to take the help of nasal spray medication, or other triptan medications to constrict blood vessels to relieve pain.

Dr. Chandril Chugh is one of the best Neurologists in the capital. With the experience of over 16 years, Dr. Chandril Chugh is now a senior consultant and head of interventional neurology at Max Super Specialty Hospital, Saket Delhi. Dr. Chandril Chug's knowledge and U.S.- based training assist him in treating all issues like brain and spine including aneurysms, stroke, back/neck pain, or headaches. Dr. Chandril Chug conducts live consultations which have likewise helped individuals in more than one way in disposing of their medical problems and keep carrying on with a solid life.

FAQs

• Q What is the main cause of cluster headaches? 

ANS - The specific reason for cluster headaches is obscure, however, cluster headache patterns propose that anomalies in the hypothalamus (body's natural clock) play a role. 

• Q How do you break a cluster headache?

ANS- Often, a cluster headache will stop before you have a chance to see a Doctor but if ever cluster headache isn't getting under control and you get a chance to see one then they will provide you with injected medications or a nasal spray. The health care provider will also you an oxygen mask with a 100% pure oxygen supply which will help you to ease the pain.

• Q Does caffeine help cluster headaches?

ANS - Adding caffeine to your diet plan may or may not be a good idea. The connection between caffeine and headache is unclear to a lot. Caffeine has been involved as a trigger in numerous sorts of headaches, but then it is likewise powerful as an adjuvant treatment to normal analgesics

• Q What helps a cluster headache behind the eye?

ANS- Inhaling pure oxygen may relieve cluster headaches. As well as nasal triptans like sumatriptan and lidocaine, there are nasal drops containing the active ingredient. Some people take medicines such as verapamil (Calan, Verelan) or prednisone to prevent attacks.

by Dr Chandril Chugh

Everything you need to know about the risk factors for stroke

Stroke is the most common neurological disorder owing to the sedentary lifestyle and unhealthy diet. It is a disease of the brain that occurs when a blood vessel gets ruptured, leading to cut off the supply of blood flow and oxygen in the brain’s tissue. Therefore, it is sometimes called ‘Brain attack’.

It is a medical emergency that needs immediate action. When oxygen supply is not reaching the brain cells and tissues, it causes failure and dies within minutes.

Types of Stroke

1. Ischemic stroke (Clots) In this stroke, obstruction of blood vessels that supply blood to the brain occurs by formation of clots. It can be a blood clot or other particles like deposition of fatty acids called plaque that cause blockage by building up in the blood vessels. In the majority of strokes, clot formation is the major cause of obstruction.
2. Silent stroke or silent cerebral infarction (SCI) is like a brain injury caused by blood clot formation that cuts off blood supply to the brain. The symptoms of silent stroke include slight loss in memory, lack of balance in the body, temporary loss of basic muscle movement, impairment of cognitive skills and ability.
3. Hemorrhagic stroke (Bleeds) In this stroke, the weakened blood vessel ruptures and bursts in the brain. The blood then accumulates and builds up in the surrounding brain tissue. This leaked blood compresses and puts high pressure on surrounding tissue, damaging the brain cells. The two types of weakened blood vessels that cause hemorrhagic stroke are Cerebral aneurysms and arteriovenous malformation.
4. Transient ischemic attack (TIA) it is also called mini stroke. In this stroke, temporary blockage of blood flow to the brain occurs. The blockage is usually not longer than 5 minutes, therefore, it is usually ignored. However, it is a warning sign for full blown future strokes. TIA can occur in any age group, but usually risk increases with age. TIA can act as a signal for a second stroke in future. If you already had a first stroke, then pay much needed attention to the warning signals. On an average 15% of all people suffer from major stroke within 3 months of TIA. Some common warning signals are weakness, numbness or paralysis of one side of the body, severe headache, dizziness, problem in understanding others, blindness in one or both eyes.
5. Brain stem stroke in this stroke, the brainstem is affected. It may have complex symptoms which are difficult to diagnose. It affects both sides of the body and leaves it in a locked- in state. The function of the brain stem is to control the central nervous system, regulates consciousness, blood pressure and breathing. A stroke in the brain stem can cause impairment of one or more functions. The severe brain strokes can cause locked- in syndrome in which the person is not able to move the part below the neck. Like all other strokes, the brain stem has a wide spectrum of symptoms and risk factors. The risk factors for brain stem strokes are high blood pressure, diabetes, heart disease, atrial fibrillation and smoking.

What are the most common risk factors for stroke and their prevention?

1. Control high blood pressure high blood pressure or hypertension is the primary cause of stroke that is more common in people nowadays. Simultaneously it is the significant controllable risk factor. Regularly check your blood pressure, know your numbers and keep them under check. Manage the high blood pressure level.
2. Do moderate exercise 5 times a week physical inactivity leads to stroke, heart disease, high blood pressure, high cholesterol level, obesity. Regular exercise is suggested by doctors, however, do not do vigorous exercise. Exercise will help in breakdown of fatty acid deposits and thereby, reduce cholesterol.
3. Eat a healthy, balanced diet Diets that are rich in saturated fats and cholesterol can raise the blood cholesterol level which in turn, accumulates in the blood vessels leading to stroke. The food high in sodium salt leads to high blood pressure and intake of high calorie food results in obesity. These factors increase stroke risk even more. First, take proper guidance and know your body type, the levels of minerals in the body in order to avoid potent barriers to a healthy body.
4. Reduce your cholesterol the presence of large amounts of cholesterol in the body leads to blood clots, a primary reason for stroke. However, some reports show that low level of high-density lipoprotein is a risk factor for stroke in men
5. Avoid smoking and avoid second hand exposure the composition of nicotine and carbon monoxide in the smoke of cigarettes can potentially damage the cardio- vascular system. Studies show that smoking while using birth control pills causes the risk of stroke even more severe.
6. Identify and treat atrial fibrillation some of the common heart diseases can increase the risk for stroke. For example- Atrial fibrillation, a heart rhythm disorder causes a clot that can reach to the brain and leads to stroke. In addition, if you have sleep apnea that is linked to Atrial fibrillation and increases the risk of stroke.
7. Diabetes in diabetes, the person has low or no production of insulin, also unable to use the insulin for glucose uptake. Insulin is a peptide hormone vital for conversion of glucose into energy stored form in the body. In case of diabetes, sugar level will rise in the blood and prevent oxygen and nutrients from reaching various tissues, including brain cells. Some factors like high blood pressure are associated with diabetic person and increase the risk of stroke.

What are the 5 warning signs of a stroke?

1. Uneven smile on person’s face or droop in face movement.
2. The numbness in arms or weakness is the warning sign.
3. Slurred speech is the indication of stroke.
4. Having trouble with vision in one or both eyes.
5. Losing consciousness, trouble walking.

Can you detect a stroke before it happens?

1. You can use the FAST test to check the most common symptoms in order to detect in the early stage.
2. Face: Ask the person to smile and see it is uneven or if one side of the face droops.
3. Arms: Ask the person to raise both the arms. If a person is not able to raise arms or one arm drops down.
4. Speech: Ask the person to randomly repeat a sentence and check for slurred speech.
5. Time: If you observe these signs, contact the doctor immediately.
6. For further queries and details, ask the stroke specialist Dr. Chandril Chugh.

by Dr Chandril Chugh

Unlocking Lumbar Lordosis Disease: Causes, Symptoms, and Treatment Insights

In the neck, upper back, and lower back, everyone’s spine exhibits slight curves. These natural curves, including the lordotic (neck and lower back) and kyphotic (upper back) curves, provide essential functions such as shock absorption, support for the head, alignment, stability, and flexibility.

However, when the lumbar curvature becomes excessive, it leads to a condition known as lumbar lordosis, also referred to as swayback. Lumbar lordosis occurs when the natural curve of the lower back arches too far inward. This can cause discomfort, pain, and mobility issues, affecting an individual’s ability to move freely and perform daily activities.

Shock Absorber: The spinal curves act as shock absorbers, cushioning the impact of daily activities on the spine.

Weight Support: The curves support the weight of the head and distribute it evenly along the spine.

Structural Stability: By maintaining the S-shaped structure, the spine stays stable and functional.

Flexibility: The curves allow the spine to move and bend with ease, facilitating various movements.

However, when the lumbar lordotic curvature becomes exaggerated, it leads to lordosis or swayback, causing discomfort and mobility issues. This condition affects both the lower back and neck, resulting in pain and restricted movement.

Causes of Lumbar Lordosis Disease

Several factors contribute to the development of lumbar lordosis disease, including:

• Spondylolisthesis: A condition where vertebrae slip forward onto the bone below, often requiring therapy or surgery.
• Achondroplasia: A type of dwarfism that affects bone growth and development.
• Osteoporosis: A bone disease characterized by decreased bone density, increasing the risk of fractures.
• Osteosarcoma: A type of bone cancer that can affect the spine and lead to lordosis.
• Obesity: Excess weight puts strain on the spine, leading to postural abnormalities like lordosis.

Types of Lordosis

In the lower back, there is a condition known as lordosis.

The most prevalent lordotic curve is in the lower back, often known as the lumbar spine. Lying on your back on a level surface is the most straightforward technique to check for this condition. With a bit of room to spare, you should be able to move your hand under your lower back.

An individual with lordosis has more space between their back and the surface of the spine. When they stand, a noticeable C-like arch will appear in case of excessive curvature. Their abdomen and buttocks will also protrude from the side.

Cervical Lordosis

Your neck should be shaped like a comprehensive C in a healthy spine, with the curve going backwards. If your neck spine does not curve as it should, you have cervical lordosis.

This might indicate that the curvature is overly steep. The curvature is in the wrong direction, referred to as reverse cervical lordosis. The curve has moved to the right. The curve has moved to the left.

Signs and Symptoms of Lumbar Lordosis Disease

Muscle discomfort is the most prevalent sign of lumbar lordosis disease. Your muscles are tugged in different directions when your spine bends unnaturally, causing them to tense or spasm. This pain may spread to your neck, shoulders, and upper back. You may also have trouble moving your neck or lower back.

Whether you're resting on a level surface, look for a lot of space between the curvature of your neck and back and the floor to see if you have lordosis. You may have lordosis if you can easily slide your hand through the gap.

Make an appointment with your doctor if you have any other symptoms, such as:

• Numbness
• Tingling
• Electric shock discomfort
• Weak bladder control
• Weakness
• Difficulty maintaining muscle control.

Diagnosis and Treatment of lumbar lordosis disease

To establish if you have lumbar lordosis disease, your doctor will review your medical history, do a physical exam, and inquire about additional symptoms. For example, your doctor will ask you to lean forward and to the side during the physical examination. They're looking at things like whether the curve is flexible or not, your range of motion, and if your spine is aligned.

Your doctor will prescribe tests after narrowing down the likely reasons, such as X-rays of your spine to check the angle of your lordotic curve. Next, your doctor will assess whether or not you have lordosis by comparing the rise to other parameters such as your height, age, and body mass.

Most patients with lumbar lordosis disease do not require medical treatment unless complicated. The severity of your curvature and the existence of additional symptoms will determine how you are treated for lumbar lordosis disease.

Conclusion

Understanding lumbar lordosis disease is crucial for effective management and prevention of complications. By incorporating proper treatment strategies and seeking timely medical intervention, individuals can mitigate the impact of lumbar lordosis disease on their overall health and well-being.

by Dr Chandril Chugh