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Neurosciences Medical Treatments

Nerology

The Neuro team provides cutting edge technology and treatment for the entire spectrum of neurological diseases and offer 24 x 7 services for trauma and strokes and have a dedicated ICU for these patients.

Is the recording of electrical activity along the scalp. EEG measures voltage fluctuations resulting from ionic current flows within the neurons of the brain. In clinical contexts, EEG refers to the recording of the brain’s spontaneous electrical activity over a short period of time, usually 20–40 minutes, as recorded from multiple electrodes placed on the scalp.  Diagnostic applications generally focus on the spectral content of EEG, that is, the type of neural oscillations that can be observed in EEG signals. In neurology, the main diagnostic application of EEG is in the case of epilepsy, as epileptic activity can create clear abnormalities on a standard EEG study.  A secondary clinical use of EEG is in the diagnosis of coma, encephalopathies and brain death.  A third clinical use of EEG is for studies of sleep and sleep disorders where recordings are typically done for one full night, sometimes more.

Nerve conduction study (NCS) is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body.Nerve conduction velocity (NCV) is a common measurement made during this test.

Nerve conduction studies are used mainly for evaluation of paresthesias (numbness, tingling, burning) and/or weakness of the arms and legs. The type of study required is dependent in part by the symptoms presented. A physical exam and thorough history also help to direct the investigation. Some of the common disorders that can be diagnosed by nerve conduction studies are:

• Peripheral neuropathy

• Carpal tunnel syndrome

• Ulnar neuropathy

• Guillain-Barré syndrome

• Facioscapulohumeral muscular dystrophy

• Spinal disc herniation

• Cubital Tunnel Syndrome

• Tarsal Tunnel Syndrome

• Vertigo / Parkinsons / Dementia Clinic

Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. It is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect medical abnormalities, activation level, recruitment order or to analyze the biomechanics of human or animal movement.

The Headache Clinic at Prashanth Hospital treats a patient with the understanding that headache is not only a biological or neurological disorder of the brain but is a disorder influenced by psychological, social, and environmental stressors. Headache disorders, particularly chronic disorders such as chronic migraine, can be highly debilitating, impacting domestic and professional responsibilities and emotional functioning. Keeping this in mind, we implement the most appropriate approach towards treating a headache.

A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the pain-sensitive structures around the brain. Nine areas of the head and neck have these pain-sensitive structures, which are the cranium (the periosteum of the skull), muscles, nerves, arteries and veins, subcutaneous tissues, eyes, ears, sinuses and mucous membranes

There are a number of different classification systems for headaches. Headache is a non-specific symptom, which means that it has many possible causes. Treatment of a headache depends on the underlying etiology or cause, but commonly involves analgesics

What causes tension headaches?

These factors are thought to contribute to tension headaches:

• Stress

• Depression

• Anxiety

• Bad posture

• Staying in one position for a long time

• Working in an awkward position for a long time

• Clenching one’s jaw

Epilepsy is a common and diverse set of chronic neurological disorders characterized by seizures. Some definitions of epilepsy require that seizures be recurrent and unprovoked but others require only a single seizure combined with brain alterations which increase the chance of future seizures. In many cases a cause cannot be identified; however, factors that are associated include brain trauma, strokes, brain cancer, and drug and alcohol misuse among others. Epileptic seizures result from abnormal, excessive or hypersynchronous neuronal activity in the brain.

Epilepsy becomes more common as people age. Onset of new cases occurs most frequently in infants and the elderly. As a consequence of brain surgery, epileptic seizures may occur in recovering patients. Epilepsy is usually controlled, but not cured, with medication. However, more than 30% of people with epilepsy do not have seizure control even with the best available medications. Surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms, all involving episodic abnormal electrical activity in the brain and numerous seizures.

DBS is a surgical procedure where slender electrical wires are accurately placed in deep locations within the brain and connected to a battery that is placed under the skin of the upper chest. Using these, the doctors are able to modulate the intricate neuronal circuitry in the brain. The amount of current being sent in can be controlled with a remote controller. Following DBS, the patient experiences a significant reduction in the movements, the fluctuations are smoothened out and the dose of medicines required can be reduced. Simply put, the patient can expect a good improvement in the quality of life!

• It has proven very useful in conditions like generalised dystonia where there is a painful spasmodic muscle movement occurring in many different muscles all at the same time

• Extremely effective in Essential tremor

• DBS has also been proven to be effective in patients with epilepsy

• Surgical therapies may be considered during the course of Parkinson’s disease especially if symptoms cannot be adequately controlled with medication.

Movement disorders are neurological disorders in which there is either 1) an excess of movement or 2) a paucity of movement that is not due to weakness or paralysis. Movement disorders are associated with changes in the brain cells that help us move. These brain cell changes can cause extra unwanted involuntary or excessive movements, called hyperkinesias. Other changes in brain cell function can cause a lack of automatic and purposeful movements, not related to weakness or spasticity, called hypokinesia. A complete medical history and careful thorough neurological examination are required to make an accurate diagnosis. Movement disorders, once correctly diagnosed, usually respond to treatment.

Demyelinating disease is a disease of the nervous system in which the myelin sheath of neurons is damaged. This damage impairs the conduction of signals in the affected nerves. In turn, the reduction in conduction ability causes deficiency in sensation, movement, cognition, or other functions depending on which nerves are involved.Some demyelinating diseases are caused by genetics, some by infectious agents, some by autoimmune reactions, and some by unknown factors. Organophosphates, a class of chemicals which are the active ingredients in commercial insecticides such as sheep dip, weed-killers, and flea treatment preparations for pets, etc., will also demyelinate nerves. Neuroleptics can also cause demyelination.The precise mechanism of demyelination is not clearly understood but there is good evidence that the body’s own immune system is at least partially responsible. Acquired immune system cells called T-cells are known to be present at the site of lesions. Other immune system cells calledMacrophages (and possibly Mast cells as well) also contribute to the damage.

Treatment typically involves improving the patient’s quality of life. This is accomplished through the management of symptoms or slowing the rate of demyelination. Treatment can include medication, lifestyle changes (i.e. quit smoking, adjusting daily schedules to include rest periods and dietary changes), counselling, relaxation, physical exercise, patient education and, in some cases, deep brain thalamic stimulation. The progressive phase of myelin sheath appears to driven by the innate immune system, which may directly contribute to the neurodegenerative changes that occur in progressive myelin sheath. Until now, there are no therapies that specifically target innate immune cells in the myelin sheath. As the role of innate immunity in the myelin sheath becomes better defined, it may be possible to better treat it by targeting the innate immune system

Our 24 hour stroke clinic is managed by expert and experienced neurologists.

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function due to disturbance in the blood supply to the brain.

This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage. As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field.

A stroke is a medical emergency and can cause permanent neurological damage and death. Risk factors for stroke include old age, high blood pressure, previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, tobacco smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. It is the second leading cause of death worldwide.

An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a “clot buster”), and some hemorrhagic strokes benefit from neurosurgery. Treatment to recover any lost function is termed stroke rehabilitation, ideally in a stroke unit and involving health professions such as speech and language therapy, physical therapy and occupational therapy.

Prevention of recurrence may involve the administration of antiplatelet drugs such as aspirin and dipyridamole, control and reduction of high blood pressure, and the use of statins. Selected patients may benefit from carotid endarterectomy and the use of anticoagulants.

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Prashanth Hospitals-Multispeciality Hospital in Chennai, Best Hospital in Chennai

Prashanth Hospitals-Multispeciality Hospital in Chennai, Best Hospital in Chennai