Saturday, June 4, 2011

EPILEPSY- Is it treatable?

What is epilepsy?

Epilepsy is a neurological disease characterized by repeated abnormal electrical discharges from the brain, resulting in fits or convulsions. Either a part of the body can be involved called as partial or focal epilepsy; or the whole body is affected called as generalized epilepsy. During a generalized epileptic attack, the person can lose complete consciousness resulting in falls or injuries.

 How is epilepsy diagnosed?

Epilepsy is diagnosed on the basis of clinical description of the seizure episode. So, it is important for the eye witness to accurately describe it to the neurologist. Doctor may get brain scans and EEG to confirm the cause and type of seizure.

Is epilepsy treatable?

Epilepsy is very well treatable with medications (anti-epileptic drugs). Neurologist would be able to select the best medication depending on the type of epilepsy and also age & sex of the patient. The medicines are required to be taken for long-term without any discontinuation.

Can women with epilepsy get married?

Women with epilepsy can get married and have normal married lives. They can get pregnant and have babies just like other women. Neurologist would advise on the safe anti-epileptic drugs in pregnancy and some vitamins (folic acid) are also required. Please discuss regarding any concerns with your neurologist.

Can people with epilepsy do normal jobs?

Most jobs are safe for people with epilepsy. However, they should avoid driving, swimming and other hazardous activities, as occurrence of seizures during these activities can be dangerous.

Is epilepsy a result of bad evils/demons?

No, they are only misconceptions.

What are the first aid measures to be adopted when someone has an epileptic attack?

1. Make the person lie down on one side (either left or right)
2. Do not give water or anything else by mouth, as it can get aspirated into lungs (causing pneumonia) in an unconscous person.
3. Try to prevent any injury because of fall or tongue bites.
4. Intra-nasal midazolam may be safely given at that time.
5. There is no point giving any keys or any other metals in person's hands, or making him smell handkerchief or socks.
6. Take him to the nearest clinic/hospital at the earliest.

Dr Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad
Phone: 0091-40-23607777/60601066
Email: drsudhirkumar@yahoo.com

Wednesday, June 1, 2011

Homocysteine in heart and brain disease

IMPORTANCE OF HOMOCYSTEINE

Myocardial infarction (heart attacks) and brain strokes (paralysis) are the two most common causes of death and disability in the world. They occur in all regions of the world, and the prevalence increases with advancing age.

There are a number of known risk factors for causing heart attacks and brain strokes, which include high BP, diabetes, high cholesterol, smoking, positive family history and so on.

Role of homocysteine in heart attacks and brain strokes
  • Homocysteine is a normal amino acid in our blood.
  • However, elevated levels of homocysteine in the blood is an additional risk factor for causing atherosclerosis (narrowing of blood vessels for heart and brain).
  • Elevated levels of homocysteine causes injury to the inside of blood vessel.
Though there are no definite reasons for elevated homocysteine levels, they tend to occur more in smokers and pure vegetarians.

It is easy to identify high homocysteine, by doing a simple blood test in fasting state.

Treatment of elevated homocysteine is also easy. One needs to use certain vitamins (folic acid, and other B group vitamins).
Please consult your neurologist for any further information.

Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology)
Senior Consultant Neurologist
Apollo Health City, Hyderabad
Phone: 0091-40-23607777/60601066
Email: drsudhirkumar@yahoo.com

Wednesday, May 25, 2011

How to diagnose migraine?

How is MIGRAINE DIAGNOSED?

Introduction

Migraine is the commonest cause of headache in the world, affecting about 15% of all women and 5% of all men. It affects younger people, affecting their education or employment. It is important to make an early and accurate diagnosis of migraine so that the best treatment can be started early.

Diagnosis of migraine is based on clinical signs and symptoms and usually no investigations are necessary.

Following features are suggestive of a migraine:

1. Headache- classically on one side of the head, but it may occur on both sides, it is described as pulsatile or throbbing type. Headache episodes last for more than 4 hours, and upto 72 hours.
2. Nausea (a feeling of vomiting) or vomiting
3. Photophobia or phonophobia- headache gets worse on exposure to bright light or noise.

Following features may not be suggestive of migraine and in these cases, one should consult a neurologist (a brain scan may be necessary):

1. Most severe headache of the lifetime,
2. Early morning headaches,
3. Drowsiness along with headache,
4. Weakness of one side of body,
5. Occurrence of fits or convulsions.

If you notice any of the above symptoms, please contact your neurologist or family doctor.

Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Phone: 0091-40-23607777/60601066
Email: drsudhirkumar@yahoo.com

What are the risk factors for brain stroke?

RISK FACTORS FOR BRAIN STROKE

Brain stroke is a medical emergency, which is characterized by sudden onset weakness or paralysis of one half of the body. Other disabilities may include inability to speak, impaired vision, severe headache or imbalance while walking.

Risk factors for brain stroke include modifiable and non-modifiable factors:

Modifiable factors:
  • Obesity,
  • Smoking,
  • High blood pressure,
  • Diabetes mellitus,
  • Elevated cholesterol
  • Elevated homocysteine levels
  • Cardiac diseases
  • Stress
Non-modifiable risk factors for stroke include:
  • Older age
  • Family history of brain stroke
  • Male sex
It is important to get regular check-ups done to identify any risk factors for stroke. If any of the above conditions are identified, proper treatment would ensure a stroke-free life. In case of any stroke-like symptoms, you should immediately contact your neurologist/family doctor.

Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Phone- 0091-4023607777/60601066
Email: drsudhirkumar@yahoo.com