Centre For Neurosciences

Arteriovenous malformations are an unusual intertwining of blood vessels between the arteries and the veins that disrupt the normal blood flow and oxygen circulation within the body. Blood flows directly from the arteries to the veins through this entangled complex bypassing the normal capillary bed, resulting in a high-pressure shunt known as a fistula. The pressure of blood pouring directly from the arteries is too much for the veins to handle. As the veins strive to receive the extra blood, they strain and widen. Blood vessels that are weakened are more likely to rupture and bleed and develop a localised swelling. Associated Anatomy Brain and spinal cord Alternate Names of Arteriovenous Malformations AVM Arteriovenous Malformations Causes AVMs are congenital and are thought to occur as a result of a variety of hereditary disorders, including: Cobb syndrome: It is characterised by malformations of the vasculature of the skin, such as wine-coloured birthmarks. It also includes AVMs in the spine, spinal cord, and/or spinal canal. Hereditary Hemorrhagic Telangiectasia (HHT): HHT is characterised by AVMs in the lungs, brain, and digestive tract. Parkes Weber Syndrome: Several AVMs form in one arm or leg in this condition. These AVMs grow longer and larger than the same limb on the opposite side. Wyburn-Mason Syndrome: This condition includes AVMs of the retina and brain, occasionally involving the face. Arteriovenous Malformations Symptoms AVMs in the brain A terrible headache that resembles a migraine Dizziness, nausea, and vomiting Seizures Stiff neck Blood pumping through the AVM causes an odd swishing or ringing sensation in the ear Vision difficulties Problems with body movement Difficulties in speaking as well as understanding Mental confusion and hallucination Spinal AVMs Sudden, excruciating backache Legs or arms sluggishness Paralysis AVMs in other parts of the body Lungs: Shortness of breath; coughing blood. Digestive tract: Pain in the abdomen and black stools. Limbs: Lumps, swelling, and pain in the arms and legs; muscle weakness or paralysis; numbness or a tingling sensation. Types of Arteriovenous Malformations (AVM) Arteriovenous malformation (AVM) These are intertwined aberrant blood vessels in which arteries shunt straight into veins with no intervening capillary bed, resulting in high pressure. Cavernoma This is a low-pressure aberrant cluster of expanded capillaries with no substantial feeding arteries or veins. Venous malformation Venous malformation is an aberrant cluster of swollen veins that resembles the spokes of a wheel but lacks feeding arteries. It has low pressure, seldom bleeds, and is usually untreated. Capillary telangiectasia It includes aberrant capillaries with expanded portions, similar to cavernoma. It also has low blood pressure and rarely bleeds. Arteriovenous fistula It refers to a direct connection between one or more arteries and veins and a sinus where they drain before exiting the skull and heading to the heart. Carotid-cavernous fistulas and dural AV fistulas are the prevalent ones. Arteriovenous Malformations Diagnosis Anterior Circulation Stroke Cardioembolic Stroke Vein of Galen Malformation Intracranial Haemorrhage Cluster/Migraine Headache Cavernous Sinus Syndromes Cerebral Amyloid Angiopathy Moyamoya Disease Cerebral Venous Thrombosis (CVM) Chronic Paroxysmal Hemicrania (CPH) Dissection Syndromes Fibromuscular Dysplasia Posterior Cerebral Artery Stroke Cerebral Aneurysms Typical Test of Arteriovenous Malformations An ultrasound is used to assess the blood flow pattern through the AVM. A CT scan or an MRI determines the extent of the AVM and its proximity to normal bodily areas. An angiography assists the doctors in deciding how to stop blood flow to the AVM by mapping its blood vessels using X-rays. Arteriovenous Malformations Treatment Depending on the type, symptoms, and location of the AVM, treatment options range from careful observation to invasive surgery. Some of the symptoms of AVMs can be relieved with medication: Anti-seizure drugs are used to treat seizures For headaches and back discomfort, pain medications are available Surgical interventions include: Embolisation: In this procedure, a thin, flexible tube (catheter) is inserted to plug the arteries supplying the AVM permanently. Sclerotherapy: This procedure involves injecting a drug or a medical-grade material into an AVM to shrink the blood vessels. Surgery: Surgery may be suggested if an AVM has bled and/or is in an easily accessible location. Stereotactic radiosurgery: This can be used to treat an AVM that is not too large but is located in a region that is difficult to access with traditional surgery. Risk Factors of Arteriovenous Malformations (AVM) Most AVMs are not hereditary. However, a family history may increase the risk of the disease. Certain conditions such as hereditary hemorrhagic telangiectasia (HHT) (“Osler-Weber-Rendu syndrome”) may put a person at greater risk for AVM. Being a male is a risk factor for brain AVMs. Possible Complications of Arteriovenous Malformations (AVM) The possible complication may include but are not limited to seizure, aneurysm (abnormal bulging or swelling in a blood vessel's wall that eventually leads to its rupture), bleeding in the brain leading to coma or death, and/or permanent damage to the brain leading to loss of memory and cognitive impairment. Prevention of Arteriovenous Malformations AVMs cannot be prevented since studies believe they are congenital, which means they are there at birth. The ideal method is to react swiftly to emerging symptoms. Epidemiology of Arteriovenous Malformations (AVM) Young adults are typically most affected, with a 30-50 % morbidity rate and a 10-15% mortality rate. AVM haemorrhage occurs at a rate of 2 to 3% every year. The chance of dying from the first haemorrhage is between 10% and 30%. An AVM is nine times more likely to bleed again in the first year after a haemorrhage has occurred. Expected Prognosis of Arteriovenous Malformations (AVM) The annual risk of intracerebral haemorrhage remains 2-4%. Those with superficial, moderate-sized AVMs have a fair long-term prognosis and may not benefit from interventional therapy. However, Young AVM patients have a high lifetime risk of bleeding. The prognosis for AVM haemorrhage is better than for other intracerebral haemorrhages. The better prognosis may be attributed to the patients' younger age and higher capacity for reconfiguration of brain function. An angiographic assessment is recommended to define the prognosis of patients with AVM. Natural Progression of Arteriovenous Malformations (AVM) The natural progression of the disease involves bleeding and possible seizures leading to a severe neurological deficit, which can be fatal. Pathophysiology of Arteriovenous Malformations (AVM) AVMs are congenital lesions composed of a complex vascular conglomerate (called nidus) connected by one or more fistulae. The exact process of forming a complex network of arteries and veins is unknown. AVMs produce neurological dysfunction through three main mechanisms. Haemorrhage mainly in brain parenchyma or maybe in the subarachnoid space and the intraventricular space. Alternatively, a seizure is a common (15-40%) consequence of AVM that contributes to the neurologic deficit. Rarely, a progressive neurological deficit may occur in 6-12% of patients due to syphoning of blood flow away from adjacent brain tissue ("steal phenomenon") Due to the mass effect of an enlarging AVM or venous hypertension in the draining veins.

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The top of the spine presses into the skull base, causing basilar invagination. The brain stem, a dense network of nerves that links the brain to the spinal cord, is constricted and pressed as a result. The disease is generally found in infants and children. Associated Anatomy Brain and spinal cord Alternate Name of Basilar Invagination Basilar impression Basilar Invagination Causes Basilar invagination can be congenital or can be developed over time due to soft bones. Congenital basilar invagination In infants can develop due to: Chiari malformation: An abnormality present at the skull base in which the brain tissues get pushed into the spinal cord. Hydrocephalus: Fluid gets filled within the deep brain cavities. Klippel-Feil syndrome: Abnormal fusion of neck bones, causing a webbed neck. Syringomyelia: Development of fluid-filled cyst in the spine. Osteogenesis: Fragile breakable bones Marfan syndrome: Weak connective tissues Basilar invagination over time can develop due to: Injury, caused in an accident Immune or endocrine or a bone or connective tissue disorder, like, brittle bone disorder, Marfan syndrome, Rheumatoid arthritis, Rickets etc. Basilar Invagination Symptoms Depending upon the part of the brainstem pressed or constricted, basilar invagination can cause different symptoms, such as: Pain in the back of the head and the upper part of the neck. Weakness of neck Convulsions in the eyes (nystagmus) Improper speech Difficulty in swallowing Dizziness Tingling and numbness in hands and feet. Loss of proprioception Paralysis in arms and legs Difficulty in peeing and pooping. Difficulty in bending the neck. Basilar Invagination Diagnosis and Test Tests for basilar Invagination are done by doctors specialised in neurology, neurosurgery and orthopaedics. Your doctor will first examine your muscles and nerves based on your symptoms. MRI is the best diagnostic test to look for abnormalities in the brain and spinal cord. X-rays and CT scans can also be performed as secondary tests for better clarity. Basilar Invagination Treatment A child with mild or zero symptoms of basilar invagination requires regular monitoring by the doctor. Other symptoms can be treated by: Anti-inflammatory medicines Performing manual traction on the neck. Use a cervical collar or cervical-thoracic brace to support the head, neck, and upper back. Physical therapy Unstable neck position and nerve constriction require surgery. Surgery is performed through the mouth, nose or back of the neck or head. Halo-gravity traction: helps to get the skull and neck in a better position. Risk Factors of Basilar Invagination Risk factors include: Chiari malformation Rheumatoid arthritis Injury during a bike ride or fall or diving. hydrocephalus Rickets Possible Complication of Basilar Invagination Complications of basilar invagination developed in the later stage of life include hydrocephalus or syringomyelia. Both these conditions block the flow of cerebral fluid around the brain and spinal cord. Loss of proprioception (a condition where you are unable to tell your body part's position without looking) and paralysis in the arms and legs can also occur. Basilar Invagination Prevention Primary Prevention Primary prevention includes: Watching new and recurring symptoms closely Not kissing follow-up appointments with doctors. Avoid strenuous activities as the neck is already fragile; it can be fatal otherwise. Secondary Prevention To avoid recurrence of the disease, do not put pressure on your skull and neck bones, especially after surgery, otherwise it could be fatal. Regularly go for imaging tests to keep check on your neck and head positioning. Epidemiology of Basilar Invagination Since it is a congenital disease, it is more prevalent in infants and children. However, basilar invagination caused due to injury and other diseases can occur at any age. About 5-10% cases of basilar invagination occur in patients of cervical and rheumatoid arthritis. Both conditions cause loss of axial supporting structures in the upper cervical spine. Expected Prognosis of Basilar Invagination Basilar Invagination is a treatable and manageable disease. With timely detection and regular monitoring, it can be cured. Those who develop this condition as a result of injury or other diseases may require surgery, which has a high success rate. Only basilar invagination, which puts pressure on the lower brainstem, can be fatal. Natural Progression of Basilar Invagination Congenital basilar invagination can be treated with regular monitoring, and physical therapy or by wearing a cervical collar. However, if left untreated or signs and symptoms get ignored, it may lead to unstable neck and head positioning, which requires surgery. Pathophysiology of Basilar Invagination Vertebra (bone) near the upper back travels up and back toward the skull base. The bone may press the brainstem and spinal cord in this abnormal posture. Basilar invagination can be congenital (existing at birth) or acquired basilar invagination (develops because of an injury or disease).

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A benign brain tumor, also known as a low-grade cortical tumor, is a mass or lump that grows in the brain. It is not cancerous and does not spread to other body parts. Benign tumors are usually not life-threatening. Types of Benign Brain Tumor Benign Brain Tumor are classified based on Growth of Benign Brain Tumor: Slow-growing or low-grade tumors grow slowly and usually have a good prognosis. Fast-growing or high-grade tumors, as the name conveys, grow more quickly. While each type has unique symptoms and characteristics, they all share one commonality: they are slow-growing tumors that rarely spread to other parts of the body. Meningiomas This is the most common primary tumor of the membranes that cover the brain. It originates in the meninges (the outer three layers of the brain's tissues). Pituitary adenomas This tumor grows in the pituitary gland, a pea-sized gland on the undersurface of the brain. Craniopharyngiomas This type of tumor grows near the pituitary gland near the base of the brain. This most often affects children, teenagers, and young adults, causing vision or endocrinological issues in a few. Acoustic neuromas It is also known as vestibular schwannomas, is a tumor affecting the nerve that connects the ear to the brain and is seen to affect hearing and cause facial pain. Hemangioblastomas This is a tumor of the brain's blood vessels. Gliomas It is a tumor of the glial tissue surrounding and supporting neurons, nerve cells, and fibers originating in the brain. Stages / Grades of Benign Brain Tumor Grade 1 - Benign brain tumors that grow very slowly. Grade 2 - Benign brain tumors with slightly faster growth than Grade 1. Benign Brain Tumor Causes The causes of benign brain tumors are not entirely known, but medically, you are more likely to develop it if you have any one or more of the following reasons: Family history of brain tumors Age over 50 Have undergone radiotherapy Genetic conditions such as neurofibromatosis type 1, neurofibromatosis type 2, Turcot syndrome, von Hippel-Lindau syndrome, tuberous sclerosis, Li-Fraumeni cancer syndrome, and Gorlin syndrome. Benign Brain Tumor Symptoms Persistent headaches vomiting seizures (epileptic fits) vision problems speech problems drowsiness general weakness paralysis change in personality with mental and behavioral changes. Typical Test of Benign Brain Tumor If required, medical diagnosis is made through tests like MRI scan, CT scan, and biopsy. Benign Brain Tumor Treatment Treatment for benign brain tumors depends on the type of tumor, size, and location in the brain. Surgery is performed to remove noncancerous brain tumors. In most cases, further intervention is not needed. Radiation therapy or chemotherapy is recommended when the surgery cannot be performed. In some cases, it is suggested along with surgery too. Risk Factors of Benign Brain Tumor The following factors may increase the risk of any person developing a benign brain tumor: Age: While benign brain tumors have been known to occur in children and adults, they are more likely to develop in people over 50. Gender: As per certain studies, men develop benign brain tumors more than women. In the case of meningioma, it is more likely to develop in women. Family history: A family history with certain genetic disorders running in the family tree is more prone to developing a benign brain tumor. Exposure to certain risk factors: If you are exposed to particular products or ingredients like solvents, certain oil products, rubber, pesticides, vinyl chloride, etc., maybe you are more at risk of developing a benign brain tumor. Race and ethnicity: In certain countries, few races and ethnicities are more at risk of developing a benign brain tumor. Exposure to electromagnetic fields produced from high-energy power lines, cell phones, etc. Exposure to certain infections, allergens, and viruses. Severe head trauma or seizures or anti-seizures medication. Ionizing radiation like x-rays. Possible Complications of Benign Brain Tumor People may experience side effects of the treatment for months or years, such as hearing loss, cataracts, epilepsy, issues with memory, infertility, thinking, etc., and loss of vision. Benign Brain Tumor Preventions Primary Prevention of Benign Brain Tumor Though one does not know the specific ways to prevent this, one can help oneself by reducing the exposure to risk factors that may cause benign brain tumors. Secondary Prevention of Benign Brain Tumor Surgery may be recommended to ensure the complete removal of the tumor and eliminate its recurrence. Epidemiology of Benign Brain Tumor In India, the incidences of central nervous system (CNS) tumors range from 5 to 10 per 100,000 population. It is increasing and accounts for 2% of malignancies. The estimated incidence of new cases per year is 308,102 and deaths 251,329. More cases are present in men, and they respond less to the therapy. As per the statistics worldwide, new cases per year are 3.9/100,000 in males and 3.0/100,000 in females. These are all combined for brain and central nervous tumors. Expected Prognosis of Benign Brain Tumor The survival rate for adults over 40 years of age is 66%. For benign meningioma, in children 14 and below, the 5-year survival rate is over 96%. For people in the age bracket of 15 to 39, it is 97%, and for over 40 years, it is 87%. Natural Progression of Benign Brain Tumor The natural progression is better in young ones as compared to adults. The tumor's location is also a deciding factor in the condition's progression. Pathophysiology of Benign Brain Tumor Certain functions change with the growth of the brain tumor, which causes signs and symptoms related to the same development. Related Blogs Brain Tumour Treatment: What Are The Surgical & Non-Surgical Options? What is Cancer and Its Different Types? Spinal Cord Tumour - Types, Symptoms, Diagnosis and Treatments What Is an Oncologist? Understanding Their Role & How to Choose the Right One for Cancer Care Cancer Causes: A Comprehensive Guide Blood Clot in Brain

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Brachial neuritis is caused by inflammation or damage to the nerves belonging to the brachial plexus. The brachial plexus is a network of nerves that transmit nerve signals from the spinal cord to the shoulder, neck, arms, and chest region. Irritation of these nerves causes pain, burning sensation, and weakness in the shoulders that can radiate to the arm and hand. Associated Anatomy Shoulder, arm, and hand. In 75% of the cases, the symptoms only occur on one side of the body. Alternate Name of Brachial Neuritis Brachial neuritis is also known by the names of Parsonage-Turner syndrome, neuralgic amyotrophy, or brachial plexitis. Brachial Neuritis Causes The exact cause of brachial neuritis is not known. Brachial Neuritis Symptoms The symptoms of brachial neuritis depend upon which nerves of the brachial plexus have been affected and the severity of the nerve damage. Initial Brachaial Neuritis Symptoms Severe, sudden-onset pain in the shoulder, usually at night time. The pain can radiate down to the arm and hand. This pain is unrelenting and is only relieved somewhat with the strongest of painkillers. The pain is sharp and may be associated with burning and electric shock-like sensations. This can last from a few hours to even weeks. The symptoms could get aggravated with arm movement. Delayed symptoms The pain may subside after a few days, and some neurological symptoms can appear. Weakness or even paralysis of the shoulder muscles. Abnormal skin sensations such as tingling or numbness in the affected area. Loss of muscle mass or muscle atrophy in the shoulder. Shortness of breath may be experienced If nerves in the chest are affected. Brachial Neuritis Diagnosis An electromyography test is used to record and measure nerve signals to determine the health status of the nerves. Your physician may order additional tests to rule out other causes of your symptoms. These include: Blood work to detect any infection or autoimmune disease. X-ray to rule out any bony injury or problems with nearby joints or bones. CT or MRI to assess the muscles and soft tissues. The doctor will also inquire about your family history, any recent injury or illnesses, etc. Brachial Neuritis Treatments Brachial neuritis usually resolves on its own, but as the pain and other symptoms can be severe and disabling, treatment focuses on pain management and restoring the strength of the shoulder and hand muscles. Medications For pain relief, corticosteroid injections and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be administered. Physical Therapy A Physiotherapy & rehabilitative program consisting of active and passive exercises may be required to recover the lost strength and functioning of the shoulder and/or arm muscles. Transcutaneous electrical nerve stimulation (TENS) unit In this procedure, electrical signals are sent to the nerves in the affected area with the help of wires attached to the electrodes placed on the skin. These electrical signals disrupt the pain signals transmitted by the nerves and reduce pain. Surgery If the symptoms do not adequately resolve even after a period of two years, surgery may be recommended. It involves repairing the damaged nerves with the grafts harvested from the healthy nerves. Tendon transfers can also be utilised. These procedures help restore the strength and function of the affected muscles. Heat or cold therapy Heat or cold compresses can reduce inflammation and provide pain relief. Risk Factors of Brachial Neuritis Doctors and researchers have not yet been able to find what causes the nerve damage in the brachial plexus, but some risk factors have been identified for brachial neuritis: Autoimmune Disorders: Autoimmune diseases can cause the immune system to attack the healthy nerves and result in brachial neuritis. Genetics: A dominant gene has been identified to cause a kind of brachial neuritis known as hereditary neuralgic amyotrophy. A person carrying this gene might not develop symptoms unless some injury or illness activates the gene. Age: Though brachial neuritis can occur at any age, people within the age group of 20-60 years are more likely to suffer from it. Sex: Occurance of brachial neuritis is greater in males as compared to females. Others: Babies can injure the brachial plexus during birth. It can also be caused due to sustaining an injury while doing strenuous exercises. Possible Complication of Brachial Neuritis Brachial neuritis is not known to spread or cause any other illnesses, but muscle weakness can decrease the control and increase the risk of any accidents. Thus, you might need to make some changes to your routine. Brachial neuritis can sometimes lead to partial or total paralysis of the shoulder. It can also cause permanent nerve damage. Epidemiology of Brachial Neuritis Brachial neuritis is a rare condition, affecting only about 1 to 2 persons per 100,000. Age: Brachial neuritis is more frequently seen in people of age 20 to 60 years, though it can occur at any age. Sex: Brachial neuritis is more commonly seen in males as compared to females. Expected Prognosis of Brachial Neuritis Brachial neuritis usually resolves on its own in a couple of months or years. There is no cure for the root cause of this condition, but treatments are available to provide symptom relief. Natural Progression of Brachial Neuritis Symptoms of brachial neuritis change with time. It starts with severe pain, which gradually subsides, followed by weakness of the shoulder and/or arm. The symptoms do not spread to other areas of the body. Timely treatment helps in the prevention of permanent nerve damage. Pathophysiology of Brachial Neuritis Brachial neuritis is a kind of peripheral neuropathy. It occurs due to damage to the nerves of the brachial plexus. In the idiopathic form of brachial neuritis, the cause of the nerve damage is known, though it can be related to an autoimmune response in several cases. The genetic form of brachial neuritis is caused by the activation of a dominant gene following an injury or illness.

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A brain aneurysm is a condition in which there is a bulge in the blood vessels in the brain. The continuous pressure from blood circulation can lead to the rupturing of these blood vessels causing bleeding inside the brain. Associated Anatomy The blood vessels of the brain Alternate Name of Brain Aneurysm Also known as an intracranial aneurysm. Brain Aneurysm Causes The exact cause of a brain aneurysm is still under intense research. But scientists associate the condition with the following causes: Smoking: Tobacco products can irritate and weaken the brain’s blood vessels. Blood infection: The colonisation of blood vessels from pathogens causes the bulging of blood vessels. High blood pressure: Over time, pressure can build up around the blood vessels causing them to bulge out of their shape. Amphetamine and cocaine usage: Recreational drug usage has been known to form aneurysms in the blood vessels. Brain injury: Physical trauma to the brain from accidents can cause an aneurysm. Plaque buildup in arteries: A condition known as atherosclerosis can also cause the bulging of the inner walls of the blood vessels. Brain Aneurysm Symptoms Headache Impaired vision Dilated pupils Loss of sensation in the face or head Tingling in the face or head region Pain in the eye region, both upper and behind Pain around the neck region Dizziness Nausea Vomiting Loss of concentration Confusion Impaired speech Loss of feeling in the arms and legs Myocardial infarction Brain Aneurysm Stages Aneurysms are classified based on their size and shape. The classifications are: Small:15 mm in size Large:15-25 mm in size Giant: 25-50 mm in size Supergiant: Over 50 mm in size Brain Aneurysm Diagnosis An angiogram is used to distinguish cerebral aneurysms from infundibular dilutions. Infundibular dilutions are the widenings caused at the origin of the cerebral artery. Researchers are still trying to figure out whether to classify this as a form of the pre-aneurysm. It can be a potential source of bleeding. Yet, a rupture at this stage is rare. Tests for Diagnosis of Brain Aneurysm Magnetic radio angiography (MRA) and computed tomography angiography (CTA) can detect large aneurysms. To detect smaller aneurysms, an angiogram is used. For a rupture, a lumbar puncture procedure is used to evaluate the cerebral spinal fluid. Then, the red blood cell (RBC) count is taken into consideration for a final diagnosis. Learn more about the Angiography procedure in Delhi and Brain stroke treatment in Delhi. Brain Aneurysm Treatments Brain surgery In emergencies, when the aneurysm ruptures, brain surgery is needed to close the rupture. Microvascular clipping During this surgical procedure, minor cuts are made in the skull to access the aneurysm. The aneurysm is pinched off and sealed using metal cap clips. This procedure blocks the blood supply to the aneurysm. Flow diversion In this method, no cuts are required on the skull. Instead, the surgeon uses a catheter to reach the aneurysm and fill it with wire balls made up of platinum. Over time, this blocks blood flow to the aneurysm. A rupture is, therefore, not possible at this spot. Risk Factors of Brain Aneurysm Hypertension: High blood pressure damages the blood vessels and can create ruptures inside them. Genetics: Aneurysms can be caused because of inherited genes or due to diseases gained because of inherited genes such as Marfan’s syndrome, which affect the walls of blood vessels. Alcoholism: Moderate consumption of alcohol has been a known risk factor. Fitness: High body weight is a known risk factor for developing aneurysms. Cocaine: The usage of this drug has been associated with the formation of aneurysms inside the blood vessels of the brain. Female gender: The disease affects females more than males. Family history: The disease occurrence rates in closely related family members are also a risk factor. Brain Aneurysm Prevention Primary Prevention of Brain Aneurysm Fitness: Maintaining healthy body weight through regular high cardio exercises. Healthy diet: Having a proper and balanced diet with an even mix of carbohydrates, proteins, and fats. Therapy sessions are recommended for alcohol abuse and drug (Cocaine) abuse. Blood pressure: Maintaining ideal blood pressure with proper care and medications. Avoid smoking at all costs. Approach rehabilitation centres if needed. Secondary Prevention of Brain Aneurysm After the initial episode of a brain aneurysm, patients are advised to follow all the preventive measures prescribed for the primary prevention of the disease. Possible Complications of Brain Aneurysm When an aneurysm ruptures, the blood from the rupture can leak into the space around the brain leading to a condition called a subarachnoid haemorrhage. This causes intense headaches in the patient. Other complications include vasoconstriction of blood vessels that can then lead to tissue death in a condition known as vasospasm. Epidemiology of Brain Aneurysm 30 to 60 years old: This is the most affected age group. Women: Females are more affected by this condition than men. Under the age of 16: Brain aneurysms for persons below 16 are rare. Expected Prognosis of Brain Aneurysm Prognosis depends on the size and location of the aneurysm. The risk of a rupture at this location depends on the size of the aneurysm. For example, small aneurysms have a very low risk of rupture as compared to larger-sized ones. The location of the aneurysm and the patient’s age, fitness, and mental condition contribute to the prognosis. Natural Progression of Brain Aneurysm The healing of an aneurysm without medical intervention is very rare. Ruptures in blood vessels occur because of an untreated aneurysm, and ruptures require emergency treatment. It is advised to be treated immediately for aneurysms that are larger than 7 mm in diameter because of the risk of rupture. Pathophysiology of Brain Aneurysm A bulge in a blood vessel at a point of weakness that is filled with blood is called an aneurysm. The high pressure in this region pushes the blood against the blood vessels, creating pressure on the walls of the blood vessels, causing them to enlarge outward. The weakness in this region can be because of multiple factors, such as genetics or inherited hereditary conditions, which predisposes the person’s weaker inner linings of the blood vessels to bulge out of proportion. Related Blogs Blood Clot in Brain: Symptoms, Diagnosis, Treatment Brain Stroke: Warning Signs, Symptoms, and Prevention Protect Your Brain Health: How Lifestyle Changes and Medical Intervention Can Help Prevent Stroke Headache Types: What You Need to Know

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Brain cancer is a type of malignant brain tumor that affects the brain’s normal functioning. The tumor growth can originate from the brain cells( primary brain cancer) or spread from other body locations into the brain (secondary brain cancer) like lungs, breast, colon, etc. Associated Anatomy Brain and central nervous system Alternate Name of Brain Cancer Brain tumor Brain Cancer Causes There is no specific reason for brain cancer. However, some factors that could trigger brain cancer include; Exposure to high dose radiations because of other cancer treatment Hereditary conditions like neurofibromatosis, Li-Fraumeni syndrome Exposure to industrial chemicals and pesticides Infection with Epstein Barr virus Low immunity because of any immunocompromised disease Brain Cancer Symptoms Severe headache, especially in the morning Lack of coordination and cognitive functions Brain fog and lack of mental alertness Sudden loss of consciousness Problems associated with speech and other work Seizures and changes in mental capacity Lack of concentration Nausea and vomiting Tingling sensation in arms and legs Vision and eye movement disorders. Please note all these symptoms also occur in other health conditions; therefore, it's always best to consult an oncologist doctor and get the diagnosis after taking the specific tests. Stages of Brain Cancer Brain cancer is classified into four stages or grades, depending upon whether they are benign or malignant. Grade I and II are benign forms of brain cancer, and grade III and IV are malignant forms of brain cancer. Stage I: It is the initial stage in which the brain cells are benign and look like normal ones. Stage II: The cells change shape and size, resembling the normal brain cells less and less. Stage III: The cells become abnormal and spread to other parts of the brain and surrounding areas. Stage IV: The cells become malignant and spread rapidly. Brain Cancer Diagnosis The symptoms of brain cancer resemble various other common conditions like migraines, clustering headaches, subdural hematomas, encephalitis, etc. It is always recommended to check with your doctor for final diagnosis and timely treatment. Typical Test of Brain Cancer After the medical history and neurological examination, the doctor specifies various tests to diagnose the brain cancer, which include: Neuroimaging: Various imaging tests like CT scans, MRI, and PET scans are conducted to picture the cancerous growth and location inside the brain. Tissue biopsy: Tissue biopsy can be done as a part of the operation or before that to determine whether the cancerous or tumorous growth is benign or malignant. Brain Cancer Treatment There are different treatments available to treat brain cancer after considering age, stage, and type of tumor, and some of them are mentioned below. Surgery Partial or complete surgical removal of cancerous growth is done to treat brain cancer, especially in small benign tumors. Standard surgical procedures include craniotomy, stereotactic biopsy, stereotactic radiosurgery using Gamma knife. Radiation therapy When surgical removal is not possible, radiotherapy is used to shrink the cancerous growth in the brain. Chemotherapy Single or combination of anti-cancer drugs is given to destroy the cancer cells. Chemotherapy can be provided in multiple cycles, with intermittent monitoring to check the effect of treatment on cancer cells. Immunotherapy Immunotherapy is under trial and is effective against certain types of brain cancers. Risk Factors of Brain Cancer Age: more common in children and adults. Gender: affect men more than women Ionizing Radiations: high doses of ionizing radiation can trigger the cancer onset. Infections: certain viral infections could cause lymphoma in the brain. Heavy Chemical Exposure: exposure to N-nitroso compounds increases the risk of brain cancer. Head Injury: any blow or injury to the brain may also predispose to brain cancer in the presence of other predisposing factors. Possible Complication of Brain Cancer Brain cancer is an aggressive form of cancer, especially if it is malignant. It can be fatal or may cause various complications like permanent brain damage affecting body movements (paralysis) and cognitive impairment, if not treated timely. The possible complications after the treatment of brain cancer are recurrence of cancer, coma or impairment of various body functions. Brain Cancer Prevention Primary Prevention of Brain Cancer There is no specific way to prevent brain cancer. However, early diagnosis can help control its spread across various regions and have better management. Secondary Prevention of Brain Cancer Reducing radiation exposure in the head: limiting the radiation exposure in the head region can minimize the risk of developing brain cancer. Taking a good diet, physical activity, and regular checkups can prevent the onset of recurrence of brain cancers. Epidemiology of Brain Cancer There are around 120 types of brain cancers. Brain tumors roughly occur in 7-19 per 100000 population. Males are more likely to get brain cancer than females, except for meningiomas and pituitary adenomas. Brain tumors are also very common in children after leukemia. Expected Prognosis of Brain Cancer The expected prognosis of brain cancer depends on age, grade, type of tumor, and genetic mutation. Certain brain cancers like medulloblastoma have a better prognosis with timely diagnosis and treatment. However, glioblastoma multiforme, a grade IV brain cancer, has an aggressive spread and is often fatal. Natural Progression of Brain Cancer Brain cancer, if left untreated, multiples and destroys the brain cells. Both types of cancers (primary and secondary), as they grow, cause damage to the neural pathways and neural tissue of the brain. The growing tumor puts pressure on the nerves and other parts and causes disruption of various normal functions. Pathophysiology of Brain Cancer The cancerous cells are abnormal masses that are unable to perform their normal functions. These cells grow abnormally to big size and push the normal cells and damage the nerves, which causes various secondary symptoms. Related Blogs Blood Clot in Brain Brain Tumours: Identifying Symptoms and Understanding the Causes Brain Tumour Treatment: What Are The Surgical & Non-Surgical Options? Different Types of Cancer Demystifying Cancer Causes: A closer look What Is an Oncologist? Protect Your Brain Health: How Lifestyle Changes and Medical Intervention Can Help Prevent Stroke

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A brain tumor refers to an abnormal growth of cells in the brain leading to a mass or lump formation in or around it. This mass formation inside the head affects the brain’s functioning and could be life-threatening. The chances of a person developing a brain tumor in their life are less than 1%. Brain tumors are the most common central nervous system tumors, accounting for 85–90%. Types of Brain Tumor Brain tumors could be benign (non-cancerous) or malignant (cancerous). Based on their origin, brain tumors can be classified as: Primary brain tumors: These tumors start in the brain and could be low-grade (slow-growing) or high-grade (fast-growing). Secondary brain tumors: These tumors originate in other body organs (lungs, breast, kidney, etc.) and spread to the brain. Alternatively, brain tumors are classified as gliomas and non-gliomas. Gliomas originate from glial cells of the brain and are the most common brain tumors. Non-gliomas originate from cells other than glial cells and are less common. Causes of Brain Tumor Brain tumors could be caused by the following: Change in genes or mutations Exposure to radiation such as radiotherapy (cancer treatment), X-rays, or working in strong electromagnetic fields Hereditary factor: Approximately 5% of brain tumors are inherited Head injuries or history of head surgeries Metastasis of tumor from other body organs. Brain Tumor Symptoms Signs and symptoms of brain tumor include: Headaches that are more frequent and tend to worsen Seizures Vision changes Speech or hearing impairment Memory impairment Personality changes Drowsiness Fatigue Loss of control Disorientation Walking troubles Sleep issues Weakness or numbness in a specific body part Inability to concentrate Nausea or vomiting Balance disorder Risk Factors of Brain Tumor Age: Children and the elderly are at increased risk Sex: Males are more likely to develop a brain tumor than females Exposure to harmful substances such as rubber, pesticides, solvents, vinyl chloride, etc. Family history History of infections, allergies, or viral infections Race and ethnicity: White people are more prone to it than black people Exposure to radiations and electromagnetic fields Use of N-nitroso compounds in diet or supplements Head injury History of seizures Diagnosis and Tests of Brain Tumor The doctors diagnose brain tumors by enquiring about the patient’s medical history, signs, symptoms, and physical examination followed by some imaging tests, and/or biopsy (tissue sampling), etc. Various diagnostic tests include: Magnetic Resonance Imaging (MRI) This is done to obtain detailed pictures of the various parts of the brain to identify the affected area. Biopsy Biopsy (tissue sampling) is done for the final diagnosis and to identify the brain tumor’s cells, tissues, and type. In addition, various confirmatory tests could be recommended, such as: Computerized Tomography (CT) scan Positron emission tomography (PET)-CT scan Cerebral arteriogram Spinal tap Myelogram Biomarker tumor testing Specialists who treat brain tumors are called surgical neuro-oncologists. Brain Tumor Treatment Brain Tumor Treatment will depend on the age, gender, type of tumor, the area affected, stage of the tumor, and the patient’s overall health condition. Surgery Surgery to remove the brain tumor is the preferred choice in treating brain tumors. Complete surgical removal involves removing the tumor entirely without damaging brain tissue. However, if the tumor is located in a significant area of the brain, or if the removal would critically harm the patient, partially removing it is preferable. Chemotherapy or Radiation Therapy For tumors that are extremely difficult to remove surgically, chemotherapy or radiation therapy is more suitable. Stereotactic radiosurgery and targeted therapy to the affected area are the latest advancements in brain tumor treatment. Medications Medications like steroids, anticonvulsants, and pain medication could be prescribed to reduce pain, swelling, and seizures. In addition, various therapies like physiotherapy, speech therapy, and occupational therapy for managing daily activities can be recommended. Your doctor might also recommend lifestyle modifications such as following an exercise regime and diet plan to regain strength and quick recovery. Explore the Brain stroke treatment in Delhi, India. Brain Tumor Treatment Cost Brain tumor treatment cost in India depends on: The type of treatment Patient’s age and health condition Complications after the surgery Hospital stay Category of room opted for Surgeon’s expertise Diagnostic tests Medicines required Charges of anaesthesiologist, dietician and other staff Besides the surgery fee, brain tumor treatment costs could also include the expenses for immunotherapy, chemotherapy, radiation therapy, and any other additional treatment required.If you want to get an average estimate, discuss it with your Brain Tumor doctor, who could give you a clear picture of what to expect. Related Blogs Brain Tumour Treatment: What Are The Surgical & Non-Surgical Options? What is Cancer and Its Different Types? Brain Stroke: Warning Signs, Symptoms, and Prevention Spinal Cord Tumour - Types, Symptoms, Diagnosis and Treatments Cancer Causes: A Comprehensive Guide What Is an Oncologist? 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Chiari malformation is a structural defect involving the cerebellum and the spinal cord. In this malformation, the brain tissue in the cerebellum grows and extends into the upper part of the spinal canal. Associated Anatomy of Chiari Malformation The cerebellum and upper parts of the spinal cord. Alternate Names of Chiari Malformation Alternate names include Arnold Chiari malformation, spina bifida, and hindbrain herniation. Types of Chiari Malformation Type 1 This is the most common type of Chiari malformation and involves only the lower part of the cerebellum. Type 2 This type involves the cerebellum and brain stem tissues. It is often associated with a myelomeningocele congenital disability. Type 3 This involves the extension of brain tissues in the spinal cord. It occurs due to an associated congenital disability in which the fluid accumulation in the brain causes its protuberance. Type 4 This type is associated with the incomplete development of the cerebellum. Chiari Malformation Causes Developmental defects are the most common cause of Chiari malformation. During fetal development, due to a lack of nutrients in the maternal diet, the space at the skull base that encloses the cerebellum becomes small. It creates increased pressure on the cerebellum and blocks the flow of cerebrospinal fluid. Some cases of Chiari malformations occur during the later stages of life. In these cases, the cerebrospinal fluid gets drained due to injury, infection, and toxicity. Genetic mutations can also cause developmental defects that cause Chiari malformation. Chiari Malformation Symptoms Type 1 Chiari malformation is associated with the following symptoms Headache Neck pain Deteriorated coordination of motor skills Tingling sensation in the hands and feet Dizziness Hoarseness of voice Ringing sensation in the ear Sleep apnea Weakness Type 2 Chiari malformation is associated with Enlarged head Difficulty swallowing Difficulty breathing Impaired eye movement Weakness in the arms Chiari Malformation Diagnosis A physical examination can reveal an abnormality in balance, memory, reflexes, motor skills, and cognitive senses. A few imaging tests used to diagnose this malformation include Magnetic Resonance Imaging (MRI), which helps find the extent of the growth of the cerebellum and spinal cord impairing the brain's normal functioning. Computerized tomography provides a cross-sectional image of the brain tissue and helps identify blood vessels and brain tissue damage. Chiari Malformation Treatment Decompression surgery In the case of symptomatic representation of Chiari malformation, decompression of the nervous tissue and restoration of the flow of cerebrospinal fluid are required. Resection surgery Type 2 Chiari malformation associated with symptoms requires surgical treatment. A few cases might require the resection of cerebellar tissue to relieve excessive pressure. Spinal surgery In children, spinal surgery helps reposition the spinal cord and relieve excess pressure from cerebral spinal fluid. Risk Factors of Chiari Malformation Risk factors associated with Chiari malformation include: Myelomeningocele where the opening in the spinal cord persists even at the time of birth and can cause spinal displacement. Hydrocephalus In hydrocephalus, excessive accumulation of cerebrospinal fluid in the brain causes undue pressure on posterior parts of the brain. Syringomyelia This involves a cyst in the spinal column that causes excessive pressure and leads to Chiari malformation later on. Possible Complications of Chiari Malformation Due to the continuous progression of Chiari malformation, some patients may experience complications such as the accumulation of excessive fluid in the brain. Chiari malformation may also hinder the development of the spinal cord covering. The progression of Chiari malformation can possibly cause the formation of cysts in the spinal cord. In these cases, cysts become attached to the spine, causing damage to the nerves and muscles. Chiari Malformation Prevention Primary Prevention of Chiari Malformation The intake of proper nutrients like folic acid during pregnancy can prevent this congenital malformation. Avoiding exposure to hazardous substances like alcohol and drugs also prevents the occurrence of Chiari malformation. Maintaining optimal vitamin B12 with the help of supplements before conception also helps prevent congenital disabilities like Chiari malformation. Dietary modifications with the introduction of folic acid and vitamin B12-rich sources also help prevent Chiari malformation. Secondary Prevention of Chiari Malformation Most cases of Chiari malformation do not recur after surgery. In a few cases of Chiari malformation that has been treated with surgery, there is a recurrence of symptoms due to the regrowth of the bone. Creating CT scan-guided windows in the bone can accumulate brain tissue even after regrowth and prevent a recurrence. There is often a recurrence of Chiari Malformation symptoms that is associated with a cyst in the spinal cord, and this requires the repetitive decompression of the posterior fossa. Epidemiology of Chiari Malformation Most cases of Chiari malformation are classified under Type 1 Chiari malformation. The occurrence rate of this malformation is 1 in 1,000 births. Females have a slightly higher occurrence rate compared to males. In most cases, the condition is present at birth. In some cases, it becomes predominant in later stages of life. Expected Prognosis of Chiari Malformation Surgical treatment causes a reduction in symptoms and provides stability for a longer period of time. In a few cases, more than one surgery may be performed due to the condition's progression. Natural Progression of Chiari Malformation Most cases of Chiari malformation might have worsening symptoms due to the blockage of cerebrospinal fluid and increased pressure. It can lead to CSF accumulation in the brain and may be fatal in severe cases. Pathophysiology of Chiari Malformation Type 1 Chiari malformation occurs due to the compression of the cerebellum, medulla, or upper spinal cord. Due to disordered anatomy, there may be a disruption in the flow of cerebrospinal fluid through the foramen magnum. Type 2 Chiari malformation is associated with the compression of the posterior brain, the stretching of the cranial nerves, and disorientation, due to fluid accumulation in brain tissue and its expansion.

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Dementia is a broad term to describe a range of conditions causing a decline in cognitive functions. It progressively deteriorates mental abilities like memory, comprehension, and judgement. This may lead to behavioural changes in the affected individual. Associated Anatomy of Dementia Neurons in the brain Alternate Name of Dementia Senility or cognitive disambiguation Types of Dementia There are five main types of dementia. Among them, Alzheimer’s disease (abnormal shrinkage of the brain, affecting its functions) and vascular dementia (brain damage due to strokes or injury) are the most common. Lewy body dementia occurs due to deposition of small proteins (known as Lewy bodies) on the neurons, which causes decline in mental abilities. Furthermore, neurodegeneration in the frontal and temporal lobes of the brain causes frontotemporal dementia. Another dementia is the mixed type, when the individual is affected by two conditions, usually Alzheimer’s and vascular dementia. Dementia Causes Brain disorders - Structural abnormalities in the brain can cause dementia. Degeneration of neurons - Damage to nerve cells leads to conditions like Parkinson’s disease and Huntington’s disease, which are related to dementia. Head injury - Traumatic brain injury is a leading cause of dementia. Other medical conditions - Infections in the thyroid, kidney, liver, heart or lungs, and vitamin deficiencies can generate dementia symptoms. Genetic factors - Certain gene mutations can induce dementia. Side effects of medications like anticholinergic, antidepressant, and antiepileptic drugs may trigger dementia. Dementia Symptoms Frequent episodes of forgetfulness Visual and spatial disorientation Communication issues Getting lost in familiar places Difficulty in performing daily tasks Losing track of time Struggling to recognise known faces Misplacing items General confusion Repeating same questions Personality changes Dementia Stages Stage 1: Normal behaviour - Changes in the brain start taking place unknowingly. Stage 2: Forgetfulness - It starts with simple misplacing of things. Stage 3: Mild decline - Frequent forgetful episodes start occurring. Stage 4: Moderate decline - The symptoms become more evident. Loss of cognitive functions become pronounced. Stage 5: Moderately severe decline - The individual can take care of his/her personal needs and recognise immediate family and friends. But, they need help with things like address, phone numbers, and other basic facts. Stage 6: Severe decline - The individual requires complete supervision. There are noticeable behavioural changes. Even through the confusion, they are able to recognise people closest to them. Stage 7: Very severe decline - The individual loses sense of understanding and requires full-time professional care. Many do not survive up to this stage. Dementia Diagnosis A physical examination is done, where the symptoms, family history and current medical conditions are assessed. Laboratory tests, CT scan and MRI scan are conducted to rule out similar conditions. A positron emission tomography is done to study brain activity. Mental ability tests and psychiatric evaluations are carried out. Differential Diagnosis of Dementia Accurate diagnosis of dementia is crucial since its symptoms mimic a number of conditions like Parkinson’s disease, meningitis, multiple sclerosis, hypothyroidism, spinocerebellar degeneration, delirium, and vitamin B-12 deficiency. Dementia Treatment Pharmacotherapy Medications like cholinesterase inhibitors, memantine, and anti-amyloids (Aducanumab) are common prescription drugs. Rehabilitative therapy A behaviour-specific and systemic approach (like memory training and breaking down routine tasks) is undertaken to teach coping mechanisms. Sociotherapy The environment is modified by reducing stimuli (clutter and noise), making it easy for the person to focus. Risk Factors of Dementia Age - Individuals above 65 years of age are at greater risk. Strokes and Tumors - Strokes and tumors increase the chances of dementia. Family history - Having family members with dementia automatically puts one at higher risk. Excessive alcohol consumption can induce brain damage. Prolonged stress leads to depression and anxiety, which are concerning factors. Inadequate physical activity may cause diabetes, obesity and hypertension, which increase the risks. Smoking - Toxins in cigarette smoke cause oxidative stress, which is linked to dementia. Air pollution - Environmental toxins are major risk factors. Possible Complications of Dementia Decreased life expectancy, inability to express or interact, and loss of self-care are initial complications associated with dementia. These may advance to chronic depression, delusions, aggressive behaviour, injuries, poor nutrition, and total dependency for life activities. Dementia Prevention Primary Prevention Mental stimulation - Keeping the brain engaged in cognitive leisure activities helps. Being socially active - This helps to reduce depression. Dietary considerations - Having a diet low in saturated fats, and rich in fruits and vegetables, is beneficial. Avoiding head injury - Using protective headgear can prevent potential accidents. Limiting smoking and alcohol - This reduces the risk factors. Preventing lifestyle diseases - Regular exercise and proper diet keeps one away from diabetes and hypertension, which are linked with dementia. Secondary Prevention Encouraging communication - Speaking clearly in short sentences, maintaining eye contact, giving them time to answer, are some effective communication strategies. Exercise - It promotes blood flow to the brain and stimulates neuron growth. Staying active - This helps to keep the brain active. Therapies - Aromatherapy, massage/art/pet/music therapies are highly recommended. Alternative remedies - Herbal products and acupuncture may be considered, but after discussing with the healthcare provider. Being expressive - Finding ways to express feelings through singing, writing, painting or speaking, is beneficial. Joining support groups - Occupational therapists provide effective guidance. Epidemiology of Dementia Age - Common in people over 65 years of age. Gender - More prevalent in females. Race - Frequency rates are higher in African-Americans and Hispanics. Prevalence - According to the WHO, around 55 million people worldwide have dementia, with 10 million new cases every year. In India, about 4 million people live with some form of dementia. Expected Prognosis of Dementia The median survival rate is 5-10 years. Recovery depends on age, gender, comorbidity status and cognitive function. According to the WHO, dementia is the seventh leading cause of mortality, and one of the major reasons of dependency in the older generation. Natural Progression of Dementia Dementia is a progressive disorder. With time, the symptoms aggravate and affect more areas of the brain. If left untreated, it can worsen behavioural issues and result in injuries. It can make the person more agitated and anxious. Medical intervention helps the individual to cope better. Pathophysiology of Dementia Most types of dementia are caused due to accumulation of proteins in the neurons. The cerebral cortex gets degenerated, and amyloid plaques are formed. In vascular dementia, ischemic injury (restricted blood flow) to the brain occurs, leading to neuron damage. Related Blogs Alzheimer's Disease Cause, Detection and Treatment Know Myths And Facts About Alzheimers Disease Parkinson’s Disease: Symptoms & How to Prevent It Women with Epilepsy: Lead a Normal Life with Proper Treatment Understanding Hip Fractures: What Are The Different Types Of Hip Fractures?

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Dystonia is a movement problem that entails uncontrolled motions, which may include contraction, spasms, repeated movements, and uncomfortable positions. As many as 250,000 individuals worldwide have dystonia, making it the third most common movement condition behind Parkinson's disorder. Regardless of age, race, or ethnicity, this is a problem that can happen to anyone, from little kids to adults. Associated Anatomy Muscles Alternate Name of Dystonia Spasmodic torticollis or Torticollis Types of Dystonia There are various sorts of dystonia, depending on which part of your body is impacted: Hemidystonia It impacts the leg and arm on one side of your body. Multifocal dystonia It affects at the very least two various parts of your body. Segmental dystonia It affects two or more parts of your body that are close or next to each other. Generalised dystonia It does not limit up to a single part as it may impact the muscle group throughout the body. Focal dystonia It affects one particular location of your body. Dystonia Causes Dystonia can result from genetic or ecological aspects. Here are some common causes of dystonia: Genetic modifications They may be present from birth and are often inherited. Different genetic aspects can affect the balance of chemicals in manners, bringing about different kinds of dystonia. Here are some other causes of dystonia: A lack of oxygen in the brain Brain haemorrhage Use of medicines such as antipsychotics, dopamine agonists, etc. Exposure to heavy metals or carbon monoxide gas An undeveloped brain growth Infections, such as encephalitis Stroke Distressing mind injury or spinal column injury Wilson's condition is a rare genetic disorder that causes copper to accumulate in vital organs like the liver and the brain. Dystonia Symptoms Signs and symptoms of dystonia can vary from mild to severe. Dystonia can affect various body parts, and often the signs and symptoms of dystonia progress via phases. Some early signs consist of: Dragging leg (a condition in which you are not able to raise the front part of your one or both feet) Cramping of the foot Uncontrollable blinking of the eyes Speech troubles Stress or fatigue Stage of Dystonia There may be two stages of the dystonia, which include: The minor stage The condition can impact one part of your body (focal dystonia), surrounding components (segmental dystonia), or all aspects of your body (primary dystonia). The muscle spasms can range from moderate to extreme. They may hurt, as well as can hinder your performance in day-to-day life. The advanced stage The advanced stage is marked by rapid and also spontaneous balanced activities, turning poses, contortions of the torso, impressive strides as well as eventually, taking care of postural defects. The condition is usually not related to pain, but it certainly might result in discomfort in influenced areas. Dystonia Diagnosis The most common movement disorders for dystonia are Conversion disorder, Tetanus, Focal seizure, Strychnine poisoning, Hypocalcemia, Meningitis, Stroke, joint dislocation, Orbital fracture, Clonus, tremors, Parkinson's disease, myoclonus, chorea, and tics. Typical Test of Dystonia To diagnose dystonia, your medical professional will begin with a case history and a health examination. To identify if underlying conditions are creating your signs and symptoms, your medical professional might suggest: Blood or urine examinations: These examinations can expose indications of toxins like Creatinine, uric acid, urea, or other conditions. MRI or CT scan: These imaging tests can identify abnormalities in your brain, such as abnormal growths, inflammation, or proof of a stroke. Electromyography (EMG): This test is performed to know the health of muscles and the nerve cell that controls them with the electrical task. Genetic testing: Some types of dystonia are connected with specific genetics. Knowing whether these genes are present can assist overview therapy. Dystonia Treatment Your physician may advise a mix of medicines, therapy, or surgical treatment to handle your contraction. Medications Injecting toxic substances (Botox, Dysport, others) right into specific muscular tissues could minimise or eliminate your muscle contractions and reduce your irregular posturing. Shots are given as typical doses every three to four months. Anti-tumour targets chemicals in your brain (neurotransmitters) that influence muscular tissue motion. Carbidopa-levodopa medicine can boost the degrees of the neurotransmitter dopamine. Trihexyphenidyl and benztropine (Cogentin) are two drugs that act upon natural chemicals apart from dopamine. Physical treatment Your doctor could recommend physical treatment, work-related treatment or both to relieve signs and symptoms and improve the feature. Speech therapy if dystonia influences your voice. Stretching or massage to reduce muscular tissue discomfort. In order to alleviate and improve the compensatory and damaging habits caused by dystonia, physiotherapy is necessary. Surgical treatment If your signs and symptoms are severe, your physician might suggest: Deep mind stimulation: It is a surgical procedure in which electrodes are operatively implanted right into a particular part of your brain and attached to a generator dental implanted in your upper body. The generator sends electrical pulses to your mind that might help regulate your contraction. The generator setups can be used to treat your particular problem. Selective denervation surgical procedure: It is a procedure, which includes cutting the nerves that control muscle spasms, and may be an alternative to treat some sorts of dystonia that have not been efficiently dealt with utilising other treatments. Risk Factor of Dystonia Scientists have not yet determined the specific source of dystonia. But particular aspects can put you in danger of the problem. These consist of: Family history (genetics). Injury to your brain or nervous system. Stroke Taking specific medications such as neuroleptics. Infections Poisoning such as from lead. Make very accurate hand motions, such as if you are a musician, musician, or designer. Complication of Dystonia Continuous muscle mass motion and also contractions can cause fatigue and exhaustion. Individuals additionally report that their signs intensify in demanding situations. Some people with dystonia might establish irreversible malformations if their muscle spasms lead to the constraint of their tendons. Tiredness: It is a term used to define a general sensation of exhaustion or absence of energy. Fatigue: The inability to reply to stimulations; severe fatigue. Dystonia Prevention Primary Prevention of Dystonia Primary dystonia is not preventable as it is acquired. However, the Segmental dystonia can be prevented by: Adopting a healthy way of living. Regular exercising of muscles. Secondary Prevention of Dystonia Dystonia has no prevention; however, you can do a variety of things to minimise its results: Sensory tricks to decrease spasms: Touching certain parts of your body might cause spasms to quit briefly. Heat or cold: Using warmth or cold can aid in alleviating muscle pain. Anxiety management: Depression and anxiety are two of the most common nonmotor issues dystonia patients experience. However, you may recommend discovering reliable coping abilities to take care of tension, such as deep breathing, social assistance, and positive self-talk. Epidemiology of Dystonia Across the globe, primary dystonia has varying prevalence rates, between 2 and 50 cases per million in early-onset and 30 to 7320 cases per million in late-onset. Expected Prognosis of Dystonia If dystonia begins in childhood, it is most likely that signs will undoubtedly spread to various other body locations. If dystonia starts in the adult years, it usually influences one place. It generally applies to an adjacent (alongside) location if spread. Natural Progression of Dystonia Usually, dystonia does not get worse or progress to various other areas. Added symptoms that have been reported consist of anxiety attacks, anxiousness, clinical depression, and obsessive-compulsive condition. The beginning is usually during the childhood or teenage years. Pathophysiology of Dystonia Dystonia is a diverse movement problem identified by spontaneous muscle mass co-contraction of the agonist and antagonist, which may trigger turning and recurring activities or abnormal positions. Dystonia is the least recognised motion condition connected with the basal ganglia disorder.

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Epilepsy is a common medical condition that affects certain areas of the brain and causes periodic seizures. A sudden change of electrical activities in the brain can lead to generalized and local seizures. Generalized seizures impact the entire brain, whereas local or partial seizures affect a single part of the brain. It can affect any person, irrespective of gender and age. The temporal lobes of the brain are usually associated with seizures. Epilepsy Causes In most epileptic cases, the clear cause of the seizures is unknown. However, some triggers are Family medical history: The affected parents are most likely to pass faulty genes to their children, leading to epilepsy. Brain damage within the womb or after birth: Brain damage or improper brain development in the womb can occur due to less oxygen, nutrients, and underlying medical complications in the mother during pregnancy. Head or brain trauma: An accident involving brain injury or trauma can trigger the chances of post-traumatic epilepsy. Brain conditions: Tumors, stroke, and Alzheimer's can alter brain activities. Infectious diseases: Infections like HIV/AIDS, meningitis, and encephalitis directly affect the brain. Substance abuse: Prolonged use of drugs and alcohol can affect brain activity. Epilepsy Symptoms The signs and symptoms of seizure episodes include: Temporary confusion Jerking movements of the body Loss of consciousness or awareness Body stiffening Breathing problems Rapid eye movement Continuous staring without blinking Collapsing Unresponsive to words and sounds Loss of bowel and bladder control Anxiety and depression Loss of sensation (sight, hear, and taste) Loss of cognitive ability and body coordination. Stages of Epilepsy Understanding the seizure stages might help you to assist someone in need. Stage 1 Stage 1 is called the "aura" phase. It is experienced just before the seizures. The person may have: Vision problems Dizziness Numbness in the body Headache Nausea Constant fear and panic Stage 2 Stage 2 is called the “Ictal” phase. The chemical changes in your body directly affect the neurons, which cause: Hallucinations Loss of motor control Body twitching and convulsions Loss of senses, etc. Last Stage The last stage is called the Postictal phase. The brain tries to recover after the epileptic episode. You may feel: Intense thirst Fatigue Headache Confusion Body weakness and pain Nausea, etc. Epilepsy Diagnosis Various blood tests and scans can diagnose epilepsy. However, the most commonly used method is the Electroencephalogram (EEG). The EEG involves attaching the electrodes to the scalp and recording the brain waves during simple performance tasks. Based on the result of the EEG, the neurologist will be able to diagnose the exact condition. Epilepsy Treatment The seizures can be controlled with timely medicines if diagnosed accurately. Some treatment options are: Medicines: The doctors may prescribe antiepileptic (antiseizure) drugs that help minimize the seizure episodes. Nerve stimulator: The device is sometimes called the "pacemaker of the brain" and sends mild electrical impulses to the brain via the vagus nerve. Brain surgery: The surgery can be successful in case of local seizures. The treatment works differently for different people. Therefore, it is best to take a medical opinion from a neurologist to discuss the medical treatment plan. Risk Factors of Epilepsy Some factors which increase your risk of suffering from epilepsy are: Age: Though age is not an accurate factor, most epileptic episodes can occur in early childhood or in elderly adults. Family medical history: If you have family members with epilepsy problems, you may be at high risk of suffering seizures. Head injuries: Take extra precautions while driving or riding vehicles. Always wear seat belts and helmets to protect your head from gruesome injuries in case of accidents. Stroke: Vascular concerns like a stroke can harm your brain internally. Maintain a healthy lifestyle by avoiding alcohol and smoking. Brain infections: Certain bacterial and viral infections can harm the brain and spinal cord tissues and increase the risk of epilepsy. Dementia: Dementia can increase the risk of seizures in older people. Possible Complication of Epilepsy The epileptic person is likely to suffer from dementia, migraine, heart and spinal cord issues, pulmonary edema, hyperthermia, speech problems, motor difficulties, and uncoordinated reflexes. They may also suffer from psychological conditions like mood swings, fear, anxiety, and depression. The seizures can last life-long if not appropriately treated. Prolonged seizures can lead to permanent brain damage. Epilepsy Prevention Primary Prevention Vaccination: Get vaccinated at a young age against certain infectious diseases. Since bacterial and viral infections have a chance of affecting your central nervous system, it is safe to be immunized and prevent the onset of serious illness. Keep clean: Wash your hands regularly before eating. Prepare your food in a hygienic environment to avoid health complications. Pregnancy care: Healthy mothers give birth to healthy babies. Ensure consulting your gynecologist for all the medicine courses and care during the pregnancy. Be safe: Prevent brain injuries by wearing helmets on the bike and seat belts while driving. Secondary Prevention If any patient had their first seizure, inform them to take extra precautions and care to avoid any future episodes. Medicines: Do not stop any medication without informing the doctor. Lifestyle changes: Maintain a healthy lifestyle and avoid eating junk, fast food, consuming alcohol and drugs. Regular exercise helps keep the mind and body active and healthy. Ketogenic diet: The doctor may recommend cutting down carbs in your diet and eating more fats and proteins. Healthy fats help in numerous metabolic functions of the brain. Epidemiology Epilepsy is a chronic brain disease that affects all ages and sexes, irrespective of ethnicity, worldwide. Epilepsy is slightly higher in the elderly age group due to neurodegenerative concerns, dementia, stroke, and tumor risk. local seizures are more common than generalized seizures in both adults and children. Expected Prognosis The possible outcome of the disease and the rate of its expected occurrence is called prognosis. For example, people who have first epileptic episodes are at a 70% higher risk of suffering from seizures in the future. However, the prognosis also depends on the type of seizure, the age group, genetic history, and comorbidities. Natural Progression Without timely diagnosis and treatment, epilepsy can progress into a worse condition. The person may experience worsened seizures, structural abnormalities, disturbed EEG patterns, cognitive and behavioral abilities. The social interactions might also be affected over time. Pathophysiology During seizures, the body tends to undergo various biochemical and physical changes. The serum glucose and cholesterol levels decrease drastically before the onset of seizures. The electrolyte balance is also severely disturbed. As a result, the patient tends to go under alkalosis. Epilepsy alters cell metabolism, ion concentration, and receptor functions. Physically, the person has body pain, feels exhausted, becomes weak, stressed, and confused. 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Essential tremor is a neurological (related to the nervous system) condition that causes movement disorder or involuntary rhythmic shaking. While essential tremors can affect different parts of the body, trembling occurs mostly in the hands. Essential tremor is not life-threatening, but it obstructs a person from doing daily chores like eating, drinking from a cup or glass, tying shoelaces, writing, dressing, and so on. Associated Anatomy of Essential Tremor Essential tremor generally affects the hands, arms, larynx (voice box), head, chin, and tongue. The lower parts of the body are rarely involved. Essential Tremor Causes Doctors and scientists have not found the exact cause of essential tremors. No genetic, environmental, or cellular condition has been linked to essential tremor. Essential Tremor Symptoms The signs and symptoms of essential tremor include: The tremors affect the hands first. Nodding or shaking head. Tremors that worsen with fatigue, emotional stress, extreme temperatures, or caffeine. Tremors that subside with resting. Problems in balancing (in rare cases.) Twitching eyelids and other parts of your face.  Shakier voice, caused by tremors in the voice box or the tongue. Tremors in the core, feet, and legs can disrupt your gait (your style of walking.) A few factors that can worsen your tremors temporarily Emotional stress. Hunger. Fatigue. Extreme temperatures (both hot and cold.) Caffeinated drinks. Smoking habits (cigarettes.) Essential Tremor Diagnosis In order to diagnose essential tremor the following tests must be prescribed: Neurological examination Your doctor will test the functioning of your nervous system by checking the following: Tendon reflexes Gait Muscle tone and strength Posture and coordination Ability to feel sensations Laboratory Tests Your urine and blood will be tested for the following factors: Thyroid disease. Drug side effects. Metabolic problems. Levels of the tremor causing chemicals. Performance Tests To determine the degree of tremor, your doctor might ask you to do the following activities: Write something. Drink from a cup and glass. Outstretch and hold your arms. Sketch spiral lines or figure. Essential Tremor Treatment If essential tremor leads to social problems and the symptoms lead to everyday crises, you can be treated with medications or surgery. Your options include: Medications Oral drugs can help in easing essential tremor symptoms. They include primidone (Mysoline), gabapentin (Neurontin), topiramate (Topamax), and propranolol (Hemangeol, Inderal, InnoPran XL). A few more drug options include clonazepam (Klonopin), benzodiazepines alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium). Apart from this, botox shots are effective treatments for head and vocal tremors. Adaptive Devices External adaptive devices like neuromodulation devices and tremor cancellation devices help in controlling the severity of tremors. Deep Brain Stimulation (DBS) Deep Brain Stimulation (DBS) is a surgical process wherein an electrode is implanted in the thalamus and is attached to a pacemaker-type device that rests under the skin of the chest. This device releases small, painless shocks that counter faulty electrical messages in the brain. Magnetic Resonance Imaging (MRI) guided focused ultrasound This high-intensity ultrasound uses MRI to focus ultrasound and further destroy tissues of the thalamus. This painless procedure does not require any drilling or cutting into the brain. Thalamotomy This surgical process is undertaken to destroy certain parts of the thalamus. The procedure is typically carried out on only one side of the brain. Biomechanical Loading Performed by carrying out external forces to a muscle or limb, biomechanical loading helps in controlling tremors. Risk Factors of Essential Tremor A few known risk factors include: Genetic Mutation: If your one parent has a genetic mutation for essential tremor, there are 50 percent chances that you will inherit the disorder. Age Essential Tremor: It affects people who are over 40 years. Possible Complications of Essential Tremor Essential tremor doesn’t put your life at risk, but as the symptoms will worsen over time, it will lead to difficulties like: A problem in holding a glass or cup without spilling the content. Failing to eat normally. Difficulty in applying makeup and shaving. Talking disability (if your tongue or voice box is affected). Trouble in writing legibly. Essential Tremor Prevention Primary Prevention Since the cause of essential tremor remains unknown, there are no fool-proof ways to prevent it. Secondary Prevention After being diagnosed with essential tremors one can lead a normal life. However, if your tremors are severe, certain adjustments and prevention can help you in staying safe: Opt for slip-on shoes. Use a hook to fasten buttons. Consider using straws to drink from glasses and cups. Switch to an electric razor and avoid a manual one. Epidemiology of Essential Tremor Essential tremor is common in adults, especially those who are 40 and older. Expected Prognosis of Essential Tremor Essential tremor is not life-threatening, but it can be difficult for the person in performing daily activities. Moreover, tremors cause embarrassment in social settings. Furthermore, the frequency of tremors might decrease with age but its severity might increase. Natural Progression of Essential Tremor The expected progression in essential tremors is building up more types of tremors with time, for instance, rest tremor, intention tremor, and head tremor. However, these features will not appear in every essential tremor patient-it will differ from patient to patient depending on the development of these features. Moreover, an untreated essential tremor can lead to other illnesses like movement disorders, Parkinson's disease, migraine headaches, and dementia (particularly Alzheimer’s disease). Related Blogs Parkinson’s Disease: Symptoms & How to Prevent It Robotic Surgery in Uterine Cancer: Advancements and Benefits Alzheimer's Disease Cause, Detection and Treatment Know Myths And Facts About Alzheimers Disease

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Fibromuscular dysplasia is a rare medical condition that involves abnormal cell growth inside the arteries. This leads to the arteries becoming narrower, decreasing blood flow to the rest of the body. Associated Anatomy of Fibromuscular Dysplasia Arteries in the kidney, brain, legs, arms, and abdomen. Fibromuscular Dysplasia Causes While the exact cause of fibromuscular dysplasia is unknown, studies suggest that the following factors may contribute to the development of the condition. Genetics - Studies suggest that 10% of fibromuscular dysplasia cases occur in family members. However, the individual may develop fibromuscular dysplasia in different arteries than their relatives. Hormones - Research suggests that premenopausal women are three to four times more likely to develop fibromuscular dysplasia than men. This suggests that sex hormones may play a role in this condition. More studies need to be conducted to confirm this. Abnormal arteries - Lack of oxygen and abnormal location of the arteries may increase one’s risk of developing the condition. Fibromuscular Dysplasia Symptoms Many individuals with fibromuscular dysplasia may not develop symptoms at all. However, when symptoms do develop, they depend on the location of the arteries. Symptoms of fibromuscular dysplasia in the renal arteries are: High blood pressure Irregular kidney functioning Shrinkage of the kidney Symptoms of fibromuscular dysplasia in the carotid (brain) arteries are: Neck pain Headache Dizziness Ringing in the ears Blurry vision Stroke Symptoms of fibromuscular dysplasia in the mesenteric (abdomen) arteries are: Abdominal pain Unexplained and rapid weight loss Symptoms of fibromuscular dysplasia in the arms and legs are: Pain while walking/running Numbness Change in colour of the affected limbs. Stage of Fibromuscular Dysplasia While there are no exact stages of fibromuscular dysplasia, watch out for the following signs that are indicative of the condition. Aneurysm or dissection in the affected arteries Headache, severe neck and abdominal pain Weakness in arms and legs Changes in vision, speech, and consciousness. Fibromuscular Dysplasia Diagnosis Your doctor will conduct a thorough vascular examination and take your medical history to understand your health better. For a definitive diagnosis, your doctor may ask you to go through one of the following imaging tests: Duplex Ultrasound This is a non-invasive imaging test where high-frequency waves are used to create detailed images of your arteries. Magnetic Resonance Angiography This test uses magnets and radio waves to create detailed images of the arteries and organs within your body. Learn more about the Angiography Procedure in Delhi and related cardiac care services. Fibromuscular Dysplasia Treatment Currently, there is no cure for fibromuscular dysplasia. However, one can opt for treatments that help manage symptoms and prevent further health complications. If you don’t need treatment currently, your doctor may recommend keeping an eye on your condition. You can opt for the following treatments. Medications Individuals with fibromuscular dysplasia and hypertension are given beta-blockers or angiotensin â…¡ receptor blockers to relax their blood vessels and block adrenaline. Percutaneous Transluminal Angioplasty This is a procedure where a catheter with a balloon is threaded into the narrowed artery to keep it wide open and increase blood flow. Risk Factors of Fibromuscular Dysplasia The following factors increase one’s likelihood of developing fibromuscular dysplasia. Age - Premenopausal women under 50 years are at a higher risk of developing it than men. Smoking - Studies suggest that people who smoke are more likely to develop it than non-smokers. Individuals who smoke and have already been diagnosed with this condition have a higher risk of developing high-risk medical conditions. Possible Complications of Fibromuscular Dysplasia An individual with fibromuscular dysplasia may develop a wide range of possible health complications. These include high blood pressure, tears in the arterial walls, and aneurysm (bulge). These can further lead to further arterial damage, heart disease, heart failure, or an increased risk of developing a mini-stroke or stroke. Fibromuscular Dysplasia Preventions Primary Prevention Since the exact cause behind fibromuscular dysplasia has not yet been determined, there are no foolproof strategies to prevent the condition. However, you can follow these tips to decrease your risk of developing the condition. Avoid or limit smoking or the use of tobacco. Eat a balanced and healthy diet. Engage in physical exercise regularly. Secondary Prevention Individuals diagnosed with fibromuscular dysplasia can follow these to reduce the risk of recurrence of the condition: Quit using tobacco products. Check your blood pressure daily. Take the medications as per your doctor’s instructions. Go for imaging tests and follow-up appointments annually to keep track of the condition. Epidemiology of Fibromuscular Dysplasia Currently, research studies suggest that: It is four times more common in premenopausal women than men. It is commonly diagnosed in young adults. The prevalence of fibromuscular dysplasia is common in renal arteries and carotid arteries. Expected Prognosis of Fibromuscular Dysplasia People diagnosed with fibromuscular dysplasia have a normal life expectancy and live well into their 80s and 90s. In rare cases, it may result in a stroke. Consult your doctor (Cardiologist) for the appropriate treatments that will help you manage your symptoms. Natural Progression of Fibromuscular Dysplasia Studies suggest that fibromuscular dysplasia of the renal arteries may lead to further narrowing of the renal arteries (severe stenosis) and complete blockage of blood flow to the kidneys (renal occlusion). Due to limited studies, it is difficult to estimate the rate and severity of the progression. Pathophysiology of Fibromuscular Dysplasia Fibromuscular dysplasia is a medical condition characterised by abnormal cell growth inside the arteries. While it is commonly seen in renal and carotid arteries, this condition can affect any artery in your body. Narrowing of the arteries may result in an aneurysm (bulging of the artery), haemorrhage, and thrombosis (blood clots).

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A hemangioblastoma is a benign (non-cancerous) tumor. It originates typically from the lining of the blood vessels, in the spinal cord and brain, and can also grow at the back of the tissue of the retina. Hemangioblastomas can be treated with surgery and radiation, and it does not affect the surrounding healthy tissue. However, hemangioblastomas may affect regions of the brain causing neurological symptoms. Associated Anatomy of Hemangioblastoma Spinal cord, brain, and retina. Alternate Name of Hemangioblastoma Hemangioma Hemangioblastoma Causes The cause of hemangioblastoma is mostly unknown. It is a rare disease. However, most of the cases are related to von Hippel-Lindau (VHL) syndrome. VHL is a genetic disease with the distinguishing feature of abnormal growth of tumors in different parts of the body. Hemangioblastoma Symptoms The symptoms depend on the location of the hemangioblastoma. If the tumor is located in the brain, it may cause Nausea Vomiting Headache Loss of balance and coordination If the tumor develops on the spinal cord, it may cause Constipation Incontinence Muscle weakness Numbness The symptoms develop gradually and the size and location of the tumor determine its persistence or disappearance. Hemangioblastoma Diagnosis and Tests Your healthcare provider will ask you about your symptoms, health, and family history. They will advise performing a few tests, such as: Computed tomography (CT) scan This technique produces cross-sectional images from multiple angles around the body, from which hemangioblastoma can be detected. Magnetic resonance imaging (MRI) A variant of the MRI method, called a functional MRI (fMRI), is used to produce images of blood flow in regions of the brain. Cerebral angiography A contrast dye is injected into the bloodstream, so that abnormalities in the blood vessels show up in the X-rays. Hemangioblastomas can often be differentiated from the more commonly occurring intramedullary tumors because of their location on the spinal cord surface as well as their more abundant blood supplies. Hemangioblastoma Treatment Surgery is considered the standard treatment for hemangioblastomas and usually cures this condition. Following surgery, individuals who have had a hemangioblastoma should continue to visit their physician regularly for physical examinations and magnetic resonance imaging (MRI) of the brain. Stereotactic radiosurgery is an alternative to surgical resection. It is a non-invasive procedure that uses highly focused beams of radiation to target the tumor. Risk Factors of Hemangioblastoma People suffering from von Hippel-Lindau disease (a genetic condition) are likely to develop multiple hemangioblastomas in addition to cysts, in all parts of the body, including the kidneys and other organs. Although hemangioblastomas may develop at any age, this type of tumor is typically found in adults around age 40. Possible Complications of Hemangioblastoma If hemangioblastoma is successfully treated, long-term complications are unlikely. The tumors are benign and may not need treatment. At times, if the tumor grows too large, they cause certain symptoms. People having VHL usually exhibit repeated growth of hemangioblastomas. It is responsible for 82% of deaths of people belonging to this group. Other complications of Hemangioblastoma include Cerebellar edema Swelling of the brain due to high pressure caused by hemangioblastoma. Intracranial cystic lesion Typically the constituent of a cystic brain lesion is cerebrospinal fluid. The fluid exerts pressure against the brain. However, cystic brain lesions can prohibit the flow of cerebrospinal fluid, causing this fluid to go into other areas of the brain. If it is not treated appropriately, it might cause neurological damage. Prevention of Hemangioblastoma The complete removal of the tumor can prevent the disease. After the removal of hemangioblastomas, you will need regular follow-ups with your healthcare provider (neurosurgeon). This will help you in the early treatment of hemangioblastomas if they grow back. Epidemiology of Hemangioblastoma This is a condition mostly in young and mature adults, and it has been found that the tumor is primarily intra-axial infratentorial in this category. Intracranial tumors affect around 1% to 2.5% and posterior fossa tumors affect close to 10%. The second most common location of hemangioblastomas is the spinal cord, the frequency ranges between 2%-3% of primary spinal cord neoplasms and 7%-11% of spinal cord tumors. Male to female ratios in adults is 2:1. At any age hemangioblastomas may develop, and the peak age of incidence is around 20 to 50 years of age, but earlier in patients with von Hippel-Lindau disease. However, it rarely affects children. One-quarter of the patients are associated with von Hippel-Lindau disease. Expected prognosis of Hemangioblastoma If successfully treated, complications are rare in the long term. Once the tumor is successfully removed through surgery, the symptoms stop existing. It indicates a successful long-term prognosis without neurological deficiency and recurrence. However, in patients with VHL (von Hippel-Lindau), even after the removal of hemangioblastomas, new lesions consisting of small multiple hemangioblastomas recur in remote areas and damage brain nerves. Get advice from your doctor on how to manage the disease to minimize its impact on the quality of life. Natural Progression of Hemangioblastoma Hemangioblastoma progressing from solid tumor to cyst with a mural nodule has been suggested in the literature. Typically, patients are presented with symptoms due to mass effect, most often from an enlarging peritumoral cyst. This progression may help in making clinical decisions concerning regular follow-ups and the timing of surgical intervention. Pathophysiology of Hemangioblastoma Hemangioblastomas grow attached to the pia mater Parenchyma of the cerebellum Brain stem Spinal cord Pathogenesis of Hemangioblastoma Although the pathogenesis of the disease is not clear, the VHL-associated hemangioblastomas are thought to be caused by a mutation in the VHL gene. In irregular hemangioblastomas, up to 50% have mutations or deletions in the VHL gene as well. Related Blogs Spinal Cord Tumour - Types, Symptoms, Diagnosis and Treatments

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It is a chronic, neuromuscular condition characterised by involuntary contractions of the facial muscles on one side (hemi). Although it is a relatively painless condition, it causes inconvenience to the affected person. Associated Anatomy of Hemifacial Spasm Facial muscles Alternate Name of Hemifacial Spasm Tic Convulsif or Involuntary Facial Twitching Additional Types of Hemifacial Spasm Hemifacial spasms can be classified as typical and atypical. Typical hemifacial spasms begin by twitching of the eyelids, gradually progressing to the cheeks and mouth. Atypical hemifacial spasms originate in the lower facial muscles and move upwards to the eyelids. Hemifacial Spasm Causes Compression of facial nerves - An artery presses upon the facial nerve (specifically the 7th cranial nerve), at the point where it connects to the brain stem. This sends out faulty signals to the brain, causing involuntary twitches. Nerve injury - A head injury may cause damage to the nervous tissue, leading to post-traumatic hemifacial spasms. Tumours - A benign tumour may put pressure on the facial nerve, leading to convulsions. Mental stress - Anxiety, fatigue and psychological strain act as triggers. Infections or strokes -Though rare, these may cause compression of the facial nerves, inducing spasms. Congenital factors - Being born with blood vessel clusters, adjacent to facial nerves, increases the chance of developing hemifacial spasms. Side effects of other conditions - The spasms may develop as a result of complications, in individuals having Bell’s palsy and multiple sclerosis. Idiopathic -In some cases, the exact causes are unknown and are attributed to spontaneity. Hemifacial Spasm Symptoms Continuous twitching of the eye muscles. Painless, involuntary convulsions on one side of the face. Ear discomfort, like ringing sensation or pain. Spasms slowly spread down the face, to the upper neck. Feeling of the mouth being pulled to one side. Stages of Hemifacial Spasm It starts with an involuntary quivering of the eyelids. It is followed by twitching of the ipsilateral (same side) facial muscles in the cheek and mouth region. The convulsions slowly progress to the upper neck. Very rarely, it affects both sides of the face, though not simultaneously. Hemifacial Spasm Diagnosis Accurate diagnosis of hemifacial spasm is important, as its symptoms mimic those of several other movement disorders, such as: Blepharospasm (affecting muscles controlling the eyelids) Oromandibular dystonia (affecting jaws, tongue and pharynx) Bell’s palsy (facial muscle paralysis) Hemimasticatory spasm (involuntary contractions of jaw muscles) Trigeminal neuralgia (painful sensations on one side of the face) Hemifacial Spasm Typical Tests The diagnosis is conducted based on clinical history and symptoms. The affected individual undergoes a thorough physical and neurological examination. Electromyography (EMG) is done in the initial stages, to rule out possibilities of similar conditions. This is followed by advanced imaging tests like magnetic resonance imaging (MRI) scans. If surgery is being considered, a magnetic resonance (MR) angiogram is done to determine the exact location of the blood vessel that is compressing the affected nerve. Hemifacial Spasm Treatment Muscle Relaxants Commonly called Botox, Botulinum toxin is an injectable muscle relaxant used to ease the affected muscles, and reduce the spasms. It is the most effective therapy for this condition. The injections need to be taken every three to six months. Oral Medication Anticonvulsant drugs such as carbamazepine, gabapentin, and baclofen are prescribed as the initial line of treatment. Surgery Microvascular decompression (MVD) surgery is considered the last resort. The blood vessel compressing the affected facial nerve is located by craniectomy (removing a piece of the skull). A tiny sponge or Teflon padding is inserted between the nerve and the vessel, preventing further compression. Risk Factors of Hemifacial Spasm Psychological strain: People under stress and anxiety are more likely to develop this condition. Lack of sleep and rest: Long spells of wakefulness and overworking without proper rest, are concerning factors. History of medical conditions: Individuals with a history of facial palsy and hormonal imbalance are susceptible. Hereditary: The genetic angle is under research, but there have been instances of familial connections. Possible Complications of Hemifacial Spasm The MVD surgery may cause complications like infections, breathlessness, paralysis, hearing problems, double vision, and difficulty in swallowing. The condition itself can develop into trigeminal neuralgia. If the associated tumours are left untreated, they may metastasize and lead to cancer. Hemifacial Spasm Prevention Primary Prevention Relief from strain: Avoid the triggers that may lead to stress and anxiety. Staying relaxed: Practice techniques of relaxation to prevent fatigue and calm the nerves. Managing the symptoms early: Timely diagnosis and management help in restricting the condition. Maintenance of fitness: Regular exercise releases endorphins or feel-good hormones, which serve to reduce stress. Secondary Prevention Medicines: Take the prescribed medications on time. Adequate rest: Take frequent breaks and avoid getting overworked. Dietary restrictions: Limit caffeine intake. Diet must-haves: Include vitamin D, magnesium, and antioxidants in your diet. Awareness: Educating oneself regarding the expected symptoms and related hazards is important. Alternative therapies: Massage and Acupuncture techniques are viable options. Joining a support group: It helps to deal with social and emotional issues. Epidemiology of Hemifacial Spasm Prevalence: Worldwide, it has an estimated prevalence of 14.5 per 100,000 women and 7.4 per 100,000 men. In India, it affects nine people per 100,000. Age: 40 to 80 years. Gender: More common in women. Ethnicity: More frequent in individuals of Asian origin. Side affected: Left side, predominantly. Expected Prognosis of Hemifacial Spasm In most cases, injection therapy is effective in warding off the symptoms. However, the treatment needs to be continued long-term. Some may require surgery. Around 85% of people recover well after treatment. Even though it is a chronic condition, it can be managed by regular medication, preventive measures and consistent follow-ups. Natural Progression of Hemifacial Spasm If left untreated, it may end up affecting more facial muscles, which may permanently pull the mouth to one side. It may even develop into painful contractions, as in the case of trigeminal neuralgia. Pathophysiology of Hemifacial Spasm Compression of the facial nerve by an aberrant blood vessel leads to ephaptic transmission (changes in the excitability of adjacent neurons by a specific neuron). It causes demyelination of the axons at the site of compression.

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Hydrocephalus is the accumulation of fluid in the deepest parts of the brain. As a result of the additional fluid, the ventricles expand and press on the nerve. It is composed of cerebrospinal fluid pumped to the brain and throughout the spine via ventricles. When the cerebrospinal fluid pressure becomes excessive in the skull, it can result in damage to the brain tissue and impairment of brain function. Individuals from any age group can develop hydrocephalus, but it is most commonly found in infants and those who are a little older. A hydrocephalus condition can be surgically treated in order to restore and maintain normal cerebral cerebrospinal fluid levels. It is sometimes necessary to combine multiple therapies to address hydrocephalus symptoms. Alternative names of Hydrocephalus Water on the brain, water baby syndrome Associated anatomy of Hydrocephalus An excessive quantity of cerebrospinal fluid (CSF) accumulates in the cerebral ventricles and subarachnoid regions. This causes Hydrocephalus. Types of Hydrocephalus There are three kinds of hydrocephalus: Congenital Hydrocephalus Congenital hydrocephalus refers to hydrocephalus that exists at the time of birth. Acquired Hydrocephalus Acquired hydrocephalus refers to hydrocephalus that develops after birth. Normal-Pressure Hydrocephalus Normal-pressure hydrocephalus refers to hydrocephalus that occurs in elderly adults. Hydrocephalus Causes The following are the three most common causes of hydrocephalus: A stumbling obstacle: Tumours, cysts, birth abnormalities, and other brain objects can obstruct or disrupt the natural flow of cerebrospinal fluid. Fluid absorption is poor: Inflammation, injuries, or infections such as bacterial meningitis can prevent brain structures from absorbing cerebrospinal fluid. There's much too much fluid: In rare situations, the body produces more cerebrospinal fluid than the brain can tolerate. Hydrocephalus Symptoms The symptoms of hydrocephalus might vary based on age. They include the following in infants: A head that is exceptionally huge and grows swiftly. A hard or bulging soft region on top of a baby's head. Downward-focused eyes (also known as "sunsetting of the eyes"). Irritability or craziness. Vomiting or malnutrition Seizures Muscle tone and strength issues Touch is less responsive. Growth has been slow. Hydrocephalus symptoms in toddlers and children Headaches Downward-focused eyes (also known as "sunsetting of the eyes") Hazy vision An exceptionally big head Sleepiness or a lack of energy Vomiting or nausea Inadequate balance or coordination Appetite loss Seizures Peeing often or losing bladder control irritability or a shift in mood Personality shift Having difficulty performing well in school Delays or issues with previously learned abilities, such as walking and communicating Hydrocephalus symptoms in people under the age of 60 Headaches Tiredness Inadequate balance or coordination Peeing often or losing bladder control Visionary shifts A lapse in memory or focus that causes issues at work Hydrocephalus symptoms in individuals aged 60 and above Peeing often or losing bladder control Memory lapses Problems with planning or processing abilities Walking difficulties or a lack of coordination Dementia General slowing of movements. Hydrocephalus Diagnosis and Tests Your doctor will begin by performing a physical examination and asking about your symptoms, after which they will recommend testing to check for indicators of hydrocephalus. The following tests may be performed: Muscle strength, reflexes, coordination, balance, vision, eye movement, hearing, mental functioning, and mood are all checked during a neurological exam. Ultrasound is a technique that employs sound waves to provide a picture of the inside of the body. Magnetic resonance imaging (MRI) is a scan that creates comprehensive pictures of your brain using strong magnets and radio waves. A computerised tomography (CT) scan is a collection of X-rays collected from various angles and stitched together to provide a more detailed image of your brain. When a doctor inserts a needle into the lower back to extract and test some of the fluid, this is known as a spinal tap. Intracranial pressure monitoring (ICP) is a procedure that involves inserting a tiny monitor into the brain to determine how much oedema is there. A fundoscopic exam examines the nerve behind the eye to determine if swelling is present. Hydrocephalus Treatment You may not require therapy if your symptoms are minor. If the symptoms are severe, your doctor will likely propose surgery to implant a flexible plastic tube called a shunt in your brain to transfer the cerebrospinal fluid to another region of your body, such as your abdomen. The shunt is usually not removed and must be checked on a regular basis to ensure that it is operating properly. Hydrocephalus can sometimes be managed without the use of a shunt. The endoscopic third ventriculostomy operation opens a conduit in your brain for the fluid to circulate freely. In contrast, the other procedure cuts off the region of your brain that produces cerebrospinal fluid. Therapy and education can benefit persons with hydrocephalus Occupational therapy is used to assist children and adults in developing life skills. Developmental therapy is used to assist youngsters in learning social behaviours. Learning difficult tasks requires special schooling. Mental health care or social workers are required for emotional support and to assist families in finding resources. Risk factors of Hydrocephalus The following factors increase the likelihood of developing hydrocephalus Premature birth: Infants born prematurely are more likely to suffer from intraventricular haemorrhage or bleeding within the ventricles of the brain, which can lead to hydrocephalus. Obstacles during pregnancy: A uterine infection during pregnancy raises the chance of hydrocephalus in the developing baby. Incomplete closure of the spinal column is one example of a foetal development problem. Other factors that raise risks include A spinal cord lesion or tumour. A brain infection of the neurological system, bleeding in the brain. Serious head injuries. Complications of Hydrocephalus Visual changes Dysfunction of the brain. Incontinence. The way you walk alters.

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Idiopathic dystonia is a neurological disorder that causes involuntary cervical muscle contractions that can lead to abnormal postures or slow repetitive movements. The movements of the patients diagnosed with idiopathic dystonia can be painful and the patients can also have tremors or other neurological symptoms. The muscle spasms can be painful and can interfere with daily activities. Idiopathic dystonia leads to severe motor impairment such as disabling. Idiopathic dystonia is observed among the majority of people diagnosed with dystonia. It is also called primary dystonia. Idiopathic Dystonia Causes The exact cause of idiopathic dystonia is not known, but it involves changes in several parts of the brain or communications. There is no identifiable cause of idiopathic dystonia. Many people diagnosed with dystonia fall in the idiopathic dystonia category. Some of the known causes of idiopathic dystonia are as follows: Stroke Birth injury Heredity Neurological diseases Side-effects of medications such as anti-nausea medications and others Idiopathic Dystonia Symptoms As idiopathic dystonia affects various parts of the body the symptoms of idiopathic dystonia are as follows: Foot cramp or one foot can turn or you need to drag Tremor The writing skills getting worsened Difficulty in speaking The neck may turn or pull involuntarily Eyes may blink uncontrollably or rapidly Spasms may also cause the eyes to close The initial symptoms of idiopathic dystonia can be mild and can be noticed only after prolonged stress, physical exertion, or fatigue. Idiopathic Dystonia Diagnosis The healthcare professional will first understand the medical history and then go for a physical examination. To further investigate the underlying conditions the doctor can prescribe the below-mentioned tests: Imaging tests Imaging tests such as MRIs and CT scans can identify the abnormalities in brains, such as lesions, evidence of stroke, and tumours Genetic testing These tests will help to identify the genes that have dystonia Blood and urine tests These tests can help to identify the toxins in the blood and urine of an individual Electromyography This test can measure the electrical activity in muscles Idiopathic Dystonia Diagnosis Treatment As the treatment of idiopathic dystonia involves management of the muscles, the doctor can prescribe a combination of treatments. Medications Botulinum toxin is injected into specific muscles that might help to reduce muscle contractions and also improve abnormal postures. In addition, other medications recommended for the brain that affects muscle movement are: Medications that help to reduce neurotransmission Medications that block dopamine Medications that can act on neurotransmitters Medications that can increase levels of the neurotransmitter dopamine Therapy Some of the therapies suggested by the doctor would include: Physical therapy Occupational therapy Speed therapy Massage Stretching to ease the muscle pain Surgery If the symptoms of idiopathic dystonia are severe, then the doctor can also recommend surgery: Deep brain stimulation In Deep brain stimulation surgery electrodes are implanted surgically into a part of the brain and are connected to an implanted generator. The generator then sends electrical pulses to the brain that helps to control muscle contractions Selective denervation surgery In this procedure the nerves that control muscle spasms are cut, this type of surgery helps to treat idiopathic dystonia when other therapies do not work. Risk Factors Associated with Idiopathic Dystonia Anyone can be at the risk of being diagnosed with idiopathic dystonia. All categories, age, race, and ethnic background people including men, women, and children are at risk of developing idiopathic dystonia. Patients who have symptoms under the age of 21 years are more likely to experience idiopathic dystonia in the whole body. Possible Complication of Idiopathic Dystonia The complications of idiopathic dystonia would depend on the severity of the disease. Some of the possible complications are physical disabilities, difficulty with vision, depression, pain and fatigue, difficulty with jaw movement, and others. The doctors can prescribe tests such as blood tests, MRIs, and others for the diagnosis of the disease. The healthcare professionals would opt for a combination of treatments that includes medication, therapy, and surgery recommended by the doctor depending on the severity of the disease. Living with idiopathic dystonia can be difficult and frustrating sometimes as a body might not always move as you would like. Thus, patients and their families might find it helpful to talk to a therapist or join a support group. Natural Progression Idiopathic dystonia is a movement disorder that can affect one of your body or all parts of the body. In this, the muscles contract involuntarily and cause twisting or repetitive movements. Currently, there is no cure for idiopathic dystonia; however, medications can help to improve the symptoms. Additionally, idiopathic dystonia can also be a cause or a symptom of other diseases such as Parkinson’s disease, Wilson’s disease, Huntington’s disease, a traumatic brain injury, and others. Early signs of idiopathic dystonia are often mild and occasional.

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Medulloblastoma is a type of paediatric brain tumour that is malignant. This tumour arises from the cerebellum, which is a part of the brain that is located towards the base of the skull. Associated Anatomy of Medulloblastoma Medulloblastoma occurs in the brain and primarily affects the cerebellum. Medulloblastoma Causes Individuals with cancer: Many children with cancer are most likely to develop medulloblastoma. Malignancies can occur in individuals with cancer that can further lead to medulloblastoma. In individuals who have cancer, malignancies may develop over a period of time due to the abnormal changes that may occur in the orientation as well as the structure of particular cells. Chromosomal abnormalities: In most cases, these chromosomal abnormalities are not inherited from parents or previous generations. The specific causes for these abnormalities are unknown. However, they are found in the genetic code of babies and are often attributed to cellular malignant transformation. Inherited Disorders: In rare scenarios, inherited disorders such as Gorlin Syndrome, Rubinstein-Taybi Syndrome, and Li Fraumeni Syndrome can develop medulloblastoma. Medulloblastoma Symptoms Some signs and symptoms of medulloblastoma include the following. Headaches - People with medulloblastoma may experience headaches, either focused or throughout their head. Nausea - Nausea is also a common sign of medulloblastoma. Vomiting - Typically, medulloblastoma can induce the occurrences of vomiting in individuals. Tiredness - People with medulloblastoma may often find themselves too tired to perform daily tasks. Double vision - Double vision is a more advanced symptom and could indicate medulloblastoma. Dizziness - Dizziness, among other reasons, can be an indication of medulloblastoma. Poor coordination - Having poor coordination such as unsteady walking can be a symptom of medulloblastoma. Medulloblastoma Stages There are 3 stages associated with medulloblastoma. Standard-risk tumour: In this stage, the medulloblastoma is not spread to other regions of the brain or the spinal cord. High-risk tumour: In this stage, the medulloblastoma is either spread up to 1.5 cubic centimetres or has spread to other parts of the brain and the spinal cord. Recurrent tumour: This stage is a recurrent stage that occurs after treatment. Medulloblastoma may reoccur in the spine, brain, or spinal fluid. Medulloblastoma Diagnosis Medulloblastoma can be diagnosed by a neurological exam that includes the testing of balance, vision, hearing, reflexes, and coordination. Another way to diagnose is using imaging tests such as MRI or CT scans. Tissue sampling, also known as biopsy, is also a good method of diagnosis. It involves collecting a sample of the tumour for further diagnosis and analysis. Removal of cerebrospinal fluid through a lumbar puncture can also be done to diagnose medulloblastoma. Medulloblastoma Treatment The possible treatments for medulloblastoma are the following. Radiation therapy - Radiation therapy such as X-rays, high-energy beams, or protons can be used by paediatric or adult radiation oncologist administrators to kill cancer or tumour caused due to medulloblastoma. Surgery to remove the medulloblastoma - The medulloblastoma tumour can itself be removed by surgery by not harming the surrounding tissue. However, in some cases, the tumour cannot be removed. Clinical trials - Clinical trials allow individuals to participate to understand the effectiveness of available procedures of treatments that are not yet in the market. Chemotherapy - Chemotherapy is when different drugs are used to kill the tumour cells. Usually, children and adults who have medulloblastoma are given these drugs intravenously. Surgery to relieve fluid buildup in the brain - Medulloblastoma can grow to block the flow of CSF in the brain and can thereby build pressure in the brain. Surgery can help relieve this pressure. Risk Factors for Medulloblastoma Age - Age is a risk factor that can increase the risk of medulloblastoma. Most often, medulloblastoma occurs during the first 8 years of life. Gender - Medulloblastoma occurs in equal proportions in both boys and girls. Genetics - Individuals with genetic conditions such as BRCA1 gene mutations, Nevoid Carcinoma, and Turcot Syndrome are more prone towards medulloblastoma. Complication of Medulloblastoma Some of the most common complications include worsening of the symptoms. If medulloblastoma is left untreated, it can lead to worsening of the symptoms and can also result in an increasing size of the tumour. Moreover, the tumour can also spread to other body parts if proper treatment is not provided. Medulloblastoma Preventions Primary Prevention of Medulloblastoma As this condition most often is found in the genetic code, preventing medulloblastoma is not the most plausible approach. However, the primary method of preventing the condition from progressing to a stage where management and treatment gets challenging is early diagnosis. By identifying the condition early on from development, both the treatment process and the management of medulloblastoma gets much easier. Secondary Prevention of Medulloblastoma The secondary means of prevention of further progression of medulloblastoma can be to run genetic tests for the condition with genetic tests. This can pave the way for early diagnosis and improve the outcome of the treatment or procedure associated with medulloblastoma. Epidemiology of Medulloblastoma Age - Mostly, medulloblastoma occurs in the first 8 years of a person’s life. So, children are more prone to this condition. Gender - Medulloblastoma affects both girls and boys in equal ratios. Expected Prognosis of Medulloblastoma With medulloblastoma, the tumours can grow over time and increase in size. Moreover, it is also possible for this tumour to spread to different regions of the body such as other parts of the brain, the spinal cord, and the spinal fluid as well. Natural Progression of Medulloblastoma If medulloblastoma is left undiagnosed or untreated, it can result in both the growth and the spread of the tumour. The condition can be challenging to manage in such cases, as the spread may increase, and other body parts may be impacted negatively. Pathophysiology of Medulloblastoma With the progression of medulloblastoma, you may notice changes in activity, energy levels, and other aspects of the body. It can also lead to weakening of the individuals, double vision, uncoordinated movement, and poor balance.

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Meningiomas are tumors that develop from the meninges or membranes surrounding the brain and spinal cord. They are not technically tumors, but can be categorized as such, because they shrink the size of the brain, vessels or nerves. A meningioma is a common type of brain tumor that grows slowly over time. So, the signs and symptoms might take a little longer to notice. Meningioma Causes The exact cause of meningioma is unknown. However, doctors believe that some alterations in the cells make them grow out of control and form a mass or tumor like other cancers. Cancers are mostly genetic, which means you inherit the gene mutation from your parents and are at risk of getting a specific cancer. Apart from genes, some risk factors of meningioma include: Exposure to radiation People with a genetic condition like neurofibromatosis type 2. Meningioma Symptoms Because of the slow growth of meningioma, symptoms occur over time. Most symptoms depend upon the location of the tumor. It includes: Vision changes Confusion Loss of hearing or smell Seizures Headaches, especially those that are worse in the morning Weakness in arms or legs Language difficulty Grades/Stages of Meningioma Primary central nervous system tumors are graded based on different factors. It includes the tumor’s location, size, genetic findings, the extent of spread, patient’s age, etc. Meningiomas are classified into three following grades: Grade 1 These tumors are the most common, low-grade tumors that grow slowly over time. Grade 2 These are mid-grade atypical meningiomas with higher chances of coming back after their removal. Grade 3 They are anaplastic meningiomas that grow at a fast pace. These tumors are mostly cancerous. Meningioma Diagnosis Diagnosis of a meningioma is often a difficult task. As the tumor grows slowly, its symptoms can be mistakenly associated with other health conditions. If your doctor suspects meningioma, he will recommend you to a neurologist. During the visit, he would do a thorough neurological exam along with tests like: CT Scan This takes cross-sectional images of your brain through a type of x-ray. MRI A radio wave is used to create images of the brain structure. Biopsy A part of the tumor is examined through biopsy to confirm a meningioma in other cases. Meningioma Treatment The meningioma treatment depends upon various factors like tumor’s location, size, growth rate, grade, etc. Moreover, patient age, overall health and treatment goals are also considered. At first, if a meningioma isn’t causing any symptoms, you might not need immediate treatment. You will have periodic scans to monitor the tumor’s growth in such cases. However, if the tumor is overgrowing, your doctor can suggest surgical removal of a tumor. For this, the doctors will first perform craniotomy (removing a bone part to expose the brain) and then remove the tumor as much as possible. In cases where a meningioma can’t be removed completely, the doctor will use radiation therapy to kill any remaining cancer cells. Risk Factors of Meningioma Radiation exposure: Radiation therapy, which mainly focuses on the head, can increase meningioma risk. Hormones: As meningiomas are common in women, doctors believe that hormones might play a significant role in developing meningiomas. Rare genetic condition: A rare inherited condition, neurofibromatosis 2, can also increase cancer risk. Obesity: There is no clear relationship between obesity and meningiomas. However, several studies suggest that a higher BMI can increase the risk of several cancers, including meningiomas. Complications of Meningioma Meningioma and its treatment can cause some complications like: Difficulty concentrating Weakness Personality changes Seizures Memory loss Sensory Changes Weakness Language difficulty Related Blogs Spinal Cord Tumour - Types, Symptoms, Diagnosis and Treatments

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A migraine is a severe headache that causes a pulsing sensation or extreme throbbing pain on one side of the head. Migraine is a complex neurological disease accompanied by symptoms like vomiting, nausea, and acute sensitivity to sound and light. Migraine attacks are intense enough to interfere with your daily chores and can confine you to bed for days. Associated Anatomy The brain. Types of Migraines Migraine Without Aura (Common Migraine) Migraine With Aura (Classic Migraine) Other types of migraines Chronic Migraine Menstrual Migraine Basilar Migraine Vestibular Migraine Abdominal Migraine Retinal (Ocular) Migraine Hemiplegic Migraine Silent (Acephalgic) Migraine Status Migrainosus Migraine Headache Causes Migraines seem to be related to genes and the brain, and their exact cause remains unknown. They can be genetically transferred. Currently, studies are of the opinion that migraines start when your trigeminal nerve is triggered, and receives signals from overactive nerve cells. This causes sensations in the face, and head, and gives your body cues to release certain chemicals like calcitonin gene-related peptide (CGRP) and serotonin. CGRP acts on the blood vessels on the lining of the brain to make them swell, and then, the neurotransmitters lead to pain and inflammation. Migraine Headache Symptoms Migraines can give you trouble for around four hours, and severe migraines can last much longer. As migraines attack in phases or stages, each phase has different signs and symptoms. Common Symptoms of Migraine Sensitivity to noise, light, and odors Upset stomach Abdominal pain Loss of appetite Nausea and vomiting Feeling tired Tender scalp Feeling cold (chills) or warm (sweating) Pale skin color Blurred vision Fever (rare) Diarrhea (rare) Prodrome Symptoms Irritability Depression Problems concentrating Difficulty reading and speaking Difficulty sleeping Fatigue Nausea Muscle stiffness Sensitivity to sound and light Food cravings Increased urination Aura Symptoms Speech changes Numbness and tingling Weakness on either side of the body Visual disturbances (one might see blurry spots, lines, or sparkles) Headache Symptoms Stiffness or neck pain Giddiness Anxiety Insomnia Nausea and vomiting Sensitivity to smell, light, and sound Nasal congestion Postdrome Symptoms Depression Mood swings (euphoric mood) Fatigue Inability to concentrate Lack of comprehension Stages of Migraine Migraines can typically progress through four stages or phases: prodrome, aura, attack, and post-drome. However, every person with migraines would not necessarily experience all the stages. 1. Prodrome (Pre-headache phase) A day or two before a migraine attack you can notice subtle changes in your behavior (mood swings, food cravings) and health (constipation, fluid retention, increased urination) which indicates an upcoming migraine attack. 2. Aura (Warning phase) Some people can visualize aura before or during migraines. This phase can include other disturbances (speech changes, numbness, and tingling) along with visualizing aura. The symptoms gradually build up within a few minutes of the start of migraines and can last up to an hour. 3. Headache (Attack phase) A migraine attack or acute headache generally begins as a mild ache and develops into throbbing pain. If you indulge in any physical activity, the pain might get worse. Furthermore, the pain can begin in the forehead, travel from one side of the head to another, or affect your entire head. While a migraine headache lasts for about 3 to 4 hours, the severe ones can last over three days. 4. Postdrome (Recovery phase) Post the attack phase, you might feel confused and drained. Sudden head movements can bring back a brief pain. Migraine  Headache Diagnosis Migraines are diagnosed based on factors like family history, medical history, symptoms, and neurological examination. If your migraine doctor observes any unusual or complex headache patterns, a few tests including Magnetic Resonance Imaging (MRI) Computerized Tomography (CT) Scan Scan may be recommended to rule out other illnesses. Both these tests will help doctors diagnose bleeding in the brain tumors, infections, strokes, and other brain and neurological conditions. Migraine  Headache Treatment Migraines cannot be cured completely. Therefore the migraine treatment has two main aims Stopping or reducing symptoms Preventing future attacks A few medications that are used to treat migraines include: 1. Pain Relievers Medicines Over-the-Counter (OTC) Pain Relievers: A few prescription medications or over-the-counter painkillers include paracetamol (acetaminophen) and ibuprofen, aspirin or naproxen. Other migraine relief pills with the combination of aspirin, caffeine, and acetaminophen work well in mild migraine attacks. Triptans: Prescription drugs such as rizatriptan (Maxalt-MLT, Maxalt) and sumatriptan (Tosymra, Imitrex) block the pain pathways to the brain and are used in the treatment of migraines. Administered in the form of shots, pills, and nasal sprays, they provide relief from the symptoms of migraines. However, these are not safe options for heart patients. Dihydroergotamine (D.H.E. 45, Migranal): Administered as an injection or a nasal spray, this drug is effective when taken when migraine symptoms are experienced. Lasmiditan (Reyvow): Lasmiditan is an oral pill that significantly improves headaches, but it can cause dizziness. Intranasal zavegepant (Zavzpret). Anti-nausea (Antiemetic) medicines: Metoclopramide, chlorpromazine, prochlorperazine (Compro), and metoclopramide (Reglan) can help combat migraine symptoms that are accompanied by vomiting and nausea. They are usually prescribed pain relievers. Opioid and barbiturate medications: These medications are highly addictive and are allowed only when no other treatments are working for a migraine patient. 2. Preventive Medicines Blood pressure-lowering medicines Antidepressants Antiseizure medicines Botox injections Atogepant (Qulipta) Rimegepant (Nurtec ODT) Calcitonin gene-related peptide (CGRP), monoclonal antagonists: Drugs from this class relieve migraine symptoms such as pain, nausea, and sensitivity to sound and light. 3. Neuromodulation devices These devices act on the trigeminal nerve and the vagus nerve to provide relief from migraines. 4. Alternative Treatment Care Alternative treatments like acupuncture, biofeedback therapy, cognitive behavioral therapy (CBT), magnesium or riboflavin supplements, meditation, yoga, or acupressure can be considered for relieving migraine symptoms. Risk Factors Associated with Migraine Factors that make you more prone to getting migraines are: Family History: If any of your family members suffer from migraines, then your chances of developing it increase. Age: Migraines can be experienced at any age, but in many cases, the first attack is experienced during adolescence. It peaks in the 30s and gradually subsides in the following decades. Sex: Women are three times more prone to migraines than men. Hormonal Changes: Migraine headaches among women can begin before or after the onset of their period cycles. The symptoms tend to change during pregnancy and improve after menopause. Migraine Prevention Since the exact cause of migraine attacks remain unknown, primary prevention is not possible. However, secondary preventive medication can reduce the intensity of migraines. A few options include: Blood pressure-lowering medications Antidepressants Anti-seizure drugs Botox injections CGRP monoclonal antibodies Possible Complications of Migraine Medication overuse remains the biggest complication in case of migraines. Drugs like acetaminophen, aspirin, and the ones with caffeine combinations come with a great risk of overuse. Epidemiology of Migraine Headache Migraines affect children, teenagers, and adults. In adults, the peak of migraines is observed in the 30s and it gradually lessens in the following decades. Women are more prone (three times more than men) to migraines. Expected Prognosis of Migraine Headache Migraines affect different people in different ways, therefore its management also varies from person to person. The best outcomes can be achieved by following your doctors’ advice, managing symptoms, avoiding personal migraine triggers, practicing preventive methods, and reporting any vital changes in normal patterns as they occur. Natural Progression of Migraine Headache An untreated migraine can lead to health ailments like panic disorders, depression, and anxiety. It could also lead to sensory problems like photophobia and cardiovascular diseases such as stroke, hypertension, and coronary heart diseases. Pathophysiology of Migraine Headache A migraine is a primary sensory processing disturbance that involves neurovascular headaches. During the attack or neural events, the blood vessels are dilated which results in further nerve activation and pain aggravation. Frequently Asked Questions 1. Is migraine a serious problem? Yes, migraine can be a serious problem due to its debilitating symptoms and impact on daily life. 2. Is migraine a lifetime disease? Migraine is a chronic condition, often lasting a lifetime, but its severity and frequency can vary. 3. Is migraine a mental illness? Migraine is not a mental illness; it's a neurological disorder characterised by severe headaches and other symptoms. 4. How long does a migraine last? Migraine duration varies, typically lasting a few hours to a couple of days. 5. Is a migraine painful? Yes, migraine is known for causing intense and painful headaches, often accompanied by other distressing symptoms. Related Blogs Migraine headache: Symptoms, Home Remedies, and Treatment Understanding Migraine Causes and Lifestyle Modifications for Prevention How to Handle Migraines at Home? Frequently Asked Questions about Migraine Headaches: Causes Diagnosis, and Treatments Headache Types: What You Need to Know Ways To Get Rid Of A Headache Quickly Top Reasons You Have a Headache Cluster Headaches - Causes, Symptoms and Treatment

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Neurofibromas are benign nerve tumours that grow on the outer layers of the nerves in the body. It consists of an overgrowth of nerve tissue along with blood vessels and other types of cells and fibres that grow on nerves in the skin, under the skin, or deeper in the body, including in the abdomen, chest, and spine. Associated Anatomy of Neurofibroma The brain, spinal cord, and nerve cells. Neurofibroma Causes The majority of neurofibromas are linked to a hereditary condition known as neurofibromatosis type 1. (NF1). It is brought on by a mutation or alteration in the NF1 gene. As a result, it inhibits cell proliferation, allowing cells to multiply and form tumours. If one parent has the NF1 genetic mutation, a child can inherit it. Solitary Neurofibromas can, nevertheless, develop in people who do not have NF. These are known as sporadic neurofibroma. Neurofibroma Symptoms Signs and symptoms of Neurofibroma include- Sensational changes (pain, numbness, tingling) Pea-sized bumps on or under the skin Changes in mobility Flat, light brown patches on the skin (clumsiness in the hands, trouble walking) Armpit freckles or groin area freckles Tiny lumps on the eye's iris Bone malformations Learning difficulty Disability for clarity Large head size Optic glioma Stages of Neurofibroma Localised Neurofibroma They show as rubbery bumps or lumps on or just beneath the skin, and their size and number might vary. It mainly affects people between the ages of 20 and 30, and it can increase and multiply as they get older. Diffuse Neurofibroma (DF) Diffuse Neurofibroma (DF) is a type of neurofibroma that develops on the head, trunk, and other regions of the body, they commonly appear as elevated, velvety to the touch, and hyperpigmented skin. Intramuscular Neurofibromas Intramuscular neurofibromas are painful tumours that form on tiny nerves in the muscles. Spinal Neurofibromas This type of tumour develops on the nerve roots or peripheral nerves that branch out from the spinal cord to the rest of the body. Plexiform Neurofibromas This type of neurofibroma damages the nerve plexus (a network of large and small nerves that serve a specific part of the body such as the head, face, sciatic nerve etc.). Neurofibromatosis (NF) The majority of neurofibromas are caused by a hereditary condition called neurofibromatosis type1 (NF1). It is divided into three types- neurofibromatosis 1 (NF1) which is usually diagnosed in childhood, neurofibromatosis 2 (NF2) and schwannomatosis are typically diagnosed in early adulthood. Neurofibroma Diagnosis There are specific tests which are often used for Neurofibroma diagnosis - MRI, CT scan, Electromyography, PET scan and biopsy. MRI (magnetic resonance imaging) and CT scan (computerised tomography) assist in determining the location of a tumour as well as identifying any adjacent tissues or organs. Electromyography is a type of electromyography that helps to measure electrical pathways in the nerves. PET scan (positron emission tomography) is done to see if it's cancerous or not. Biopsy is required to confirm the diagnosis and check for malignant alterations in the tumour. Neurofibroma Treatment At this time, there is no medication available that can shrink neurofibromas or make them disappear. The only option available currently to combat neurofibromas is surgical removal. There are a few methods to address this- Plastic surgery Your healthcare practitioner may advise you to have benign tumours on the surface or beneath your skin removed (plastic surgery). Surgery A neurofibroma that is causing discomfort or weakness, is growing rapidly, or is suspected of progressing into cancer is surgically removed- organs and tissues. Radiation Therapy This treatment includes delivering high doses of radiation to the target area while reducing exposure to healthy tissues nearby. Radiation therapy is required to diagnose a malignant plexiform neurofibroma. Combination Treatment This treatment combines surgery, radiation therapy, and chemotherapy. Risk Factors of Neurofibroma A family history of neurofibroma is the most significant risk factor for the disease. A person with NF1 has a nearly 7% probability of acquiring cancer over their lifetime. It normally begins off benign (noncancerous), then progresses to cancerous, develops rapidly, and occasionally spreads to other parts of the body. Complication of Neurofibroma Vision and hearing problems can develop if it presses on the nerves leading to the ears or eyes. It can also affect short-term memory, spatial awareness (thinking about objects in different spatially oriented ways), and coordination. Other complications that may appear are- short stature and larger-than-average head size, learning disability, difficulty in paying attention, or focus, problems with speech, hypertension, the curvature of the spine, breathing problems, hormonal changes, optic glioma or tumours on the eye nerves, occasionally causing vision problem, bulging of eyes etc. Neurofibroma Prevention Primary Prevention Neurofibroma is a disease that cannot be prevented. It can, however, be diagnosed through genetic testing to see if you have the gene. Talk to your doctor about genetic testing if you or your partner have neurofibromatosis, or if any of your family members have the disease. It's also a good idea to undergo gene counselling before conceiving if you're planning a pregnancy. Secondary Prevention Neurofibroma is a common genetic neurological disorder which cannot be prevented. But it can be treated and cured. If your neurofibroma is benign or non-cancerous, your doctor may recommend that you undergo regular check-ups to monitor or keep an eye on your symptoms. It is advised to have genetic counselling before planning a pregnancy if any of the parents have a family history of having Neurofibroma. Genetic testing is advised if you have any plans to conceive. This will help to predict the risk of disease. Carefully follow the surgeon's preventive advice and medication guidelines. Epidemiology of Neurofibroma It usually occurs during the second or third decades of life (20-30 years of age). Neurofibroma is either sporadic or a part of neurofibromatosis type 1. Around 90% of the solitary neurofibromas are sporadic or infrequent and 10% are inherited. The prevalence of inherited neurofibromas is about 1 in 3,000 individuals. Expected Prognosis of Neurofibroma If neurofibroma isn't too complicated or benign, persons with NF have a nearly normal life expectancy and can live full lives again. However, some unusual problems, such as malignancy, can occur in people who have NF1. People with NF1 are more likely to get this than people without the gene, but it is still uncommon. Natural Progression of Neurofibroma Over time, adults with NF1 will develop more neurofibromas. If left untreated, it has the potential to spread quickly. They may also alter shape or colour as they develop. When they are bumped, they might cause irritation or slight discomfort. Pathophysiology of Neurofibroma Neurofibromas develop from nerve sheath cells, and it is made up of Schwann cells, fibroblasts, perineurial cells, and mast cells. They develop along peripheral nerves, including the nerve root; on nerve course sites and at nerve endings. It develops due to mutation in the NF1 gene. The NF1 gene codes for neurofibromin, which is a protein that suppresses tumours by inhibiting the cells from growing or dividing too quickly or uncontrollably. When the NF1 gene mutates, it inhibits cell growth and paves the way for cells to multiply and become tumours. Related Blogs Spinal Cord Tumour - Types, Symptoms, Diagnosis and Treatments

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Parkinson's Disease (PD) is a disorder of the central nervous system (the brain). It occurs when nerve cells in the brain, which are responsible for the production of the neurotransmitter dopamine, begin to fail. Dopamine helps to regulate movement. As levels of dopamine are reduced, Parkinson's Disease affects movement, leading to shaking, stiffness, coordination, and difficulty with walking, talking, and balance. Parkinson's symptoms usually begin gradually and get worse over time. Associated Anatomy of Parkinson's Disease Nerve cells in the brain Parkinson's Disease Causes Genetics: Studies suggest that alterations or variations in specific genes may slightly increase the risk of Parkinson's Disease. Environment: Exposure to some toxins may increase the risk of later Parkinson's Disease, but again, the risk is small. Lewy Bodies: Lewy Bodies, which are present inside brain cells, can be markers of Parkinson's. These bodies contain clumps of alpha-synuclein protein. Cells cannot break these clumps down, which may increase the risk of PD. Parkinson's Disease Symptoms Tremor: This type of shaking or trembling, usually begins in the hand or fingers. Some people with Parkinson's may rub the thumb and forefinger back and forth continuously. Bradykinesia: In simple terms, it is slowed movement. It can make seemingly simple tasks difficult. Shorter steps or dragging feet when walking are signs of this. Muscle stiffness: Rigid muscles can be painful. This may also hinder the range of motion. Balance and posture affected: A stooped posture is one of the signs of Parkinson's. Some people exhibit imbalance. Loss of unconscious movements: Those with Parkinson's may exhibit problems in terms of smiling, blinking, or swinging arms when walking. Micrographia: Those with the disorder may find it hard to write. They may also notice that their writing appears smaller and more cramped. Non-motor symptoms: Many people with Parkinson's Disease experience fatigue, especially later in the day, and pain throughout their bodies. They may also exhibit slurred speech, cognitive difficulties such as with memory, sleep disorders such as insomnia, constipation and bladder problems, swallowing problems, mood disorders such as depression, and difficulties with sense of smell. Stages of Parkinson's Disease There are five stages of Parkinson's Disease: Stage 1: Symptoms are so mild they are often missed. A distinct symptom is that tremors are generally exclusive to one side of the body. Stage 2: Moderate form, where symptoms such as stiffness and tremors are more noticeable, on both sides of the body. Stage 3: Marks a turning point in the progression of the disease as one is likely to experience loss of balance and slowing of movements. Daily tasks are difficult at this stage. Stage 4: At this stage, although it's possible to stand without assistance, walking may require it. Stage 5: The most advanced stage, leg stiffness can make it almost impossible to stand or walk. People in this stage may require wheelchairs and round-the-clock assistance. Parkinson's Disease Diagnosis Unfortunately, there is no distinct test to detect Parkinson's Disease. Parkinsons disease (PD) doctors make a diagnosis typically through signs or symptoms exhibited, as well as by conducting neurological and physical tests and examinations. Parkinson's Disease Treatment There is no cure for Parkinson's Disease but lifestyle changes, exercises, and medications can help control symptoms. Here are some of the Parkinson's treatments prescribed for those with nervous disorders. Healthy eating, exercise, and physical therapy Aerobic exercise such as walking and swimming, physical therapy that focuses on balance and stretching are important. A balanced diet also provides nutrients, such as omega-3 fatty acids, that might be beneficial. Medications Medications that increase or substitute for dopamine (people with Parkinson's disease have low concentrations of this neurotransmitter) may help manage problems with tremor and movement. Medications usually prescribed include Carbidopa-levodopa Duopa (for patients with more advanced Parkinson's) Dopamine agonists (to activate dopamine receptors) MAO B inhibitors (to help prevent the breakdown of dopamine) Anticholinergics (to help control the tremor). Surgical procedures Deep brain stimulation (where surgeons implant electrodes into a specific part of the brain to reduce Parkinson's disease symptoms). Supportive therapies Alternative medicine, yoga, meditation, and massage can help ease some symptoms associated with Parkinson's disease, such as pain and fatigue. When performed in combination with treatments, it can help improve quality of life. Risk Factors of Parkinson's Disease Age: The risk for Parkinson's increases with age. Symptoms may begin to show as early as middle age. People usually develop Parkinson's Disease when they are over 60 years old. Heredity: If you have a close relative with Parkinson's disease, it may increase your risk of getting it. Gender: Women are less likely to develop Parkinson's Disease than are men. Toxins: Some studies indicate that long-term exposure to pesticides may increase the risk of Parkinson's. Possible Complications of Parkinson's Disease Possible complications of Parkinson's Disease include: Thinking, memory, and other cognitive difficulties as well as dementia Depression, anxiety, and other mood disorders Problems swallowing, chewing, and eating Sleep disorders such as insomnia or acting out dreams Constipation, because the digestive tract becomes slower Bladder problems such as difficulty urinating Parkinson's Disease Prevention Primary Prevention Although there is no preventive method for parkinson's disease, following a balanced diet of whole foods, fruits, and vegetables, and incorporating exercise into your lifestyle are recommended. Secondary Prevention Secondary prevention of parkinson's disease usually involves physical therapy and medications that increase or substitute for the neurotransmitter dopamine. Epidemiology of Parkinson's Disease Age: Usually those 60 years or above Gender: More men are affected than women Demographic: 1-2 per 1000 of the population at any time. Expected Prognosis of Parkinson's Disease Thanks to advances in treatment, most people with Parkinson's Disease have a normal or near-normal life expectancy. Natural Progression of Parkinson's Disease Symptoms and progression differ from one person to the next. It usually takes years to progress to a point where it has an impact on daily life. Pathophysiology of Parkinson's Disease Parkinson's Disease is associated with the loss of cells in the substantia nigra of the brain, which is the area responsible for dopamine production. Related Blogs How to Control Parkinsons Disease Progression Parkinson’s Disease: Symptoms & How to Prevent It Recent Developments in the Parkinson's Disease Treatment Parkinson’s Disease: Understanding the Key Causes and Risk Factors Insomnia Symptoms: Key Signs You Should Be Aware of

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Phantom limb refers to the persistence of the sensation that a limb is still present even after amputation. About 90% of patients undergoing amputation experience phantom limb after its removal. Alternate Names of Phantom Limb Semblance, Illusion, Amputated Limb Phantom Limb Causes The phenomenon of the phantom limb can occur due to: The amputation of a limb is followed by changes in the brain's cortex. It continues to receive signals from nerves used to supply the amputated limb. The damage to nerve ending during amputation also causes persistent pain and phantom limbs. The formation of scar tissue causes physical memory of the sensations in the limb, causing phantom limb. Phantom Limb Symptoms The most common sensation associated with a phantom limb is pain. But few patients experience different forms of sensations like: Tickling Numbness The feeling of cold and warmth Itching Tightness Cramps Shooting, stabbing pain The sensation of burning Crushing and throbbing pain The feel of pins and needles Vibrations in the amputated limb A feeling of electric shock Phantom Limb Diagnosis There is no specific test to diagnose the phantom limb and its pain. The physical examination and medical history related to amputation are used to analyse the condition. In addition, if the phantom limb is associated with pain sensation, the doctor will rule out other causes of pain, including infection and pain in the residual limb. Ultrasounds and blood tests are advised to rule out these causes. Phantom Limb Treatment In most cases, phantom limbs recover with time. But if the symptoms like pain are prolonged, the treatment modalities will be required. Multiple treatment options are available to treat symptoms associated with a phantom limb, as mentioned below: Antidepressants These medications can relieve the pain associated with a phantom limb. Antiseizure, antipsychotics, muscle relaxants and painkillers drugs can also help. Non-invasive therapies Therapies like acupuncture and mirror therapy also help to relieve symptoms associated with a phantom limb. Invasive treatments Some cases may require invasive therapies like spinal cord stimulation and deep brain stimulation. Transcutaneous electric nerve stimulation and transcranial magnetic stimulation are also beneficial. Brain Stimulation If other treatments do not help, surgical brain stimulation is used for stimulation of the motor cortex. Risk Factors of Phantom Limb Some risk factors that increase the chances of developing phantom limb include: Pain before amputation If the limb that has to be amputated has pain, the brain will retain the feeling of pain in the limb even after its removal. Residual pain in remaining limb If during amputation the nerves get damaged, the pain in the remaining limb increases the chances of the phantom limb with pain sensation If the amputation site develops a blood clot, the risk of phantom limb increases. Possible Complications of Phantom Limb The phantom limb is commonly associated with chronic pain sensation. This regular pain results in disturbed sleep related to patients waking up multiple times. The sleep disturbance further leads to worsening pain. An additional complication commonly associated with phantom pain includes depression. Due to impaired activities in the presence of chronic pain, patients experience anxiety and depression. Early detection and an appropriate treatment plan prevent pain progression and save an individual from associated complications. Phantom Limb Preventions Primary Prevention of Phantom Limb As the phantom limb carries on the sensations present in the limb before amputation, using an effective pain management technique can prevent pain in the phantom limb. Some studies have shown that regional anaesthesia before amputation can be a preventive measure. Epidural anaesthesia can be combined with calcitonin and ketamine to prevent postoperative pain in the phantom limb. Secondary Prevention of Phantom Limb Proper care of the stump and rehabilitation prevents the phantom limb. After treatment, multimodal pain helps prevent a phantom limb's reoccurrence. The use of gabapentinoids from the first day after surgery can be used as a preventive measure for phantom limbs. NSAIDs and paracetamol as analgesics are also preventive measures. Using a team approach with close integration of surgeon, physician, anesthesiologist, physiotherapist, and rehabilitation staff also helps post-amputation prevention of phantom limb and phantom pain. Epidemiology of Phantom Limb Phantom limb occurs in 80-90% of patients undergoing limb amputation. The phantom limb is more common in adults than in children. The occurrence rate increases with the patient's age undergoing amputation. The prevalence of phantom limbs does not differ specifically with gender, but the intensity of sensations associated with a phantom limb is more in females than males. There is no association between ethnicity and phantom limb prevalence. Expected Prognosis of Phantom Limb The chronic pain associated with the phantom limb can affect the day-to-day activities of amputees. But the combination of treatment with non-invasive and invasive treatment modalities can help recover from the phantom limb and pain associated with it. Natural Progression of Phantom Limb Usually, the phantom limb decreases with time and even disappears after a few months. As the healing of a wound after amputation takes 3-6 months, at the same time, the nervous system signals adjust to changes in the sensory input from the amputated limb leading to the disappearance of the phantom limb. Pathophysiology of Phantom Limb There are multiple theories to explain the pathophysiology of phantom pain. During amputation, the peripheral nerves of the limb get damaged and disrupt the input and output signals associated with an amputated limb. These changes lead to persistent sensation in the amputated part of the limb. Due to the restructuring of cortex receptors after amputation, the neighbouring sensory receptors in the cortex that supplies the remaining limb appear as sensations in the amputated limb. Frequently Asked Questions 1. Is phantom pain painful? Yes, phantom pain can be distressingly painful. It's the sensation of pain in a missing limb or body part that is often experienced post-amputation. 2. Is phantom limb a neurological disorder? Indeed, a phantom limb is linked to a neurological disorder. The brain continues to perceive sensations from the absent limb, causing phantom limb sensations. 3. What part of the brain is the phantom limb? The brain's somatosensory cortex is associated with phantom limbs. It still processes sensations from the missing limb, leading to phantom sensations. 4. How do you stop phantom pain? Managing phantom pain involves diverse approaches, including medication, nerve blocks, mirror therapy, and neuromodulation techniques. Consulting a healthcare professional and pain management doctor is recommended for tailored solutions. 5. Is phantom pain a disorder? Yes, phantom pain is considered a type of disorder. It's the perception of pain in a non-existent limb and often occurs after amputation or severe nerve damage.

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The spinal cord runs all the way down our back, encased in the spinal column or the vertebral column. To reach various parts of the body and transmit signals, the spinal cord branches off into nerve roots. Sometimes, the nerve roots can get damaged, squeezed, or pinched. The symptoms experienced due to this pinching are known as radiculitis. Associated Anatomy of Radiculitis The entire back Radiculitis Causes The tissues surrounding the nerve often change in size and shape, narrowing the space for the nerve to exit. Several factors are known to contribute to radiculitis. Some include: Age - related degeneration of the spine Spinal injury Herniated discs – Herniated discs when the discs are damaged or displaced and press on the nerves Bone spurs – extra growths of bone in the spine caused by osteoarthritis or other conditions Thickened spinal ligaments that cause compression of the nerves Growths in the spine (cancerous or non-cancerous) that press against nerve roots Lifestyle-related causes include poor posture, performing rigorous exercises or lifting heavy weights, and engaging in repetitive motions. Radiculitis Symptoms Since the nerve can be compressed at various segments of the spinal cord, the symptoms present differently. This is how they may appear: In the upper back – numbness or weakness on one side; pain in the arm, upper back pain, shoulder pain, or neck pain. In the mid-back – tingling sensation or numbness in the area; shooting pain or burning sensation around the abdomen or rib cage. In the lower back – sharp pain that shoots down towards the foot, weakness or numbness in the leg or foot, tingling feeling or numbness in the leg or back, hypersensitivity, sharp pain experienced while coughing or sitting. Radiculitis Diagnosis Doctors rely primarily on a physical examination and review of the symptoms to ascertain the location and level of pain in radiculitis. In addition, they may also prescribe the following: Electromyography – an electrical impulse test that helps test nerve function X-ray, MRI, CT scans to obtain radiological images of the spine. Radiculitis Treatment The treatment options for radiculitis vary depending on the location, severity, and presentation of the pain. Some of the alternatives include: Medication to manage symptoms and reduce inflammation Steroid injections to help relieve pain and reduce inflammation Physical therapy to help retard nerve damage and strengthen muscles Weight loss or management intervention to reduce the impact on the affected area of the back Application of heat or ice pack for immediate pain relief Cervical collar or back brace for additional support and relief from strain to the impacted area Surgery is sometimes recommended to help alleviate pain. This may include removing some or all parts of the impacting vertebra or slip disc. Risk Factors of Radiculitis Several factors place an individual at risk for radiculitis. Some of them may include: Genetic predisposition to radiculitis or degenerative bone diseases Advancing age Poor posture Repetitive motion Improper exercising or lifting movement Overweight Complications of Radiculitis In extreme cases, it is possible that the individual experiences a loss of bladder and bowel control. The pain may also cause other regions of the back and limbs to feel pained or sore. Radiculitis Preventions Primary Prevention of Radiculitis Some measures can help prevent pain from nerve compression. They are: Exercising to develop better core stability and strength Maintaining optimal weight Lifting weights carefully with a proper posture Avoiding sitting in one place and one posture for too long Ensuring the right posture while sitting or driving Regular movement A proper exercise routine that includes proper weight-training Avoiding tilting the head when talking on the phone, or holding the phone to the ear with the support of the shoulder Secondary Prevention of Radiculitis To help manage the condition and minimise frequent bouts of pain, your doctor may suggest that you undertake a supervised exercise programme and shed any extra weight. Epidemiology of Radiculitis Radiculitis has been found in 3 to 5% of the patient population. Of this, the percentage of individuals presenting with lower back pain lies between 12 to 40%. The prevalence is higher among females, whites, and those who smoke. The most common age group affected is between 40 to 50. The occurrence of pain in the lower back is more common than pain in the upper back and neck regions. Prognosis of Radiculitis Most individuals manage their pain effectively with conservative forms of treatment. By maintaining weight and optimal exercise, it is possible to enjoy a relatively pain-free experience. Natural Progression of Radiculitis Radiculitis usually starts with a pain that radiates from the spine into other parts. In the initial stages, the pain feels mild and more like numbness. There may also be a tingling sensation. If untreated, the severity of the pain is most likely to increase. There is a possibility of nerve damage from the untreated condition. In this case, the skin starts to become highly sensitive to touch. Muscles may also start to weaken at this stage. If it is allowed to progress, eventual muscular or nerve death is possible. Pathophysiology of Radiculitis Most individuals with radiculitis would show weakness in the back and affected areas. Pain is among the most commonly experienced symptoms. The pain is often described as the sensation of shooting pain or an electrical shock that originates at the buttocks and moves down towards the foot. Abnormalities in the gait are another observable sign of the condition.

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Spasmodic torticollis or cervical dystonia is a rare and painful state where your muscles in the neck get contracted on their own. This causes the head to turn on one side. The spasmodic torticollis may also result in your head getting tilted uncontrollable either forward or backward. Spasmodic torticollis is a very rare disorder. This can happen at any age but is mostly seen in middle-aged persons. The women folk are relatively more prone to this condition than men. The symptoms begin slowly and gradually increase to a point of no return. There is no medicine for spasmodic torticollis. At best botulinum toxin may be injected to somewhat control the signs and symptoms of spasmodic torticollis. Spasmodic torticollis is an extremely painful condition because of the unnatural position of your head. This may have ramifications in your social life and affect your employment as well. The causes of spasmodic torticollis are unknown, however, some genetic factors cannot be ruled out. Associated Anatomy of Spasmodic Torticollis Spasmodic torticollis or cervical dystonia is a neurological disorder which originates from the brain. The affected muscles come from the accessory nerve called Cranial Nerve XI. However, the 2nd, 3rd and 4th cervical nerves are also affected by spasmodic torticollis. Torticollis is a condition of horizontal turning of the head. While doing so, ipsilateral splenius and contralateral sternocleidomastoid muscles are used. These are located in the chin to shoulder area of the body. Spasmodic Torticollis Symptoms Spasmodic torticollis causes the head to twist and turn abnormally. The contraction of the nerve causes the head to twist in different directions. Some of the signs and symptoms of spasmodic torticollis are as under: Torticollis - This is the most common posture noticed in a person affected by spasmodic torticollis. In this condition, the chin is twisted towards either of the shoulders, and the head starts rotating sideways. Anterocollis - In this condition, the head tends to tilt forward. Retrocollis - This is a condition where the head tilts backwards. Laterocollis - A person with this condition will find the head to tilt towards one side. Anterior Sagittal Shift - In this condition the headrests on the shoulder and bend forward. Posterior Sagittal Shift - This is a situation, where the head bends backwards while resting on the shoulder. Other symptoms that can be associated with spasmodic torticollis are trembling hands. The symptoms may get worse with stress. It has been noticed that symptoms have improved with some sensory tricks like touching the cheek of the patient. A very small segment of people may also experience spontaneous remission of spasmodic torticollis. But these are temporary reliefs and eventually, recurrence of the disease is noticed. Less than 1 percent of the affected people are lucky to get permanent remission of spasmodic torticollis. The person having spasmodic torticollis experiences some secondary problems as well. The common secondary problems are spine arthritis, nerve roots getting compressed, and narrowing of the spinal cord around the neck region. The patient feels severe muscular pain in the region where the head is turned or twisted. Spasmodic Torticollis Causes There are no identifiable causes that may lead to spasmodic torticollis in a person. However, there may be some other underlying cause leading to spasmodic torticollis and hence, may be considered a consequential disorder. Some of such causes as under: Genetic susceptibility Approximately 10-25% of the patients having this condition have a similar family history. Gene mutation Mutations in genes like GNAL, THAP1, CIZ1, and ANO3 may lead to spasmodic torticollis. Congenital infantile torticollis This is an inherent disorder where the baby is born with a short neck muscle which eventually leads to spasmodic torticollis. Doctors are also of the opinion that spasmodic tortillas may occur in a person as a result of the use of certain drugs such as antipsychotics or anti-nausea medicines. Spasmodic Torticollis Diagnosis As a standard practice to carry out diagnosis clinical examinations are carried out by the medical practitioners. Apart from the clinical examinations, doctors obtain detailed case histories and ascertain the signs of spasmodic torticollis and the stage at which the disease has reached. There are no specific laboratory tests associated with spasmodic torticollis. However, some of the tests are carried out, are: Magnetic Resonance Imaging (MRI) of the brain. MRI of the neck. Electromyography – this is done in case there are palpable signs of nerve irritation. Spasmodic Torticollis Treatment The treatment of spasmodic torticollis is mainly symptomatic and is planned around easing the pain and agony of the affected person. Some of the standard treatments of spasmodic torticollis include: Botulinum Toxin Injections It is a very common symptomatic treatment of spasmodic torticollis. The botulinum toxin prevents the affected nerve from releasing acetylcholine, thereby muscle does not contract to cause the head to tilt. The effects of the injection typically start taking place after 2-3 days. The best effects are found after 4 weeks of injection. The patient who has undergone this treatment may expect relief of 2-6 months. Oral Medication Among the medications that are given orally to a patient suffering from cervical dystonia or spasmodic torticollis, dopaminergic agents like levodopa are used. Apart from this, anticholinergic medicines like benztropine, baclofen, clonazepam and trihexyphenidyl are frequently used to treat spasmodic torticollis.The usual side effects of medication are memory loss and sedation. The side effects start occurring even at the initial stage of medication. Deep Brain Stimulation Surgery Deep Brain Stimulation Surgery operation entails the placement of electrodes in the brain area and electronic pulses are sent to the brain. Risk Factors of Spasmodic Torticollis Women are twice as likely to be at risk of spasmodic torticollis than men. This disease often occurs in office settings. Spasmodic torticollis occurs mostly in people between 40 and 60 years of age. There is no ethnicity attached with this ailment.

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The trigeminal nerve is located in the head. It is one of the largest nerves in the head. It is one of 12 nerves connected to the brain. The trigeminal nerve connects our eyes, face, mouth, and forehead to the brain thus controlling its movement and activity. Trigeminal neuralgia is a condition when the trigeminal nerve is damaged due to an accident or the blood vessel pressing against the trigeminal nerve. The protective coating of nerves by myelin sheath undergoes damage upon the pressing by blood vessels resulting in trigeminal neuralgia. Trigeminal neuralgia (TN) is felt as a sudden but intensive pain in the cheeks or the jaws on one side of the face. The intensity of the pain is very difficult to manage. Taking treatment can help recover from the pain and reduce the onset of trigeminal neuralgia again. Generally, women are more prone to get Trigeminal neuralgia than men. Trigeminal neuralgia is more common and can even develop in kids. Associated Anatomy of Trigeminal Neuralgia The trigeminal neuralgia affects the trigeminal nerve connecting the head to the brain in the body. It affects the eyes, face, forehead and mouth (jaws and gums). Alternate Name of Trigeminal neuralgia The other names for Trigeminal neuralgia douloureux. Trigeminal Neuralgia Causes and Risk Factors Trigeminal neuralgia results in pain developing in one side of the face but spreading throughout. In rare cases, it gets developed on both sides of the face if the patient has multiple sclerosis. TN can develop pain in the lower, upper jaws, lips and gums, cheeks, nose, sides of the face, eyes and forehead. The TN caused pain is also called a shock attack or stabbing attack which can be due to any of the following reasons: Washing the face Shaving Nose blowing or cleaning Touching the skin Smiling Drinking cold or hot drinks Facing strong wind or breeze Brushing the teeth Doing makeup Although the correct reason for Trigeminal neuralgia is not known, in most cases, Trigeminal neuralgia is caused by one or a combination of the following factors: Injury: The main reason for Trigeminal neuralgia is an injury to the trigeminal nerve. This can occur due to an accident, oral surgery, or trauma. Disease: Disease like Multiple sclerosis can cause Trigeminal neuralgia. Less common Factors: There are a few other factors which are less common and can be a cause of Trigeminal neuralgia can be the pressure on the nerve due to the formation of a tumorous cell, cysts or arteries. Trigeminal Neuralgia Symptoms Trigeminal neuralgia has pain as the major symptom. The pain can form either of the following patterns: Sudden but shooting and intensive pain Pain attacks while chewing, talking, brushing or touching the face Pain attacks ranging from a few seconds or more Spasm or cramp in the facial muscle Recurrent pain attacks lasting for a longer time from weeks to months Pain develops on one side of the face and spreads all over the face. Pain attacks while sleeping. Types of Trigeminal Neuralgia TN1 or Type 1 Trigeminal Neuralgia This develops more intense pain that is burning and sharp around the lips, nose, forehead, eyes and scalp. The pain spreads and lasts for a longer time. TN2 or Type 2 Trigeminal Neuralgia Pain caused by TN2 type of trigeminal neuralgia is less intensive but occurs as a constant pain around the lips, nose, forehead, eyes and scalp resulting in aching and burning pain. Trigeminal Neuralgia Diagnosis The symptoms of TN are very similar to the other facial disorders. There are no separate diagnosing tests for detecting TN. Thus, diagnosing can be a little challenging. In case of pain in the jaws, gums, nose, forehead, scalp, and lips, after any oral/ facial surgery, it is necessary to consult a doctor to understand the root cause of the problem. He will examine you neurologically and may refer you to a neurologist and neurosurgeon specialist. Magnetic Resonance Imaging (MRI scan) can help detect the tumour or Multiple sclerosis pressing against the trigeminal nerve. The degree of compression is calculated with recent advancements in scanning methods. The doctor will treat you based on the history, symptoms and clinical evaluation. Trigeminal Neuralgia Treatment The treatment for Trigeminal neuralgia usually depends on the patient’s overall health condition, and clinical history but it also includes factors such as age, area affected, cause of the Trigeminal neuralgia, and severity of Trigeminal neuralgia. Some common Trigeminal Neuralgia treatment options include: Medications like carbamazepine, gabapentin, clonazepam, valproic acid, baclofen. Botox injection results are not satisfactory. In the advanced stage of Trigeminal neuralgia, surgery is recommended. Surgery aims to either remove the damaged trigeminal nerve (microvascular decompression) or destroy it (brain stereotactic radiosurgery) using injection (Glycerol injection) or passing electricity. But, the procedure has the risk of making the face numb for the rest of its life. Complications of Trigeminal Neuralgia Advanced Trigeminal neuralgia has possible complications resulting in severe damage to the trigeminal nerve causing intense pain spreading throughout the face and may affect the movement of the eyes, nose, mouth, and cheeks. Trigeminal Neuralgia Preventions Trigeminal neuralgia can't be prevented but the risk can be reduced by the following measures: Avoid having hot or cold drinks. Eat foods at room temperature. Avoid washing your face with cold or hot water directly. Instead, use cotton Wash your mouth with lukewarm water after eating instead of brushing. Avoid the cold breeze. Avoid touching your face often. Epidemiology of Trigeminal Neuralgia The estimated incidence of Trigeminal neuralgia is high in women compared to men. Expected Prognosis of Trigeminal Neuralgia Fortunately, recent advancements in diagnostic procedures, treatment options, and medication have drastically reduced the number of new cases of Trigeminal neuralgia and its associated complications. Natural Progression of Trigeminal Neuralgia Trigeminal neuralgia doesn’t spread to other organs of the body. With time Trigeminal neuralgia of the affected site causes severe pain. The patient has to get medical treatment else it can affect the movement of the face and head. Pathophysiology of Trigeminal Neuralgia Trigeminal neuralgia causes severe, shock-like and sudden pain in the eyes, forehead, mouth, jaws, gums, lips, and nose due to damage to the trigeminal nerve spreading the pain all over the face. Frequently Asked Questions 1. Is trigeminal neuralgia lifelong? Yes, trigeminal neuralgia is usually a lifelong condition characterised by recurring severe facial pain. 2. How serious is trigeminal neuralgia? Trigeminal neuralgia is a highly painful disorder, often considered debilitating due to intense facial pain episodes. 3. What age does trigeminal neuralgia start? Trigeminal neuralgia can begin at any age, but it commonly starts after 50, affecting both young and older individuals. 4. Is neuralgia curable or not? While there is no definitive cure for neuralgia, various treatments aim to manage symptoms effectively and improve the patient's quality of life. 5. Is neuralgia caused by stress? Stress can exacerbate neuralgia symptoms, but it is not the primary cause; factors like nerve compression or irritation usually trigger neuralgia. Related Blogs Tomotherapy - What to Expect?

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Tuberous Sclerosis is a rare genetic multisystem disorder that manifests as benign or non-cancerous tumours, which may develop in different parts of the body. The disease appears shortly after birth; however, it may not lead to any obvious harm immediately. Associated Anatomy of Tuberous Sclerosis The tumour in tuberous sclerosis may impact the eyes, skin, brain, lungs, kidneys, and heart. However, it is not limited to these body parts only. Tuberous Sclerosis Causes Any mutation in the TSC1 or TSC2 genes (responsible for controlling hamartin and tuberin, respectively) can cause Tuberous Sclerosis. These genes together help to regulate the size, division, and growth of cells. Tuberous Sclerosis Symptoms The symptoms of tuberous sclerosis can vary from case to case. The most common symptoms include: The appearance of light-coloured skin patches, small and harmless thickening of the skin, or reddish bumps under or around the nails. Acne like growth in the face in early childhood is also common. Cognitive disabilities and developmental delays can also occur as a symptom of tuberous sclerosis. Mental health disorders, such as ADHD and autism spectrum disorder, can also be associated with this condition. Tumour growth in the brain may even lead to seizures as the first symptoms among children. Heart issues, such as abnormal growth in the heart, may be a symptom of tuberous sclerosis. Herein, growths in the heart are largest at birth and shrink over time. Behavioural problems may include self-injury, aggression, hyperactivity, and problems with emotional or social adjustment. Non-cancerous growths in the kidney can also be a symptom of this condition. Growths may develop in the lungs, causing shortness of breath or coughing during exercise or physical activity. Growths may develop in the eye in the form of white patches on the retina. They may not necessarily interfere with vision. Tuberous Sclerosis Diagnosis Depending on the symptoms, several tests may be conducted to diagnose the condition. These could include evaluation of seizures with the electroencephalogram, Magnetic Resonance Imaging (MRI), Computerised Tomography (CT) scan, and ultrasound for the evaluation of kidneys, lungs, and liver. Echocardiogram or Electrocardiogram testing could also be done for heart evaluation. Examination of the eye, routine developmental screening, and genetic screening are also used as diagnostic tools. Tuberous Sclerosis Treatment While there is no cure for tuberous sclerosis treatment that can help manage the symptoms. In terms of medications, anti-seizure medications may be used to manage seizures. Drugs can also be prescribed for behaviour problems, heart arrhythmias, acne-like skin growths, and certain types of growths in the brain and kidney which cannot be surgically removed. Surgery may be done to remove certain growths affecting the function of an organ, such as the heart or kidney. Surgeries can also help control seizures caused by growths in the brain (if they do not respond to medication). Laser treatment can be done to improve the appearance of skin growths. Early intervention therapy, including physical, occupational, or speech therapy, can help special needs children with tuberous sclerosis. Children can learn to manage their day-to-day activities. Behaviour and psychiatric management can help children adjust to conditions and address social, behavioural, or emotional issues. Risk Factors of Tuberous Sclerosis The following factors may increase the risk of contracting tuberous sclerosis: Inheritance: The status of a copy of the genes has a 50% chance to be passed on in pregnancy from the autosomal dominance in either the mother or the father. Random error in cell division: The two genes (TSC1 or the TSC2) act as tumour suppressors, and new mutations in either can cause the disease. Possible Complications of Tuberous Sclerosis The manifestation of the condition in multiple organs may increase the complications related to the disease. In newborns, Cardiac rhabdomyoma (or tumour in the heart) can be fatal. Among the possible complications is the impact on the kidney. The conditions can lead to renal lesions, cysts, polycystic kidney disease, or renal cell carcinomas among patients. Asymptomatic renal angiomyolipomas are also common. The lesions can lead to bleeding and rupture. They can also lead to hematuria, haemorrhage, tender abdominal mass, or flank pain. In the lungs, Lymphangiomyomatosis may develop, which is characterised by cystic changes in the lungs. Possible complications may include manifestation in the central nervous system, including those of cortical or subcortical tubers, subependymal nodules, and symptomatic subependymal giant cell astrocytomas (SEGA). The tubers can lead to seizures or cognitive impairment among the patients. Tuberous Sclerosis Prevention As the disease is genetically related, there is no primary prevention. In case of a family history of tuberous sclerosis, one must consult a genetic counsellor. They must also keep in contact with the doctor at all times to chart and understand the child’s development. Epidemiology of Tuberous Sclerosis Tuberous sclerosis impacts 1 in 6000 to 10,000 live births. The prevalence overall is determined to be around 1 in 20,000 individuals. Due to the autosomal dominant nature of tuberous sclerosis, it has an equal chance of occurrence in males and females. It can occur in any ethnical or racial group. However, in females, the morbidity and mortality related to benign lung tumours are more. Expected Prognosis of Tuberous Sclerosis The disease prognosis varies from patient to patient, depending on the severity of the symptoms. By paying attention to specific issues related to tuberous sclerosis, individuals with mild symptoms have a normal life expectancy. However, those severely impacted may show signs of persistent epilepsy or severe mental retardation. Natural Progression of Tuberous Sclerosis If not treated, tuberous sclerosis can be life-threatening as the patient may develop symptoms related to kidney lesions, brain tumours, heart tumours, or lung lesions. Pathophysiology of Tuberous Sclerosis Being genetically related, tuberous sclerosis has a very broad clinical spectrum. It can impact nearly every organ system. The mutation in TSC1 and TSC2 genes makes the body incapable of regulating cell division, thus causing the tumour to grow in various locations.

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Derived from the Latin words, ‘vertere’ meaning ‘to turn’ and ‘igo’ meaning ‘condition’, vertigo is the faulty perception of the body, in relation to space. The surroundings seem to spin in rotational motion, while the body remains stationary. These episodes of dizziness may last for a few seconds or continue for days. Causes of Vertigo The impact dislodges the debris in the inner ear. This free-floating debris induces false movement signals in the brain. Antidepressants, sedatives, hypertensive drugs and anticonvulsants may trigger spells of dizziness. In certain cases, the exact reasons are unknown. Inner ear issues Benign Paroxysmal Positional Vertigo (BPPV) - Sudden changes in the head position cause displacement of calcium carbonate crystals in the inner ear (otoliths). This sends incorrect signals to the brain. Labyrinthitis - Inflammation of the fluid-filled channels (labyrinths) of the inner ear may trigger vertigo. Meniere’s Disease - Fluid accumulation in the inner ear generates a change in ear pressure, causing dizzy spells. Vestibular Neuritis - Inflammation of the vestibular nerve causes improper passage of sensory information to the brain, leading to vertigo. Cholesteatoma - Non-malignant cysts of epithelium erode bones behind the eardrum and cause vertigo. Head or neck injury Medication Idiopathic Symptoms of Vertigo Feeling unsteady Sensation of rotation Nausea Vomiting Motion sickness Constant headache Ringing sensation in the ear (tinnitus) Repetitive, uncontrolled eye movements (nystagmus) Feeling of stuffiness within the ear Stages of Vertigo Mild - The dizzy spells last briefly and go away on their own. Moderate - It is more symptomatic and requires the individual to lie still. Severe - Even after lying down, there is a sensation of constant movement. This is accompanied by nausea and vomiting. Vertigo Diagnosis Typical Tests for Vertigo Physical Examination: A thorough Physical Examination is done, wherein the physician asks detailed questions regarding the episodes and symptoms. Posturography Test: A Posturography Test is performed to assess your balance and posture control to determine how well you can maintain stability under different conditions. Vestibular Function Tests: Several tests are conducted to evaluate inner ear function and balance, including: Fukuda-Unterberger’s test (stationary marching with eyes closed for a minute) Dix Hallpike Test (Making you lie down with head hanging at 450 and turned to one side for at least 45 seconds) for BPPV Rhomberg’s test (standing with feet together, eyes closed and open, with arms on the sides, for 10 seconds each) are carried out. Imaging Tests: A CT Scan or MRI Scan may be performed to rule out structural abnormalities, brain lesions, or other neurological causes of vertigo. Hearing, Vision, and Blood Tests:Additional tests for hearing, vision, and blood work are often recommended to identify any related conditions that might contribute to vertigo symptoms. Differential Diagnosis of Vertigo It’s important to differentiate vertigo from other conditions that may cause dizziness or imbalance: Vertigo should not be confused with acrophobia (fear of heights). Vertigo is a symptom that can occur as part of acrophobia but is not the same condition. Vertigo must also be distinguished from lightheadedness and imbalance, which have different underlying causes. Other medical conditions closely associated with vertigo include: Anxiety disorders Anaemia Multiple sclerosis Brain stroke Meningitis Brain neoplasms (tumours) Vertigo Treatment Vertigo treatment depends on the underlying cause and severity of symptoms. Common treatment options include medication, rehabilitation exercises, repositioning procedures, and, in rare cases, surgery. 1. Medication Medications known as vestibular sedatives are commonly prescribed to help reduce dizziness, nausea, and balance-related discomfort. These medicines work by stabilizing the signals between the inner ear and the brain. 2. Vestibular Rehabilitation Training (VRT) Vestibular Rehabilitation Therapy is a specialized exercise-based program designed to restore balance and improve stability.It includes: Eye, head, and shoulder movement exercises (performed in sitting and standing positions) Gaze stabilization and focusing exercises Mobility and posture improvement exercises These exercises help the brain adapt to inner ear changes, reducing vertigo episodes over time. 3. Epley Manoeuvre Or Canalith Repositioning Procedure (CRP) The Epley Manoeuvre, also known as the Canalith Repositioning Procedure (CRP), is used mainly for Benign Paroxysmal Positional Vertigo (BPPV).In this procedure: The patient’s head is moved through a series of specific positions to shift the calcium crystals (otoliths) within the inner ear canals. These movements reposition the otoliths to an area where they no longer cause abnormal balance signals, providing significant relief from vertigo symptoms. 4. Surgery In severe or persistent cases where other treatments are ineffective, surgical intervention may be recommended.Common surgical options include: Canal Plugging Surgery: Used to block the affected semicircular canal, preventing false movement signals. Microvascular Decompression Surgery: Performed to relieve pressure on the vestibular nerve when vascular compression is the cause. Vertigo Prevention Primary Prevention of Vertigo Avoiding Stress - Preventing anxiety attacks reduces the risk factors. Preventing Head Injury - Taking care to prevent falls and wearing a helmet while riding or playing sports, are of assistance. Lifestyle Changes - Regular exercising and preventing lifestyle diseases like diabetes, high cholesterol and hypertension, are beneficial. Dietary Considerations - Limiting salt intake, caffeine, sugary stuff, tobacco, and alcohol helps to ward off symptoms. Relaxation Techniques - Sleeping well, yoga, and tai chi are useful. Secondary Prevention of Vertigo Self Treatment - Getting up slowly, avoiding sudden head jerks, sleeping with the head elevated, and squatting while picking something up, should be practised. Avoiding Certain Activities - It is best not to indulge in driving or climbing ladders if there have been dizzy spells in the past. Minimum Exposure To Bright Light - Steer clear of bright lights. Using Support - Use a cane while walking, to avoid unnecessary falls. Vitamin D Supplementation - Taking vitamin D and calcium supplements prevents recurrence of symptoms. Alternative Treatments - Herbal remedies and acupuncture techniques may help. Risk Factors of Vertigo Migraine - Migraine is associated with spells of dizziness. Age - It is common in 70% of individuals aged above 65 years. Family History - Vertigo can be a symptom of hereditary syndromes. Past Instances - Previous episodes of dizziness are concerning factors. Medical Conditions - Diabetes, arrhythmia, ataxia, syphilis, and multiple sclerosis may trigger vertigo. Anxiety - Stress hormones (cortisols) are potential risk factors as they affect the vestibular system. Pregnancy - Hormonal changes during pregnancy may induce vertigo. Possible Complications of Vertigo Individuals with vertigo are advised against the handling of heavy machinery. Vertigo is linked to unexpected falls, which may lead to bone fractures and injuries. Severe cases are linked with paralysis of limbs, slurring of speech, irregular heartbeat and vestibular nerve damage. Epidemiology of Vertigo Age - It is more common in individuals above 65 years. Gender - It is thrice more prevalent in women. Race - Studies show greater frequency in African-Americans and Asians, as compared to their Caucasian counterparts. Prevalence - It affects about 20% of adults annually. In India, BPPV affects about 107 per 100,000 yearly. Expected Prognosis of Vertigo BPPV has a recurrence rate of 50% in five years. Individuals with peripheral vertigo experience a recovery rate of up to 90% with the Epley manoeuvre treatment. Natural Progression of Vertigo Episodes of vertigo are sporadic and affect the quality of life, if left untreated. Mild cases may get better without treatment. If the underlying cause is not treated, it leads to long-term health complications. 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