Neurology Hospital in Chennai

Epilepsy Overview

Epilepsy is a central nervous system disorder which causes periods of abnormal brain function called seizures. Typically, a patient experiences at least 2 unprovoked seizures before a definitive diagnosis can be made. Seizures that affect a defined zone in the brain are called focal seizures. Seizures that affect all areas of the brain are called generalised seizures. Epilepsy can occur at any age, and the symptoms can vary widely. Some children outgrow epilepsy with age.

Signs and symptoms for Epilepsy

Epilepsy affects brain activity, so it could cause a range of symptoms that affect processes governed by your brain. Symptoms of the seizure may include temporary disorientation, staring blank into space, uncontrollable jerky spasms of the arms and legs, loss of consciousness and frothing from the mouth.

Causes for Epilepsy

Epilepsy could be caused by traumatic injury to the head, lack of oxygen to the brain, a brain tumour, stroke, or infectious brain diseases such as meningitis, AIDS and viral encephalitis. High fever, low blood sugar and alcohol withdrawal could also cause seizures. However, in almost half of all cases of epilepsy, the cause is unidentifiable.

Risk factors for Epilepsy

A family history of epilepsy could increase the patient’s chances of developing the condition. Traumatic brain injury, stroke, high fever, brain infections and dementia in geriatric adults, could increase the patient’s risk of epilepsy.

Complications for Epilepsy

Having a seizure could be dangerous depending on what the patient is doing when the seizure occurs. patient may fall down and injure themselves. This could be even more dangerous if the patient is swimming or driving when the epilepsy attack happens. The unpredictability of the attack adds to danger. Patients with epilepsy are also more likely to develop mental health issues because of the condition.

Diagnosis for Epilepsy

A seizure could be a symptom of a serious medical issue and must be medically investigated immediately. If you suspect that you or a loved one has had a seizure, please go to the emergency room immediately. The doctor usually starts with a medical history and a physical and neurological exam to test motor and cognitive abilities. In order to diagnose epilepsy, other conditions that could cause seizures need to be ruled out. For this reason, the doctor may prescribe a few blood tests to check the presence of infection, kidney function, liver function and blood glucose levels. An Electroencephalogram (EEG) is a non-invasive imaging test to record electrical activity in various parts of the brain. EEGs are the most commonly used diagnostic test for epilepsy. CT scans, PET scans and MRI scans may be taken to rule out both acquired brain abnormalities like tumours and also to detect some development abnormalities like dysplasia that could cause seizures. These are the group of patients who require careful selection of medications. Some of them can have seizure freedom if a meticulous surgical resection of the abnormality is done. A proportion of patients will have a genetic cause for epilepsy and respond well to medications alone.

Treatment for Epilepsy

Epilepsy cannot be cured completely; however, it can be managed. The treatment plan is based on the severity of the symptoms, the patient’s general health and how well they respond to therapy. The treatment usually includes anti-epileptic drugs, which reduce the frequency and occurrence of the seizures. In order to be effective, the medication must be taken at the right times and frequency, as prescribed by the physician. Irregular consumption of the medication could trigger seizures. Possible side effects of the medication include skin rashes, fatigue and problems with coordination and memory. In rare cases, the patient may experience effects such as depression and liver inflammation.

If medication is ineffective, surgery may be considered in selected cases to stop the seizures from occurring. The surgical treatment for epilepsy involves resecting (removing) the part of the brain where the seizures originate. This is possible only for focal seizures, where the origin can be traced back to one specific part of the brain. This is done through extensive brain scans and studies. The surgical approach is planned carefully, to ensure that functional parts of the brain that deal with speech, memory, mobility etc. are not affected. For this reason, the surgeons may elect to perform the procedure while the patient is awake and responsive. If the portion of the brain where the seizures originate is too large or involves a functional area, the surgeons may choose to perform a multiple subpial transection. In this procedure, the surgeon interrupts some neural paths in the brain to prevent the seizures from spreading beyond where they originate. This does not stop seizures from occurring, but reduces their intensity.

A variety of alternative therapies have also been proven useful in managing the frequency and intensity of seizures, such as deep brain stimulation, vagus nerve stimulation and ketogenic diet.

Prevention for Epilepsy

As the cause of epilepsy is unknown, the condition itself cannot be prevented. However, seizures can be prevented. Each patient has unique triggers, and identifying and staying away from those triggers can help prevent seizures to some extent

Stroke (Brain Attack) Overview

A stroke occurs when the blood supply is reduced or cut off to a part of the brain. This reduces oxygen levels in the brain and can lead to death of the oxygen deprived brain cells. It only takes 3-4 minutes for a brain cell to die when deprived of oxygen, hence a stroke is a very serious event that requires immediate medical attention at the emergency room. There are primarily two types of strokes – Ischemic stroke and Haemorrhagic stroke Ischemic stroke is the most common type of stroke, in which a blood clot in the brain prevents oxygenated blood from reaching a part of the brain tissue. Haemorrhagic stroke occurs when a blood vessel ruptures, usually as a result of an aneurysm or an arteriovenous malformation. Transient Ischemic stroke is a brief disruption in blood supply to tissues in the brain. Normal blood flow resumes shortly and the symptoms resolve without treatment soon after. This is also called a “mini-stroke”.

Signs and symptoms of Stroke (Brain Attack)

The signs and symptoms of a stroke include slurred speech, difficulty comprehending others, paralysis or numbness of the extremities, blurred vision, headache, dizziness, vomiting, and loss of motor co-ordination. A typical symptom of a stroke is an imbalanced drooping of the face to one side. The patient must be rushed to the hospital as soon as they experience as stroke, as immediate treatment can help reduce neurological deficits. The common acronym FAST ( Facial drooping, Arm weakness, Slurred speech and Time < 3 hours) can be remembered to suspect and shift a stroke patient to nearby stroke care centre.

Causes of Stroke (Brain Attack)

There are two main causes of a stroke – a blocked artery (ischemic stroke and transient ischemic stroke) or a ruptured blood vessel (haemorrhagic stroke). The blocked artery in the brain is usually caused by fatty deposits and or blood clots that cause a disruption in blood supply. A blood vessel could also rupture and trigger a stroke. The rupture could be caused by an aneurysm, an arteriovenous malformation, uncontrolled high blood pressure, overtreatment with blood thinners or a traumatic brain injury.

Risk factors of Stroke (Brain Attack)

There are a multitude of factors that could affect your risk of stroke. People older than 55 years are at a higher risk of experiencing a stroke. Men are more likely to experience a stroke than women, but women are more likely to die as a result of the stroke than men. Pre-existing conditions like diabetes, high blood pressure, hypertension and high cholesterol increase the patient’s risk of experiencing a stroke. Family history is also an important risk factor. There are also lifestyle conditions that cause strokes, such as being overweight, physical inactivity, alcoholism, smoking and use of drugs such as methamphetamine and cocaine.

Complications of Stroke (Brain Attack)

A stroke can cause temporary or permanent impairment of brain function, depending on how long the stroke lasted and which part of the brain was affected. Complications may include paralysis, speech impairment, memory loss and pain. Patients who have experienced a stroke are also more likely to develop depression.

Diagnosis of Stroke (Brain Attack)

Strokes happen very suddenly, and the patient needs to be treated within 3 hours of the event. The doctor will assess the patient’s condition by way of a physical exam, blood pressure evaluation, blood tests, a CT scan, an MRI scan, a carotid ultrasound exam, a cerebral angiogram and an echocardiogram (ECG). The detailed tests are required to identify the cause of the stroke and plan an appropriate course of treatment.

Treatment of Stroke (Brain Attack)

Ischemic strokes are caused by blood clots or blockages in an artery in the brain. They are usually treated with anticoagulant and anti-platelet drugs, 24 to 48 hours after the stroke symptoms begin. Thrombolytic drugs may also be prescribed to dissolve the existing blood clots in the brain. These drugs work effectively when administered within 3-4.5 hours from the symptom onset. This quickly reduces the blockage and restores blood flow, minimising any permanent damage to brain function. In case drug therapies are ineffective at clearing the blockage in the artery in the brain, it is surgically removed. The procedure is known as a Mechanical Thrombectomy, during which a catheter is inserted into the brain artery and the clot is vacuum suctioned out. In case of haemorrhagic stroke due to aneurysms, the surgeon will perform a procedure in which the “neck” of the aneurysm is clipped, to separate it from the artery and cut off its blood supply. This prevents the aneurysm from rupturing.

Prevention of Stroke (Brain Attack)

Stroke prevention strategies include controlling hypertension, cholesterol levels and diabetes. Patients who have already experienced one stroke are advised to quit the use of tobacco, alcohol and other drugs. They must also ensure adequate exercise and a heart healthy diet. The patient may also be prescribed anti-platelet drugs and anti-coagulants to keep clotting under control.

Parkinson’s Disease Overview

Parkinson’s disease is a progressive nervous system disorder that affects nerve cells that produce dopamine, affecting mobility and co-ordination. When a patient has Parkinson’s disease, the cells of the substantia nigra get destroyed, resulting in reduced dopamine levels. The condition starts gradually, with slight hand tremors, stiffness or slowing of movement. The symptoms worsen with time. medications can significantly improve the patient’s quality of life in Parkinson’s disease

Signs and symptoms for Parkinson’s disease

Early symptoms of Parkinson’s disease include a decreased sense of smell, voice changes, stooped posture, constipation and small cramped handwriting. Gradually, with time, motor function problems such as tremors, stiffness, balance issues and slow movements begin. The patient may also develop a blank facial expression, speak at a low volume, decrease blinking and swallowing and reduce the swing of their arms while they walk. Severe symptoms of Parkinson’s disease include hallucinations, depression, anxiety, psychosis, difficulty sleeping and problems with attention and memory.

Causes for Parkinson’s disease

The exact cause of Parkinson’s disease is unknown, but it appears to be related to both environmental and genetic factors. Some medical researchers also believe that Parkinson’s disease could be caused by a viral infection.

Risk factors for Parkinson’s disease

Geriatric patients are at a much higher risk of developing Parkinson’s disease compared to younger adults and children. Continuous long-term exposure to certain environmental toxins has been linked with an increased risk of Parkinson’s disease. Men are at a higher risk of developing the condition than women.

Complications for Parkinson’s disease

Parkinson’s disease is often accompanied by dementia, depression and difficulty chewing, swallowing and sleeping. Parkinson’s disease is also linked with an increased frequency of constipation and bladder control disorders. The patient may also experience blood pressure fluctuations, sexual dysfunction and a decreased sense of smell.

Diagnosis for Parkinson’s disease

There are no specific tests to diagnose Parkinson’s disease. The neurologist diagnoses the condition based on a detailed patient medical history, a review of the signs and symptoms and a physical and neurological exam. The doctor could use imaging tests and blood tests to rule our other conditions that c0uld be causing your symptoms.

Treatment for Parkinson’s disease

Parkinson’s disease has no cure at present, but the condition can be managed with medication. These medications supplement dopamine to compensate for the loss in natural production. The efficacy of the drugs decreases with time. Deep Brain Stimulation has also proven effective in reducing the symptoms of Parkinson’s disease. The therapy involves implanting electrodes in the brain, connected to a generator implanted under the skin beneath the collarbone to transmit electrical signals to the brain. Deep Brain Stimulation therapy is usually recommended to patients with advanced stage Parkinson’s disease.

Prevention for Parkinson’s disease

As the cause of Parkinson’s disease is still undetermined, it is difficult to define preventive strategies. Some studies have shown that regular aerobic exercise could help reduce the risk of Parkinson’s disease.

Meningitis Overview

Meningitis refers to an inflammation of the meninges, which are the three membranes surrounding the brain and the spinal cord. Meningitis occurs when the fluid surrounding the meninges becomes infected with viral or bacterial infections. The condition could also be triggered by drug allergies, cancer or fungal infection. Certain infections that cause meningitis are contagious, transmitting from one patient to another via coughing, sneezing or close contact. Meningitis can afflict patients of any age. Early detection and treatment are crucial to prevent complications.

Signs and symptoms for Meningitis

Early meningitis exhibits typical influenza symptoms. This includes sudden high fever, severe headache, nausea and vomiting. The patient may also experience stiffness of muscles, seizures, sensitivity to light, dizziness, confusion and rashes. In infants, meningitis could cause a bulge or a soft spot on the baby’s head called a fontanel, excessive sleeping or irritability, poor feeding, vomiting, high fever, and sluggishness.

Causes for Meningitis

Meningitis is usually caused by a bacterial or viral infection that begins in the ears, sinuses or throat. Viruses that can cause meningitis include the West Nile virus, influenza, HIV, mumps, measles and herpes. Meningitis could also be caused by auto-immune disorders, syphilis, tuberculosis or cancer medications.

Risk factors for Meningitis

Meningitis is common in children below the age of 5, teenagers and geriatric adults. People who are immune compromised, such as patients with HIV and auto-immune disorders, are at a higher risk of contracting meningitis. Meningitis spreads easily in places where communities live in close quarters, like college dorms, boarding schools and barracks. Pregnant women and people who work with animals are at an increased risk of contracting a listeriosis infection, which can cause meningitis.

Complications for Meningitis

The complications typically associated with meningitis are seizures, migraines and memory problems.Meningitis could also cause hearing or vision loss if it has afflicted the concerned part of the brain. In severe cases, it could cause hydrocephalus (a build-up of fluid in the brain) or a subdural empyema (a build-up of fluid between the brain and the skull). These would put pressure on the brain tissue and cause loss of function, which would become permanent if left untreated. Meningitis could also cause toxins and infection to be released into the blood stream, through which it can spread to other parts of the body. This could result in gangrene. Meningitis could also cause pneumonia.

Diagnosis for Meningitis

Meningitis is diagnosed with the help of a physical exam, a detailed medical history, a panel of blood tests to diagnose infection, a CT scan or an MRI scan to check for swelling of the meninges, and a spinal tap. The spinal tap is a conclusive test to identify the cause of the infection.

Treatment for Meningitis

The treatment depends on the type of meningitis in question. Bacterial meningitis is treated with antibiotics. Viral meningitis usually goes away on its own without treatment. Rest, fluids and over-the-counter pain medications are recommended at this time. However, for more serious cases of viral meningitis, the doctor may prescribe antiviral medication. Antifungal medication is prescribed to treat fungal meningitis. Parasitic meningitis may be treated symptomatically, or by attempting to eliminate the source infection.

Prevention for Meningitis

Meningitis is caused by a bacterial, viral or fungal infection so the key to preventing it is essentially good hygiene. Wash your hands frequently. Do not share personal objects like toothbrushes and personal cosmetics. Cover your mouth and nose if you cough or sneeze. Be sure to get all your vaccinations as well.

Encephalitis Overview

Encephalitis is an acute inflammation of the brain, usually caused by an infection. The infection could be viral, bacterial, fungal or due to autoimmune causes. Primary encephalitis occurs when an infection or inflammation directly affects the spinal cord or the brain. Secondary encephalitis is when an infection starts in another part of the body, and spreads to the brain or the spine through the blood stream. Encephalitis can cause cognitive problems, vision loss, hearing loss, seizures or movement problems. Encephalitis is a relatively rare disease, but it can be life-threatening.

Signs and symptoms for Encephalitis

Patients with viral encephalitis in the initial stages experience fever, headaches, muscle pains and fatigue. More severe cases experience symptoms such as seizures, speech impairment, hallucinations, loss of consciousness or a coma. Infants with encephalitis may develop a fontanel, which is a bulge or a soft spot in the skull.

Causes for Encephalitis

Encephalitis is usually caused by a viral infection. Less commonly, it could be caused by a bacterial or a fungal infection. HIV, herpes, polio virus, West Nile virus, mumps and the rabies virus could cause encephalitis. Autoimmune encephalitis is another cause which involves an immune mediated attack on the brain cells.

Risk factors for Encephalitis

Immuno-compromised patients, infants and geriatric adults are the most at-risk demographics for encephalitis. People living in mosquito-infested areas are also at a higher risk of encephalitis because mosquitoes typically carry viruses that trigger it.

Complications for Encephalitis

Patients diagnosed with severe encephalitis are likely to develop loss of memory, personality changes, epilepsy, fatigue, intellectual deficits, difficulty breathing, speech impairment, loss of vision or loss of hearing. In extreme cases, the patient may go into a coma. Encephalitis, if treated too late or left untreated, can be fatal.

Diagnosis for Encephalitis

Encephalitis is diagnosed on the basis of patient medical history, a physical and neurological exam, a panel of blood and urine tests to check for infections or autoimmune antibodies, a spinal tap, an electroencephalogram (EEG) and a brain biopsy.

Treatment for Encephalitis

Mild cases of encephalitis are treated with bed rest, plenty of fluids and anti-inflammatory medications. The treatment largely focuses on alleviating symptoms. Encephalitis caused by certain infections like herpes respond to anti-viral drug treatments. However, not all viral infections respond well to this therapy. Anti-convulsant drugs are prescribed to patients who develop frequent seizures as a result of the inflammation. Immunosuppresants are used to treat patients with autoimmune encephalitis.

Prevention for Encephalitis

The best way to avoid contracting encephalitis is to get vaccinated properly for all the common illnesses as prescribed by the local health authority in your area. Preventing the infestation of mosquitoes in your immediate living environment, and using mosquito repellent could also help prevent contracting pathogens that cause encephalitis.

Multiple Sclerosis Overview

Multiple Sclerosis is a chronic central nervous system disorder that affects the brain, the spinal cord and the optic nerves. Multiple sclerosis is an auto-immune disorder in which the immune system attacks the protective myelin sheath of the nerves, causing nerve damage. The signs and symptoms of the condition vary widely, depending 0n the nerves affected and the extent of damage. With time, the disease can cause permanent loss of function in the affected nerves. With treatment, the patient’s symptoms and the pace of nerve degeneration can be managed and controlled.

Signs and symptoms for Multiple Sclerosis

The symptoms of multiple sclerosis vary widely, based on the affected nerves and the extent of nerve degeneration. The patients experience problems with vision, balance, sensation and rarely disabling weakness. Most patients at some point of their life have problems with bladder continence. Long term issues also include tremors, chronic pain, problems with cognitive functions, memory and speech, sexual dysfunction, seizures.

Causes for Multiple Sclerosis

The causes of multiple sclerosis are unclear. In some cases, it appears to be caused by an auto-immune response elicited in response to environmental toxin or an infection.

Risk factors for Multiple Sclerosis

Smokers are more likely to develop multiple sclerosis than non-smokers. There also appears to be genetic link, so a family history of multiple sclerosis increases the patient’s risk of developing the condition. Vitamin D deficiency appears to be linked to a higher risk levels.

Complications for Multiple Sclerosis

Patients with multiple sclerosis may develop paralysis, incontinence or depression. The disease can cause a loss of mobility.

Diagnosis for Multiple Sclerosis

The doctor will need a detailed patient medical history, physical exam, an MRI scan, a panel of blood tests, an optical CT scan and a spinal tap to perform an accurate diagnosis.

Treatment for Multiple Sclerosis

Treatment for MS can provide symptomatic relief and slow the progression of the condition. The doctor may treat the patient with drug therapies that keep a check on the immune cells. Drugs are also useful to treat incontinence, fatigue and walking disability. Heat massages, acupuncture, stress management techniques and a healthy diet also play a vital role. The patient would also be advised to quit smoking and avoid drinking. Rehabilitation, physical therapy, speech therapy and cognitive rehabilitation may also be helpful. In the case of severe multiple sclerosis attacks, the patient may be treated with intravenous steroid and plasma exchange. This process involves extracting the patient’s blood, isolating the plasma from the rest of the blood, replacing it with new plasma and transfusing the blood back into the patient. This process aims to remove the antibodies in the patient’s blood that are attacking the central nervous system.

Prevention for Multiple Sclerosis

As the exact cause of multiple sclerosis is still unknown, there are no strategies in place for prevention.

Optic Neuritis and Neuromyelitis Optica Overview

The optic nerve is the nerve that carries sensory information from the eyes to the brain. Optic neuritis is a condition in which the optic nerve becomes inflamed, affecting vision. Optic neuritis can flare up suddenly, due to nerve disease or an infection. The inflammation typically causes loss of vision in only one eye and/or pain in the eye, especially with movement. Optic neuritis is often associated with multiple sclerosis.

Signs and symptoms for Optic Neuritis and Neuromyelitis Optica

Optic neuritis usually affects only one eye but in a few disorders bilateral visual loss is reported. The patient may experience eye pain that intensifies with movement of the eyeballs, partial or total loss of vision, loss of colour perception or seeing flashing lights.

Causes for Optic Neuritis and Neuromyelitis Optica

The exact cause of optic neuritis is unknown. It is generally considered to be caused by an auto-immune response and is associated with conditions like multiple sclerosis, neuromyelitis optica, or an MOG antibody disorder. For a few patients it can happen after infections like mumps, measles, tuberculosis, Lyme disease, sinusitis or meningitis.

Risk factors for Optic Neuritis and Neuromyelitis Optica

Patients with multiple sclerosis and Neuromyelitis optica are more likely than others to develop optic neuritis. The disease appears to be more common in females between the ages of 20 and 40 years.

Complications for Optic Neuritis and Neuromyelitis Optica

Optic neuritis could result in complications even after the symptoms have resolved. They patient may have permanent optic nerve damage, and vision changes. The drugs prescribed for the treatment of optic neuritis could also cause weight gain and mood swings.

Diagnosis for Optic Neuritis and Neuromyelitis Optica

Optic neuritis is diagnosed on the basis of a routine eye exam, vision tests, a pupillary response test, an ophthalmoscopy to check if the optic nerve is swollen and possibly a lumbar puncture or a spinal tap.

Treatment for Optic Neuritis and Neuromyelitis Optica

In most cases of optic neuritis, treatment with intravenous steroids will help in hastening the recovery. A few severe cases might require plasma exchange therapy.

Prevention for Optic Neuritis and Neuromyelitis Optica

Optic neuritis currently has no preventative strategies.

Guillain-Barre Syndrome Overview

Guillain-Barre syndrome is a rare auto-immune disorder. It is a serious disease, in which the immune system attacks healthy nerve cells in the peripheral nervous system. This causes muscle weakness, numbness, tingling sensation in the extremities and eventual paralysis. The condition is typically triggered by an infectious illness like gastroenteritis or a respiratory infection. There are multiple types of Guillain-Barre syndrome, such as acute inflammatory demyelinating polyradiculoneuropathy and Miller Fisher syndrome.

Signs and symptoms for Guillain-Barre Syndrome

The symptoms of Guillain-Barre syndrome begin as tingling sensations on extremities, like the hands, the feet or the face. As the condition progresses, the patient may experience prickly pins and needle sensations, muscle fatigue, difficulty with muscle co-ordination, rapid heart rate and difficulty breathing.

Causes for Guillain-Barre Syndrome

The exact cause of Guillain-Barre syndrome is unknown, however, it appears soon after a respiratory or digestive tract infection. The condition triggers an auto-immune response, prompting the immune system to attack the nerves. This disrupts nerve function, causing muscle weakness, numbness and possibly paralysis.

Risk factors for Guillain-Barre Syndrome

Guillain-Barre syndrome can occur in patients of any age, but it is most common in older male adults. Guillain-Barre syndrome could be triggered by influenza, Zika virus, hepatitis, HIV, Hodgkin’s lymphoma and trauma, putting patients with these conditions at increased risk of developing this disease.

Complications for Guillain-Barre Syndrome

Guillain-Barre syndrome affects the nervous system, causing a range of complications affecting nerve function. Patients may experience breathing difficulties, cardiac arrhythmias, blood pressure fluctuations and bowel and bladder dysfunction. Being immobile also puts patients at an increased risk of developing bed sores. Patients may continue to experience residual numbness even after the symptoms of Guillain-Barre syndrome resolve.

Diagnosis for Guillain-Barre Syndrome

Guillain-Barre syndrome can be tricky to diagnose initially because many of its symptoms are similar to those caused by meningitis, heavy metal poisoning etc. The disease is diagnosed on the basis of a physical exam, patient medical history, a spinal tap, an electromyography test to check nerve function and nerve conduction tests.

Treatment for Guillain-Barre Syndrome

Patients with Guillain-Barre syndrome can have a faster recovery when treated early with plasma exchange therapy or immunoglobulin therapy. Plasma exchange helps remove the antibodies in the blood that attack the nerve cells. Immunoglobulin therapy works to block the effect of the antibodies attacking the nerve cells. The patient may also be given medication to reduce blood clots and relieve pain and will need physiotherapy to recover muscle strength and co-ordination.

Prevention for Guillain-Barre Syndrome

As the cause of Guillain-Barre syndrome is still unknown, we have no preventive strategies for it.

Transverse Myelitis Overview

Transverse myelitis is a disorder characterised by inflammation of the spinal cord. Usually, both sides of the same section of the spinal cord become inflamed. The neurological disorder damages the myelin sheath, which is the insulating protective layer of the nerve cell. This interrupts the electrical signals sent from the spinal cord to the rest of the body, resulting in sensory problems, bowel and bladder dysfunction, muscle weakness, or paralysis. Transverse myelitis could be caused by infections or auto-immune disorders.

Signs and symptoms for Transverse Myelitis

Transverse myelitis may cause symptoms below the affected part of the spine, on one side or both sides of the body. These include shooting pains in the lower back, abdomen, chest, arms or legs. Some patients also experience numbness and tingling in various parts of the body, distorted sensation of cold or hot, severe muscle weakness and sensitivity to light. Patients usually experience bowel and bladder control problems as a result of nerve dysfunction below the waist. This includes retention of urine frequent urination, urinary incontinence and constipation.

Causes for Transverse Myelitis

The exact cause of transverse myelitis is unknown but it appears to be triggered by an infection or an auto-immune condition. Viral, bacterial and fungal infections in the body could trigger the inflammation that target the spinal cord. Bacterial skin infections and gastrointestinal infections also appear to trigger the condition. A number of other neurological conditions like multiple sclerosis, neuromyelitis optica or sarcoidosis could also lead to transverse myelitis.

Risk factors for Transverse Myelitis

Transverse myelitis can occur in patients of any age. Patients with multiple sclerosis or neuromyelitis optica are at a higher risk of developing transverse myelitis.

Complications for Transverse Myelitis

Patients with post infectious transverse myelitis usually only experience one episode. But patients with autoimmune background tend to have a relapsing transverse myelitis picture. Patients who recover often experience complications such as chronic pain, muscle spasms, partial or total paralysis, sexual dysfunction, depression or anxiety.

Diagnosis for Transverse Myelitis

The physician first reviews the patient’s medical history and performs a physical and neurological exam. The doctor will also require an MRI scan and a CT scan to visualise the extent of inflammation and damage. A panel of blood tests and a spinal tap may also be required to check for infections or evidence of antibodies from an auto-immune attack.

Treatment for Transverse Myelitis

Recovery from transverse myelitis can be hastened by immunotherapetics like steroids, plasma exchange or cyclophosphamide. Symptomatic therapy for the complications include pain medication and other medicines for relief of muscle spasms, depression and bowel dysfunction. If the doctor suspects that the transverse myelitis is caused by a viral infection, they may treat it with antiviral drugs. The patient may also be recommended physical therapy to regain muscle strength and co-ordination.

Prevention for Transverse Myelitis

As the exact cause of transverse myelitis is unknown, it cannot be prevented.

Autoimmune Encephalitis Overview

Autoimmune encephalitis is a condition in which the body’s immune system attacks healthy tissue in the brain or spinal cord. It is a rare, dangerous disease that can cause serious physiological and psychological damage. Patients may experience neurological symptoms like seizures and memory problems. In addition to this, they may also experience psychological symptoms like psychosis, panic attacks and excessive aggression. Autoimmune encephalitis is associated with the production of antibodies to the protein on nerve cells. In some cases, it may be associated with a cancerous tumour. There are different types of autoimmune encephalitis including acute disseminated encephalomyelitis (ADEM), Hashimoto’s encephalopathy, limbic encephalitis and Rasmussen’s encephalitis. Autoimmune encephalitis does not appear to have a relationship with patient family history.

Signs and symptoms for Autoimmune Encephalitis

Patients with autoimmune encephalitis experience neurological and psychological symptoms that may include impaired memory, slurred speech, abnormal movement, poor muscle co-ordination, problems with balance and impaired vision. The patient may also have psychological symptoms like psychosis, aggression, panic attacks, excessive euphoria and fear as well.

Causes for Autoimmune Encephalitis

The exact cause of autoimmune encephalitis is unknown but it appears related to the production of antibodies that target proteins on the nerve cells. The body may begin producing these antibodies as a result of an auto-immune disease, a teratoma (tumour), or cancer.

Risk factors for Autoimmune Encephalitis

Patients with multiple sclerosis seem to be at an increased risk of developing autoimmune encephalitis.

Complications for Autoimmune Encephalitis

Patients with autoimmune encephalitis could develop long-term neurological deficits and permanent psychological changes.

Diagnosis for Autoimmune Encephalitis

The diagnosis of autoimmune encephalitis is made by a multidisciplinary team of rheumatologists, neurologists and psychologists. The diagnosis requires a thorough physical and neurological exam and a detailed medical history. The physicians will also require detailed imaging tests such as MRI and CT scans. A spinal tap may be done to check the cerebrospinal fluid for antibodies. An abdominal ultrasound may also be performed to check for tumours.

Treatment for Autoimmune Encephalitis

Early diagnosis and treatment can reduce chances of permanent neurological deficits. The patient may be treated with steroids to reduce brain inflammation. If the condition is triggered by a teratoma, the doctor may recommend surgical removal of the tumour. The doctor may also treat the patient with plasma exchange therapy or intravenous immunoglobulin therapy. If these treatments do not work, as a last resort, the doctor may suggest immunosuppressant medication. Once the encephalitis is under control, the patient may be recommended physical therapy, speech therapy or occupational therapy.

Prevention for Autoimmune Encephalitis

As the cause of autoimmune encephalitis is not known, there are no specific preventive strategies in place.

Central Nervous System (CNS) Vasculitis Overview

Vasculitis is a blanket term for conditions that cause inflammation in the blood vessels, specifically in the brain and central nervous system. Vasculitis is a dangerous disease that can result in loss of oxygen supply to critical brain or spinal cord tissue. Primary central nervous system vasculitis is confined to the brain and the spinal cord. Secondary central nervous system vasculitis is accompanied by an autoimmune condition or a viral or bacterial infection. Diagnosis of CNS vasculitis is challenging because the symptoms are similar to many other disorders

Signs and symptoms for Central Nervous System (CNS) Vasculitis

Symptoms of CNS vasculitis include headaches, memory disturbances, speech slurring, and weakness of limbs. Systemic vasculitis will also have skin rashes, fatigue, unexplained weight loss, fever, joint pains, abdominal pain, dark urine and numbness.

Causes for Central Nervous System (CNS) Vasculitis

The exact mechanism of inflammation in the vessels of the brain is unclear. In some cases, the vasculitis appears to be caused by either an immune response or a viral infection. However, in many cases, the cause remains unexplained.

Risk factors for Central Nervous System (CNS) Vasculitis

In general, central nervous system vasculitis is quite rare. It can occur in patients of any age or gender, but appears to be most common in men above 50 years of age.

Complications for Central Nervous System (CNS) Vasculitis

Patients with central nervous system vasculitis may develop complications such as osteoporosis, pneumonia and other infections. Patients are also at risk of relapse.

Diagnosis for Central Nervous System (CNS) Vasculitis

Diagnosing central nervous system vasculitis is a challenge because it has symptoms that are very similar to many other neurological diseases. The doctor will begin with a physical and neurological exam and a patient medical history. The doctor will also need a panel of blood tests to check for anaemia, elevated white blood count, elevated platelet count and inflammation markers. The patient will also need a CT scan, an MRI scan and a cerebral angiogram. The doctor may also require Menigeal and brain tissuee biopsies and a lumbar puncture.

Treatment for Central Nervous System (CNS) Vasculitis

CNS Vasculitis is treated in stages. The initial stage is induction therapy. In this phase, high-dose steroids are usually administered, often intra-venously. This is done with or without immunosuppressant therapy to decrease the body’s autoimmune response. These steroids are reduced and stopped over a course of six months. This usually put the disease in remission. This is the maintenance stage. In this stage the patient is treated with low doses of steroids and immunosuppressants to keep the symptoms under control. The treatment for CNS Vasculitis is usually prolonged, and may, in some cases, be for life.

Prevention for Central Nervous System (CNS) Vasculitis

As the cause is unknown, Central Nervous System Vasculitis cannot be prevented.

Migraine Overview

Migraines are strong headaches, usually accompanied by nausea and sensitivity to light. They occur in stages referred to as Prodrome, Aura, the Attack, and Postdrome. The length of each phase and symptoms experienced differ according to the patient. Having a family history of migraines is a strong risk factor for developing the disease. Migraines can occur at any age. The right medication with supportive therapies and lifestyle changes can help manage the condition.

Signs and symptoms for Migraine

The symptoms of migraines differ in each phase. During the Prodrome, one or two days before the Attack, the patient may experience constipation, mood swings, increased thirst and frequent urination. Aura refers to the visual distortions that the patient experiences. For some patients, the aura overlaps with the attack. The patient may experience vision loss, see shapes, forms or shadows that don’t exist, have difficulty speaking, and have muscle weakness or pins and needles sensations. The Migraine Attack usually lasts anywhere from 4 to 72 hours. It is characterised by a persistent throbbing pain, coupled with nausea and sensitivity to light and sound. After the Attack is the Postdrome. During this phase, the patient may feel severely drained and exhausted from the migraine. Movement may cause the headache to return.

Causes for Migraine

Although the exact cause of migraines is not identified, there appear to be strong links with family history and environmental factors. Each patient may have a set of triggers that appear related to the migraine. Identifying and avoiding these triggers could help reduce, if not avoid, the frequency of the episodes.

Risk factors for Migraine

A family history of migraines is a strong risk factor for developing the conditions. Women are also 3 times more likely to develop migraines than men.

Complications for Migraine

Possible complication of migraines may be caused due to excessive medication use. Patients with very severe pain are at risk of headaches resulting from over medication, which then require more painkillers for treatment. This results in a vicious cycle of medication-overuse.

Diagnosis for Migraine

Migraines are diagnosed by a neurologist, on the basis of the patient medical history and a physical and neurological exam. The doctor may also require a CT or MRI scan to rule out other causes for the patient’s symptoms.

Treatment for Migraine

The goal of treatment is to relieve the patient’s symptoms and reduce the frequency of the migraines. Patients are usually prescribed a combination of painkillers to relieve symptoms and preventative medication to reduce the frequency of attacks. Preventative medication may include anti-seizure medication, anti-depressants, blood pressure medications or Botox injections. Non-traditional therapies such as acupuncture, biofeedback and cognitive behavioural therapy have also proven to be useful in the treatment of migraines.

Prevention for Migraine

As the exact cause of migraines is still unknown, the condition cannot be prevented.

Cluster Headache Overview

Cluster headaches are highly painful, short-duration headaches that occur in clusters or rings. The attacks are usually short, but recur frequently, often at the same time each day. The cluster headaches usually last a few months before going into remission. Cluster headaches are rare and not life threatening. Medication is very helpful in providing symptomatic relief. Cluster headaches are typically associated with compression or an abnormality in a facial nerve.

Signs and symptoms for Cluster Headache

Cluster headaches are usually abrupt. The pain may be located behind one eye and radiate to other parts of the face. Patient may also experience redness, swelling and tearing of the affected eye, as well as restlessness and excessive sweating.

Causes for Cluster Headache

The exact cause of cluster headaches is unknown, but studies suggest that it is linked to abnormalities in the hypothalamus (the body clock). It could also be caused due to pressure on the trigeminal nerve, which controls facial movement.

Risk factors for Cluster Headache

Men are more likely to develop cluster headaches than women. People with a family history of cluster headaches are at a higher risk of developing the condition.

Complications for Cluster Headache

Cluster headaches usually do not cause any permanent brain damage or pose any threat to the patient’s life. They do, however, interfere with the patient’s lifestyle and day-to-day functions.

Diagnosis for Cluster Headache

Cluster headaches are diagnosed on the basis of a patient medical history and a physical exam. The diagnosis is largely dependent on the patient’s description of their symptoms, and the duration and location of their headaches. The doctor may require some imaging tests and neurological tests to rule out other conditions.

Treatment for Cluster Headache

Treatment can reduce symptoms, shorten the time period of the head aches and prevent attacks. For severe prolonged cluster headaches, the patient may be administered oxygen or local intranasal anaesthetics for instant pain relief.

Prevention for Cluster Headache

At present, there are no preventative measures that can be taken to prevent cluster headaches. Once the condition has been diagnosed, the doctor may administer preventative therapies such as a nerve block or lithium carbonate, to try to prevent further attacks.

Idiopathic Intracranial Hypertension Overview

Idiopathic intracranial hypertension is a condition characterised by high cerebrospinal fluid pressure inside the skull. The cerebrospinal fluid gets backed up in the skull and spinal cord, putting pressure on the brain tissue and the optic nerve. The elevated pressure could cause severe headaches and loss of vision. Untreated, the condition could result in permanent neurological deficits.

Signs and symptoms for Idiopathic Intracranial Hypertension

The symptoms of idiopathic intracranial hypertension usually include headaches, a ringing sensation in the ear (tinnitus), temporary blindness or “double-vision”, peripheral vision loss and neck and shoulder pain.

Causes for Idiopathic Intracranial Hypertension

The word “idiopathic” means unknown. The causes of the condition and undetermined by medical science at present.

Risk factors for Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension is a rare disorder, but women between the ages of 20 to 50 years are at the highest risk. Having a body mass index of greater than 30 increases the chances of developing the disorder.

Complications for Idiopathic Intracranial Hypertension

The build-up of cerebrospinal fluid in the brain could put pressure on the optic nerve and cause permanent blindness. The condition could also recur, if not kept in check regularly.

Diagnosis for Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension is diagnosed on the basis of patient medical history, a physical exam, an eye exam, an MRI scan, a CT scan, a lumbar puncture and a panel of blood tests. These tests are required to rule out other causes of the intracranial hypertension like a brain tumour or an obstruction.

Treatment for Idiopathic Intracranial Hypertension

Immediate treatment for idiopathic intracranial hypertension focuses on relieving intracranial pressure and restoring vision. This is done with medication. If medication is ineffective, the physicians may recommend surgically inserting a shunt to relieve the pressure. The surgeon inserts a thin hollow tube through the obstruction and connects it to a flexible tube to channel the cerebrospinal fluid to another part of the body where it can be reabsorbed more easily, like the abdomen. Long-term strategies to prevent recurrence of the symptoms include diet and exercise regimens to promote a healthier body mass index.

Prevention for Idiopathic Intracranial Hypertension

Although the cause of idiopathic intracranial hypertension is unknown, maintaining a healthy weight can help reduce the patient’s risk of developing the condition.

Alzheimer’s disease Overview

Alzheimer’s disease is a progressive neurological degenerative disease. It results in a slow, irreversible death of brain cells, causing irreparable loss of memory and cognitive skills. Damage usually begins in the hippocampus, the part of the brain responsible for memory. The degeneration spreads to the rest of the brain causing shrinkage of the brain tissue. Early onset Alzheimer’s disease affects patients between the ages of 30 and 60 years. Late onset Alzheimer’s disease occurs in patients above 60. Alzheimer’s disease can progress into dementia.

Signs and symptoms for Alzheimer’s disease

One of the earliest symptoms of Alzheimer’s disease is memory loss. Patients may have difficulty remembering recent events or conversations. Patients may also find it difficult to think and reason, make decisions, plan and perform routine familiar tasks or they may behave inappropriately in social settings. Patients may also undergo sudden changes in personality or develop mental illnesses like depression.

Causes for Alzheimer’s disease

The exact cause of Alzheimer’s disease is unclear. At a surface level, Alzheimer’s disease is caused by an imbalance of brain proteins, which disrupts the function of the brain neurons. The neuron damage causes a loss of function, as critical chains of neurons are broken. Studies suggest that triggers could include a combination of lifestyle, environmental and genetic factors. The damage usually originates in the hippocampus and spreads to the rest of the brain tissue. Degeneration generally begins long before symptoms begin to show.

Risk factors for Alzheimer’s disease

Family history is a strong risk factor for Alzheimer’s disease. Old age also increases a person’s risk of developing Alzheimer’s disease. Patients with certain pre-existing conditions, such as Down syndrome or Mild Cognitive Impairment (MCI) are also at increased risk of developing Alzheimer’s disease. Other lifestyle factors that could raise the risk include insufficient sleep, excessive alcohol consumption and obesity.

Complications for Alzheimer’s disease

Alzheimer’s disease leads to permanent loss of memory, language skills, judgement and cognitive abilities. As the disease progresses patients may also experience a loss of motor function, balance and bowel or bladder control. They may also develop bed sores, fractures, malnutrition, dehydration and dental issues.

Diagnosis for Alzheimer’s disease

Diagnosis of Alzheimer’s disease is largely based on the ability of the patient or their family member to describe the patient’s symptoms and behaviours. The doctor will also perform a complete physical and neurological work up to rule out other possible conditions that could be causing the patient’s symptoms. This usually involves a series of lab tests, an MRI scan, a CT scan and a PET scan.

Treatment for Alzheimer’s disease

Alzheimer’s disease is treated with medication. The treatment is intended to help with memory loss and cognitive changes. Other medications such as anti-depressants may also be prescribed to treat the behavioural changes. In addition to this, the patient needs to be provided with a safe and healthy living environment. They could tend to wander off and hence certain safety measures may need to be put in place. The house will also need to be accident-proofed.

Prevention for Alzheimer’s disease

Alzheimer’s disease is not preventable.

Frontotemporal Dementia Overview

Frontotemporal dementia is a broad term for a group of uncommon brain disorders that affect the frontal and temporal lobes of the brain. These are the parts of the brain associated with personality, language and behaviour. In frontotemporal dementia, the brain cells in the frontal or temporal lobe atrophy (shrink) and die, disrupting neural networks and causing changes in behaviour. Frontotemporal dementia is often misdiagnosed as psychosis or Alzheimer’s disease. Frontotemporal dementia often occurs between the ages of 45 and 60 years.

Signs and symptoms for Frontotemporal Dementia

The symptoms of frontotemporal dementia differ in each patient and get significantly worse with time. The patient may experience significant behaviour changes, including loss of empathy and interpersonal relationships, loss of inhibitions, inappropriate social behaviours and repetitive compulsive behaviour. The patient’s vocabulary may also decline, causing them to have trouble naming even simple day-to-day objects. They may make mistakes in sentence construction or forget how to pronounce words. Patients also typically experience difficulty with their motor skills, similar to Parkinson’s disease. The patient may have tremors, muscle spasms, suffer from poor co-ordination or have difficulty swallowing.

Causes for Frontotemporal Dementia

The underlying causes of Frontotemporal dementia are unknown. There are certain genetic mutations that appear to cause shrinkage of the frontal and temporal lobes. However, more than half the patients who develop frontotemporal dementia have no family history of the condition, so the correlation is weak.

Risk factors for Frontotemporal Dementia

Family history is the only known risk factor. However, many people who have no family history of frontotemporal dementia also develop the condition so the connection is not well-established.

Complications for Frontotemporal Dementia

Frontotemporal dementia is not fatal. Patients can live with the condition for years. However, patients are at an increased risk of developing pneumonia and other infections or have an accidental fall. The consequences of these conditions could be very serious.

Diagnosis for Frontotemporal Dementia

There are no specific tests to diagnose frontotemporal dementia. The disease is diagnosed by a process of eliminating other medical conditions that cause similar symptoms. The doctor will require a panel of blood tests, sleep studies, neuropsychological testing to check the status of cognitive and reasoning abilities along with an MRI scan and a PET scan.

Treatment for Frontotemporal Dementia

There is no cure for frontotemporal dementia. Alzheimer’s medication does not seem helpful in treating frontotemporal dementia. Antidepressants and antipsychotic medications have been effective in treating some cases.. Speech therapy has also been effective in patients with the condition.

Prevention for Frontotemporal Dementia

As the cause is unknown, there are no preventative strategies for frontotemporal dementia.