Neurosciences

Many individuals have trouble with mathematics. However, acalculia seems more than simply a problem with calculus or algebra. Acalculia makes individuals unable to do simple math tasks, such as determining which two numbers are bigger or multiplying numbers together. Acalculia is a disorder that is acquired rather than inherited, and one can be affected at any time.

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Agnosia is a rare condition characterised by the inability to recognise faces, voices, objects, or even places. It involves the impairment of one or more senses, although patients can often use their remaining senses to compensate for the loss.

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The inability to produce a clinically perceivable movement is considered akinesia. Patients with akinesia may experience this issue in different ways, such as a halt in mid-action, slowed response, and even complete immobility. In medical terms, akinesia is defined as a condition in which patients are restricted from experiencing any body movement. The main reason for having this issue is a tiny amplitude or significant increase in the times which has been taken for initiating a reaction. Studies have also defined it as the result of severe bradykinesia, which was mislabeled as akinesia. Because of this, differentiating between the two was very difficult. However, at last, a lack of quick build-up of sufficient strength in the commencing movement has been identified as akinesia. Symptoms of Akinesia Some of the symptoms which are associated with akinesia are: It might be difficult when a patient initiates to walk someplace. Rigidity in the muscles, mostly beginning in the legs and neck. Face muscles also become stiff like a mask. Disability in moving the feet properly. All patients with this disease do not experience similar symptoms. The acronym TRAP has been used frequently by doctors for characterising the symptoms of akinesia. The acronym stands for: Tremor at rest Rigidity Akinesia Postural instability The foetal akinesia deformation sequence (FADS) is a kind of Akinesia that intends to produce a slew of anomalies in the development of a baby in the mother's womb. The symptoms of that kind of Akinesia are: Facial anomalies Underdeveloped lungs Joint contractures Intrauterine growth restriction Causes of Akinesia Akinesia can be observed in both adults and children. Some of the causes which help in developing Akinesia in adults are: Parkinson's Disease: Due to the reduced amount of dopamine that has been produced in the human brain, the ability to control muscles gets affected. Hormone Levels: Severely reduced levels of thyroid hormone or Hypothyroidism can result in Akinesia Progressive Supranuclear Palsy: This is a brain-damaging condition that develops gradually and affects the balance of the human body first. Medication used for relieving Parkinson's symptoms: If a patient consumes too much medication for Parkinson's disease, the dopamine gets inhibited. Doctors have also identified genetic causes related to akinesia. Doctors have identified two gene variants linked to an increased incidence of prenatal akinesia. If a patient has a family history of the illness or has had infants born with it, they should consult a genetic specialist. They can then be examined for the gene mutations DOK7 and RAPSN, which have been linked to akinesia. Diagnosis of Akinesia As akinesia is a sign of Parkinson's disease, it can be detected during a motor examination. When a patient is requested to execute particular actions, such as walking or finger tapping, a neurologist or physician can observe movement. Treatment of Akinesia Depending on the symptoms of Akinesia, treatment has been initiated by the doctor. Medication: A combination of levodopa, a central nervous system drug, and carbidopa is one of the most popular therapies for akinesia caused by Parkinson's disease. Carbidopa reduces the severity of levodopa's negative effects, such as nausea. Lack of dopamine can cause akinesia in patients with Parkinson's disease. Dopamine is produced in the brain and then transported throughout the body via neurons. Because the brain converts levodopa into dopamine, it helps to alleviate akinesia and other Parkinson's disease symptoms. Carbidopa and levodopa might interact with other drugs and have serious adverse effects. MAO-B inhibitors also prevent dopamine from being destroyed by the enzymes of the human body naturally. This also increases the amount of dopamine available to combat akinesia and slows Parkinson's disease progression. Implantable Stimulator: Doctors may consider the idea of surgically implanting electrodes, which is called deep brain stimulation that activates movement centres if typical drugs wear off too quickly or do not have the desired impact on akinesia. In more advanced situations, this therapy can aid with symptoms. Home Treatment: Regular exercise might help to cope with the pain and suffering that often accompany akinesia and other motor function issues caused by PD or PSP. It is critical that a patient does not overexert or fall when exercising. Stretching the muscles with yoga or tai chi can help halt the growth of akinesia. Complications of Akinesia Complications that may be faced by patients with akinesia are: Having blurred vision. Loss of vision. Unable to move eyes quickly. Unable to look up and down easily. Unable to keep eye contact for very long. Difficulty in swallowing. Symptoms of depression-like mood swings. Risk Factors of Akinesia Risk factors include: Postural instability. History of slowed muscle movements. Issues with muscle rigidity. Having Parkinson's disease for a long time. The risk factors of FAD are: Fetal oedema Abnormalities in the development of the nervous system. History of maternal illness or drug use. Chondrodysplasias Prognosis of Akinesia It is critical to get treatment for akinesia since the symptoms increase the probability of a patient falling. This can result in broken bones and other injuries. Patients with Parkinson's disease or other diseases may benefit from seeing a physical therapist, who may teach them how to push through "freezing" moments and move in a safer manner whenever feasible. Other than supportive care, there are currently no therapies for PSP or foetal akinesia. Support may include assistance with breathing for newborns born with akinesia whose lungs are not completely grown or functioning. Each year, new research on Parkinson's disease, Parkinson's syndrome, and other associated illnesses emerges, with a focus on Lewy bodies and other biological traits that may cause these conditions. Doctors and scientists may get closer to knowing how to treat and cure akinesia and its causes as a result of this research. Review Reviewed by Dr. Vinny Sood, Principal Consultant, Neurosciences, Neurology.

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Alexia, also known as pure word blindness or agnosia Alexia, is a disorder characterized by a partial or complete inability to read. It is not a problem with vision but rather an impairment in language comprehension. Alexia can manifest in different subtypes with varying signs and symptoms, but all affected individuals experience difficulties in reading, either with reduced speed or complete impairment.

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Alzheimer's disease is a progressive neurological disorder manifesting as an impairment in memory, thinking, and behaviour.  In this condition, people forget recent events, though they might easily recall things that happened years ago. They often tend to forget their close family members. In natural course, gradually, they might also forget how to get ready, feed themselves, and use the washroom.

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An aneurysm is a swelling formed by the weak walls of the blood vessels responsible for supplying blood to the brain. It is somewhat like a balloon in the brain. When this balloon bursts or ruptures, it causes bleeding in the brain, also known as haemorrhage. Brain aneurysms occur when the wall of a blood vessel in the brain bursts, causing a bleed into the surrounding tissue. They can occur at any age and are especially common in older people. Aneurysms are frequently misdiagnosed as bleeding from other sources or conditions, resulting in lost time and potentially life-threatening complications. Even though comparatively older people are at higher risk of contracting aneurysms, anybody can get it. Even teenagers. It can be life-threatening if it isn't diagnosed early and treated adequately. Types of Aneurysm Aneurysms can be of the following types: Abdominal Aortic Aneurysm: This aneurysm occurs in the aorta, which carries blood from the heart to the body. They are usually mistaken for a heart attack and can have symptoms like severe pain in the jaw, backache, etc. Cerebral Aneurysms: Commonly known as brain aneurysms, they are little bulges occurring above the aorta present in the brain. They aren't an issue of concern until they become big and rupture. Thoracic Aortic Aneurysms: These aneurysms occur in parts of the aorta that go through the chest. They are usually asymptomatic, making it difficult to be diagnosed on time. Aneurysm Causes Aneurysms can be caused by the following: High blood pressure: High blood pressure can cause aneurysms. Blood pressure refers to the force of blood flowing through the blood vessels. Blood pressure is measured by how much pressure it places on artery walls. The blood vessels may be weakened or enlarged if the pressure increases above an average rate. Atherosclerotic Diseases: People with atherosclerosis have a form of plaque buildup in their arteries. Plaque is a hard substance that comprises cholesterol, fat, and other substances that damages the arteries and prevents blood from flowing freely. Other Factors: Certain risk factors can increase the chances of contracting aneurysms. Smoking frequently, being obese, pregnant, and following a diet high in cholesterol and fat can cause an aneurysm. Any family history of heart conditions also increases the chances of getting an aneurysm. Aneurysm Symptoms Symptoms of aneurysms may vary depending on the type of aneurysm one suffers. They are: Cerebral Aneurysm Symptoms  Nausea. Vomiting. Seizures. Drooping eyelid. Confusion. Loss of consciousness. Stiff neck. Severe headache. Numbness on one side of the face. Dilated pupils. Double vision. Abdominal Aneurysm Symptoms Severe back and abdominal pain which doesn't go away. Fainting. Faster heart beats. Shortness of breath. Clammy skin. Nausea. Severe pain in the legs. Dizziness. Thoracic Aortic Aneurysm Symptoms Trouble while swallowing food. Low blood pressure. Loss of consciousness. Shortness of breath. Severe pain in the arms, neck, and jaw. The doctor will suggest a few diagnostic tests to confirm the occurrence of an aneurysm. Aneurysm Diagnosis Aneurysms can be diagnosed with the help of the following diagnostic tests, they are: CT Scans: The computer-generated X-ray, known as a CT scan, is used to look inside the body. The process involves passing an X-ray through the body, which takes many minutes. A CT scan can show the presence of an aneurysm and provide insights into if the aneurysm has burst, detecting blood that has leaked into the brain. MRI Scans: MRI is a powerful tool for imaging the brain. MRI uses magnetic fields to create images of brain tissue. This type of scan is valuable in determining the effects of blood vessel abnormalities and the anatomy of aneurysms and other vascular lesions. Angiogram: Angiogram uses X Rays to click clear images of blood vessels. Here, a catheter is inserted into the arteries to deliver the dye. This test is instrumental in diagnosing strokes, clots, aneurysms, etc. Lumbar Puncture: This test is usually ordered when there's a possibility of a ruptured aneurysm. Here, a small fluid from in between the space between the spinal cord and its protective cover is extracted by the doctors. The blood in the fluid could indicate brain hemorrhage, bleeding, and even aneurysms. Ultrasound: Abdominal ultrasound can help to detect abdominal aneurysms. An ultrasound uses sound waves to get a clear image of the abdomen. The results of the above-mentioned diagnostic tests are usually available on the same day. A healthcare specialist will map treatment plans based on the results of these tests. Few tests might require not consuming any food at least twelve hours before it. The healthcare service provider will inform about such special requirements well. Aneurysm Treatment Treatment for an aneurysm may involve: Endovascular Treatment: It is relatively less invasive than surgical clipping. Here, a catheter is inserted into one of the arteries and threaded through the patient's body until it reaches the aneurysm. Once found, several devices are used to destroy the aneurysm. Surgical Clipping: Here, a part of the skull is removed to get proper access to the aneurysm and locate the blood vessel that's feeding the aneurysm. The neck of the aneurysm is then clipped to restrict further blood flow. Medications: Pain relievers, calcium channel blockers, and anti-seizure medications may also be a part of the treatment plan for aneurysms. Lumbar Drainage Catheters: This surgery helps reduce the pressure on the brain from excess hydrocephalus associated with the ruptured brain. The catheter is placed in the space filled with fluids or in the area surrounding the spinal cord and brain to drain the excess fluid into an external bag. Shunt Surgery: A shunt system consisting of a flexible silicone rubber tube and a valve is sometimes introduced. It creates a drainage channel from the brain to the abdominal cavity. Rehabilitative Therapy: Damages caused to the brain may require the patient to relearn certain skills. Hence, the doctor may prescribe physical, speech, and occupational therapy. Treatment for Unruptured Aneurysms: Unruptured aneurysms can be treated with the help of an endovascular coil or a flow diverter. Doctors will choose the right treatment option after considering the aneurysm's size, location, and nature. The patient's general health, age, family history with aneurysms, and presence of congenital diseases that could increase certain risks are also considered while making a treatment plan. Aneurysm Prevention One can take certain preventive measures to reduce the risk of contracting an aneurysm. They are: Quitting smoking. Maintaining a balanced diet. Giving up on the consumption of alcohol and recreational drugs. Controlling high blood pressure with the help of medications and other lifestyle changes. Exercising regularly. Maintain a healthy weight. Sleep well. Try to reduce stress. Outlook Somebody with an unruptured aneurysm can live comfortably without noticing it. But it can be fatal once it ruptures. Ruptured aneurysms can induce coma, cause hemorrhagic stroke, and long or short-term brain damage. Full recovery is possible but completely dependent upon the aneurysm's extent and nature and the patient's overall health. Those diagnosed with unruptured aneurysms can work actively towards reducing the risk of rupture by making certain lifestyle changes along with the prescribed treatment. Regular checks can detect aneurysms at their early stages and provide necessary treatment. Consult the doctor immediately in case of any symptoms relating to the aneurysm. Reviewed & Updated On Reviewed by Dr. Amit Gupta, Principal Consultant, Neurosciences, Neurosurgery, Spine Surgery on 18-July-2023. Related Blogs What You Need To Know About Brain Aneurysms? Frequently Asked Questions on Brain Aneurysms ANEURYSM RISK FACTORS: WHAT TO KNOW CEREBRAL ANEURYSM RUPTURE- AN EMERGENCY Know About Endovascular Stenting (TEVAR) For Abdominal Aorta and Common Iliac Aneurysm

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Anomia, also known as Anomic Aphasia, is a language disorder characterised by difficulty in naming objects while speaking and writingt is commonly caused by brain damage resulting from stroke, trauma, or tumours. Individuals with anomia experience trouble recalling the names of objects, despite having grammatically fluent language skills.

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Anosognosia is a mental disorder characterised by a lack of comprehension, awareness, or acceptance of one's own mental health condition. It can occur in individuals who have experienced a brain injury or coexist with other mental health disorders such as schizophrenia and bipolar disorder. People with anosognosia may exhibit no awareness of their condition, making it challenging for healthcare professionals to provide effective treatment. Lack of awareness can lead to noncompliance with treatment regimens, further complicating the management of the individual's mental health.

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Apraxia is a disorder of the brain and nervous system in which a person is unable to carry out tasks or movements when asked, even though the request or command is understood, they are willing to perform the task, the muscles needed to perform the task work properly, the task may have already been learned. Apraxia is unable to carry out tasks or movements when asked, even though: The request or command is understood They are willing to perform the task The muscles needed to perform the task work properly The task may have already been learned

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Ataxia is a condition of poor muscle control, which leads to involuntary and clumsy movement. Patients may have difficulty walking, making hand coordination, speech and swallowing, eye movement, and maintaining balance. It occurs mostly when the cerebellum is damaged, which can happen due to stroke, head injury, and long-term alcohol consumption.  Types Ataxia is classified into three types based on their cause: Inherited Ataxia: As the name suggests, inherited ataxia develops from mutations in certain genes, which are received from parents, thus causing ataxia. It is of two types- Dominant Ataxia: In dominantly inherited Ataxia, only one copy of the mutated gene is required to develop this condition, and the mutated gene can come from any parent. Recessive: In this condition, two copies of the mutated gene are inherited, one from each parent. This condition is relatively rare because the chances of both parents having mutated ataxia gene is comparatively lower than one parent having it. Acquired Ataxia: Acquired ataxia is caused by nerve damage caused due to head injury, infections like HIV, stroke, etc. Idiopathic Ataxia: No causative agent has been discovered for nerve injury.  Symptoms Ataxia can either develop over time or can occur suddenly. Some of its symptoms are: Walking unsteadily Poor coordination Poor balance Difficulty with motor tasks, such as eating, writing, or buttoning a shirt Change in speech Involuntary back-and-forth eye movements (Nystagmus) Difficulty swallowing Hereditary Ataxia will have different signs and symptoms depending on the mutation. It causes the following symptoms: Scoliosis Weakened heart muscle High arching feet Causes The cerebellum and its connected organs are responsible for proper movement and posture to maintain balance. If damaged, it can lead to ataxia. Hereditary Ataxia: It is caused by mutated genes which develop abnormal proteins. These proteins hamper the proper functioning of the nervous tissues or degenerate them. As the disease progresses, the symptoms will worsen. Usually, it affects the cerebellum and spinal cord. Idiopathic Ataxia: Unknown cause. Acquired Ataxia: It is caused due to the following reasons: Head injury Stroke Brain Tumour Infections, such as meningitis, HIV, and chickenpox Cerebral palsy Degenerative diseases such as multiple system atrophy can cause ataxia in adults near age 50 Autoimmune conditions, such as multiple sclerosis, may cause Ataxia An underactive thyroid (hypothyroidism) Vitamin deficiencies, including vitamin B12, Vitamin B-6, vitamin E, and thiamine, can cause Ataxia. This type of Ataxia is reversible. As a potential side effect of certain medications, especially barbiturates, sedatives, antiepileptic drugs, and some types of chemotherapy. Poisoning from heavy metals, like lead or mercury. Excessive alcohol intake Risk Factors Risk factors that can lead to Ataxia are: Viral infections like the Coxsackie virus, Epstein-Barr, or HIV Bacterial infections such as Lyme disease Exposure to certain toxins, like lead, mercury, thallium, alcohol, and organophosphates found in insecticides Long term Alcohol consumption Vitamin Deficiency Head Injury Poor cardiovascular health Diagnosis The doctor will need the medical history. They'll ask whether a patient has a family history of inherited ataxia. The first step is to find a treatable cause. The doctor may also inquire about the medications and alcohol intake. They will then conduct physical and neurological examinations. Tests can help doctors and medical professionals check things like co-ordination, balance, movement, reflexes, muscle strength, memory and concentration, vision, hearing. The Neurologist may prescribe the following tests: Imaging tests: A CT or MRI scan creates detailed images of the brain, which can be used by doctors to see any abnormality. Blood tests: In order to rule out infection, vitamin deficiency, hypothyroidism, etc. Lumbar puncture: With a lumbar puncture, a cerebrospinal fluid (CSF) sample is collected. The sample is sent for biopsy. Genetic testing: Many types of hereditary ataxias can be tested genetically. A blood sample is used in this sort of testing to determine whether a patient has genetic alterations associated with inherited Ataxia. Treatment In the case of acquired Ataxia, treating the underlying cause, such as an infection or a vitamin deficiency, can ease symptoms. But that is not possible with all types of acquired Ataxia. There's no cure for a few types of Ataxia. However, several interventions may help ease the symptoms and improve the quality of life. These include: Medications: Few medications can help treat the symptoms that occur with ataxia. For example: Amitriptyline or Gabapentin for nerve pain Muscle relaxants for cramps or stiffness Antidepressants for depression PDE-5 inhibitor for Erectile Dysfunction Assistive devices: Wheelchairs and walkers can help with mobility. Communication aids can help with speaking. Physical therapy: It can help the patient with mobility and balance. It can also help the patient prevent the weakening of muscles and reduction of flexibility. Speech therapy: A language and speech therapist can help with two of the most prevalent symptoms of Ataxia: slurred speech (dysarthria) and swallowing difficulties (dysphagia). A nutritionist may also be referred to the patient for nutritional guidance. For example, their diet may need to contain easier-to-swallow foods. Occupational therapy: Occupational therapy teaches various strategies to adapt to the loss of mobility and make it easier to do day-to-day activities. The therapist may be able to teach the patient how to use a wheelchair and other mobility devices. They can also advise on home changes, such as adding guide rails or a stairlift, to make their life easier. Therapy: Ataxia, in some situations, causes depression. The patient's primary care physician and therapist can help manage the symptoms. Complication: Complications of Ataxia can be: Difficulty in breathing and choking while eating can lead to death Decreased movement can lead to pressure sores, injury, and clots Cannot walk properly May need lifelong support for daily activities Patients with other memory and behavioural problems, such as dementia, may not be compliant with care Depression Constant Fatigue Erectile dysfunction Review Reviewed by Dr. Sanjay Saxena, Senior Director & HOD, Neurosciences, Neurology.

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Athetosis is a neurological disorder that causes slow, irregular, involuntary, writhing, and rolling movements, particularly in the distal limbs. The movements may be continuous or discontinuous. Athetosis-associated movements make it tough for the person to maintain a stable and erect posture. The affected body parts are the face, neck, limbs, trunk, tongue, fingers, and other body parts. The fingers are affected negatively by their flexion happening separately and irregularly. The hands and the feet also move in a similar manner. For instance, while driving or writing, the person suffering from athetosis has no idea about where the steering would rotate or the pen would go! This is a serious movement disorder that can lead to many associated deformities. Individuals with athetosis find it very difficult to control these random movements. Even if they try to control it, they may find the situation getting worse, even to a stage where they are not at all able to control any movement. Causes Athetosis is often caused by a birth disorder or some neurological problem in the case of adults. Another rare cause of athetosis includes stroke or trauma. Given below are some of the major causes behind the development of athetosis. Basal Ganglia Disease Any injury to the basal ganglia may lead to the appearance of irregular and involuntary movements, such as athetosis. A basal ganglion is a group of subcortical nuclei present within the brain and primarily responsible for controlling motor functions and easing out coordinated movements. Any injury to the basal ganglia or a particular part of the brain leads to impaired motor functions, such as the appearance of dystonic movements like athetosis. Other functions of the basal ganglia include executive functions, motor learning, emotional behaviours, habit formation, addictive behaviours, etc. What happens when the basal ganglia gets injured? In case of injury to the basal ganglia or associated brain part, the person is likely to develop symptoms of athetosis. The person’s brain loses its ability to support the muscle movements or perform coordinated movements. A child/person with basal ganglia dysfunction may face difficulty in walking, starting or ending any movement, etc., as in the case of Parkinsonism and cerebral palsy. The person may show abnormal movements, abnormal posture, and abnormal tone. Diseases of Basal Ganglia Some of the diseases which affect basal ganglia are Huntington’s disease and Wilson’s disease. Huntington's disease is a rare, inherited progressive degeneration of the brain’s nerve cells. The person suffering from this disease shows mixed symptoms, such as movement-associated impairments, psychological disorders, and cognitive disorders. Wilson’s disease is also a rare and inherited disorder that leads to copper accumulation in the brain, liver, and other organs of the body. This results in copper poisoning in the human body. Birth-related problems When the fetus doesn't get enough oxygen supply, the chances of developing athetosis become higher. Lack of oxygen in the body or asphyxia can lead to brain damage. It also leads to reduced nutrient supply to the brain and increased dopamine levels in the brain. Such changes may impact the basal ganglia and lead to its impairment. Cerebral Palsy Cerebral Palsy is a birth-related disorder caused due to abnormal development or damage to the brain while growing. This leads to impaired motor skills and reduced ability of the child to perform coordinated movements. Cerebral Palsy, which is caused due to damage to the basal ganglia, is called athetoid cerebral palsy. It is usually caused due to low oxygen levels and/or high bilirubin levels in the infant’s body. The CP child exhibits athetosis-related movement impairment. Jaundice Jaundice in newborns can damage basal ganglia due to high levels of bilirubin. Although treatments are available, they are not very effective. They may only lower the levels of bilirubin, while the efficacy of the body against the infection is not high as the blood-brain barrier is not properly functional at such a young age. Therefore, toxins enter the infant’s body and damage the basal ganglia. This further leads to the appearance of athetosis. Drug toxicity If a person consumes drugs that lead to increased levels of dopamine in the body, the chances of basal ganglia damage increase further, leading to athetosis. Stroke Stroke can also lead to the occurrence of athetosis as it leads to brain damage or dysfunction. Symptoms The major signs and symptoms of athetosis include- Difficulty in walking properly. Difficulty in maintaining an erect posture. Writing, slow, and involuntary movements. Abrupt and unpredictable muscle movements. The situation gets worse while attempting to improve posture or movement. Uncontrolled movements. Uncontrolled movements in another muscle group while attempting to control movements in one muscle group. Tremors. Torso twisting. Grimacing (to make an expression of pain). Difference between athetosis and chorea Sometimes, confusion between athetosis and chorea can arise due to the fact that they are actually very similar. In fact, the two can even occur together. When they occur jointly, the condition is referred to as choreoathetosis. Athetosis is even sometimes called slow chorea. However, in chorea, the movements are very brief, dancelike, and rhythmic. Such movements may start at any point and end at any point all of a sudden. Difference between athetosis and dystonia Another similar condition that may be confusing is dystonia. The latter is also a movement-related disorder leading to involuntary, repetitive, and usually persistent muscle contractions. Even in dystonia, 'overflow' happens. Overflow is a term used to demonstrate a situation where a person feels immense pressure in a muscle group while attempting to control the movements of another muscle group. The major difference between dystonia and athetosis includes the formation of more sustained body postures in the former. Diagnosis Athetosis is usually considered one of the symptoms of an underlying disorder. It is not considered a disorder by itself. It happens due to the damage/overactivity of the basal ganglia. Therefore, for treating athetosis, it is very important to first diagnose the root cause of the affecting disease. To eliminate the root cause or underlying issue, the neurologist or physician will undertake the following steps- Learning about the medical history of the patient. Running a physical exam to determine the power of muscle contractions. Conducting some blood tests to know about the haematological status of the patient. Running some brain imaging tests to view the insides of the brain (in case of brain injury or damage). Conducting gross motor function tests to test motor abilities and coordinated movements of the patient. Since these tests are not definitive tests, the doctor may take some time to reach a confirmed diagnosis of the problem. Treatment Once the root cause or underlying issue is determined, it becomes easier to treat athetosis. Sometimes, due to the severity of the issue, specific and symptomatic treatment might be prescribed to the patient, such as- Anti-dopamine drugs- These are the drugs that help in lowering the levels of dopamine and thereby reducing its effects. Botox therapy- Injections of botox are given to the patient to slow down the involuntary actions of the muscles. Physical Therapy- Physiotherapist-assisted exercises and therapy should be taught to the patient. Lifestyle Management- Changing your lifestyle, eating healthier, and exercising regularly for muscle strengthening can help improve the complications. Complications Athetosis is a long-term effect of a chronic disorder. So, determining the underlying cause is important to eliminate the possible complications of athetosis. The possible complications of athetosis include- Uncontrolled walking. Inability to speak properly. Permanent posture deformity. Difficulty in performing day-to-day activities. Review Reviewed by Dr. Vivek Kumar, Senior Director, Neurology.

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Ballismus is a serious movement disorder that is characterised by sudden and involuntary movements, muscle weakness, and incoordination of proximal limb movements. The movements are generally spontaneous, continuous, repetitive, and of large amplitude. If it is not treated on time, it can continue damage and may lead to permanent dysfunction. Ballism is also known to affect the muscles of the face. The upper and the lower limbs are affected equally. However, if the person relaxes or takes some rest, the movements tend to decrease. Types of Ballismus Monoballismus Monoballismus generally affects only the one-sided lower limb or upper limb. It is usually a mild form of ballismus. Biballism In this type of ballismus, either both the upper limbs or lower limbs are involved. This is a bit deeper form of ballismus. Hemiballismus Hemiballismus is a type of ballismus where one complete side of the body is affected. This leads to the development of random involuntary muscle actions in one side of the body (including both the upper limb and the lower limb). Symptoms Ballism is typically determined by the occurrence of the following symptoms in arms or legs - Abnormal involuntary movements. Irregular muscle tweaks. Frequent violent movements. Causes Stroke A stroke occurs when the blood supply to the brain is blocked due to various underlying reasons such as arteriosclerosis, atherosclerosis, high LDL, etc. Due to stroke, the blood supply to other parts of the brain is also blocked. If basal ganglia get damaged, motor functions of the body are severely damaged. The body starts performing irregular, continuous, high-amplitude involuntary movements. Traumatic brain injury Ballismus is also known to occur due to certain traumatic brain injuries. Cases have been recorded where people have developed ballismus or ballism after an assault, violence, or any accident. Due to this, the patient suffers from random involuntary movements. Amyotrophic lateral sclerosis This is a type of brain damage that causes gliosis and neuronal loss. Gliosis is a non-specific change in the glial cells due to damage to the CNS. This disease can also damage the sub-thalamic nucleus and various other parts of the brain. This is a serious disease that may lead to the potential development of ballismus. Non-ketotic hyperglycemia Patients suffering from non-ketotic hyperglycemia can develop ballism as one of the complications. This occurs due to the development of lesions in the subthalamic nucleus. This is the second most common cause of ballismus. It is majorly found in the elderly, located particularly in the Eastern side of Asia. This is also related to genetic predisposition, as only a specific area is affected. Decreased production of GABA and acetylcholine have led to the development of hyperglycemia. Neoplasms Neoplasms are an abnormal growth of the body cells. If this growth happens to be in the basal ganglia, the body tends to develop ballismus. Tuberculomas Tuberculomas are tumours caused due to tuberculous meningitis, a type of brain infection. If this tumour occurs in the basal ganglia, it can lead to the development of ballism or ballismus. Vascular malformations Many times, due to Malformations of vascular structure, the blood supply to a part of the brain is hindered. This results in a stroke and, ultimately, ballismus. Demyelinating plaques Demyelinating Plaques affect the conductive capacity of the neuron as these affect myelin sheaths. The functioning impairment of the neurons results in weak signals to the basal ganglia, ultimately leading to ballismus or hemiballismus. Post-viral infection complications Sometimes, ballismus also occurs as a complication of immunocompromising viral infections such as HIV AIDS. It typically occurs as a result of secondary infection due to the lost immunity power. The most common infection is toxoplasma infection, resulting in the formation of lesions around the basal ganglia. Diagnosis Diagnosis of ballismus is clinical and is based on clinical signs and symptoms. The doctor/physician looks out for possible signs and symptoms to confirm the diagnosis of ballismus. He/she notices some sudden, flinging movements present on the limbs and maybe on the face. Sometimes confusion may arise between athetosis, chorea, and akathisia, as all of these are associated with random involuntary movements. However, the only difference is that in the above-mentioned movement disorders, the muscle actions are less violent and of lower amplitude. Treatment The treatment of ballismus is based on the underlying issue that caused the appearance of ballismus. The neurology doctor determines the exact cause of ballismus, such as neoplasm, hyperglycemia, various infections, lesions, plaques, etc. Some of the patients may also not need treatment because of the severity of the disorder. Given below are some treatment options for ballismus- Dopamine Blockers While opting for pharmacological treatment, one should go for dopamine blockers or antidopaminergic drugs. This is effective in 9 out of 10 patients suffering from ballismus. Anticonvulsants Topiramate, an anticonvulsant, is known to affect patients suffering from ballismus. ITB Therapy Intrathecal baclofen (ITB) therapy is an effective solution for ballismus or hemiballismus. It is also a treatment option for various disorders such as cerebral palsy and multiple sclerosis. Botulinum Injections Injections of botulinum are known to cure some levels of ballismus. However, it is more recent research, and its outcomes are yet to be discovered. Antipsychotics Antipsychotic drugs are also prescribed to the patient suffering from ballismus. The usage of this drug is also under research, and its consequences are also observed. Neurosurgery Functional neurosurgery is the last treatment option for patients suffering from ballismus. These are the patients who have not responded to other treatment options. Lesioning of the globus pallidus or deep brain stimulation of the globus pallidus are the surgical options employed to treat ballismus. Amongst the two, the former option is considered better as the stimulation required for the brain is continuous and effective. Prognosis Patients with this disease have had a very poor prognosis in the past. Many patients are seriously injured or die. Patients are currently responding very well to ongoing treatment, and most of them have spontaneous remission. Review Review by Dr. Vivek Kumar, Senior Director, Neurology.

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Occasional, fleeting eyelid twitches are a common and typically benign experience, often linked to fatigue, stress, or eye strain. However, in some rare cases, these involuntary muscle contractions progress far beyond simple twitches. They become persistent and severe, significantly disrupting the normal functioning of the eyelids and impacting daily life, even causing temporary functional blindness. One such debilitating condition is Blepharospasm, a neurological movement disorder characterised by uncontrollable blinking and forceful, sustained eyelid closure. This can profoundly affect crucial activities from reading and driving to maintaining essential eye contact during conversations. At Max Hospitals, we recognise the unique challenges presented by blepharospasm and here to provide comprehensive diagnosis and tailored treatment plans to help individuals effectively manage this condition and reclaim their quality of life.

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Bradykinesia is a medical term used to describe a slowness of movement or a significant reduction in the speed of voluntary activities. Mainly, this disease is related to Parkinson's disease as it is considered the most common symptom of this disease. It also depicts the side effects of certain medications. The difficulty in initiating movement can impact the ability of the individuals to carry out activities of daily living.

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Glioma is a type of tumour in the brain and spinal cord. It begins in the gluey supportive cells (glial cells) that surround nerve cells and help them function. Gliomas are called intra-axial brain tumours because they grow within the brain's substance and often mix with normal brain tissue. The brainstem is the brain area attached to the spinal cord and placed below the brain and just above the back of the neck. The brain stem is responsible for controlling breathing, heart rate, and muscles used in seeing, hearing, walking, talking, and eating. It has got three parts, namely: The midbrain, which originates from the centre of the brain. The medulla oblongata, which joins to the spinal cord. The pons, which is situated between the medulla oblongata and the midbrain. Brain stem glioma is a form of central nervous tumour that takes place when cells in the brain stem undergo a change and begin to grow rapidly and out of control, thereby resulting in a tumour that can be either cancerous or benign.  Usually, the brain stem glioma spreads by the time it is diagnosed. It spreads evenly through the brain stem. This form of tumour is generally very aggressive as it grows and extends rapidly. Very few brain stem tumours, which are termed focal tumours, are localised.  Most brain stem tumours occur in the pons region, where surgery is difficult, thereby making brain stem glioma challenging to treat. Brain stem glioma generally occurs in children between the age group of 5 and 10 years. Classifications for Brain Stem Glioma The general classifications for brain stem glioma are as follows: Diffuse Brain Stem Glioma: This is the most common classification where the tumour spreads entirely throughout the pons and to the midbrain, the medulla, or surrounding parts of the brain. These are preferred to be high-grade tumours, very aggressive and carry atypical-looking cells. Focal Brain Stem Glioma: About 20% of brain stem tumours belong to this category and are confined within a small area of the brain stem. They usually happen in the midbrain or medulla rather than the pons. These are benign or low-grade tumours and are less aggressive. Symptoms of Brain Stem Glioma Sometimes, children do not have any of the changes or symptoms, or in certain cases, the cause of a symptom may be attributed to a different medical condition that is not a brain stem glioma. Children with a brain stem glioma may encounter the following symptoms: Double vision or inability to close the eyelids. Drooping of the face. Difficulty while chewing as well as swallowing food. Weakness in the upper and lower extremities, clumsiness or wobbliness, and difficulty while walking. Difficulty talking. Headache Vomiting Diagnosis of Brain Stem Glioma Apart from a physical examination being conducted by the doctor, the following tests may be recommended to diagnose this condition: MRI: An MRI uses magnetic fields to generate detailed images of the body. A special dye is administered before the scan to obtain a clearer picture. This dye can be inserted into a patient's vein. Computed Tomography (CT or CAT) Scan: CT scan can be used to assess the size of the tumour. At times, a contrast medium is administered before the start of the scan to provide better results on the image. This dye can be inserted into a patient's vein or given as a tablet or in liquid form to swallow. To ascertain a brain stem glioma, this test generally does not provide adequate detail to reach a definite diagnosis, and hence, an MRI is still required. Biopsy: A biopsy is the withdrawal of a small tissue taken for detailed examination with the help of a microscope. A biopsy is generally not performed for the diffuse type of brain stem tumour. However, for a focal tumour, it is generally carried out to find out the type of tumour. Brain Stem Glioma Treatment Treatment options depend on various factors, like the type and grade of the tumour, possible side effects, the family's preferences, and the overall health of the child. The most common treatment approaches used for brain stem glioma in children are radiation therapy, chemotherapy, and surgery. Sometimes, these treatments are used together. Radiation therapy Radiation therapy is the preferable treatment option for children with brain stem glioma. Radiation therapy uses high-energy X-rays or other particles to damage tumour cells. The most commonly given radiation treatment is called external-beam radiation therapy, which uses protons rather than X-rays. Chemotherapy Chemotherapy is the administration of drugs to destroy tumour cells, usually by keeping the tumour cells from growing, dividing, and making more cells. Chemotherapy is given by a medical oncologist. Systemic chemotherapy gets into the blood circulation in order to reach the tumour cells throughout the body.  Surgery Surgical intervention is the elimination of the tumour and a few surrounding tissues during an operation. Surgery is done to treat brain stem glioma only when the tumour looks focal on an MRI scan.  Complications of Brain Stem Glioma Systemic complications and postoperative neurological deterioration are common. Respiratory failure, dysphagia, and pulmonary aspiration are possible life-threatening postoperative complications that may occur days or weeks after surgery. The impaired respiratory drive may result in progressive carbon dioxide retention and hypoxia, leading to respiratory arrest. Damage to these nerves impairs swallowing and protective and coughing reflexes and may result in dysphagia, vocal cord paralysis, and gastric stasis.  Outlook With the latest research in the medical field and advances in technology, the brain stem glioma survival rate in adults is on an upward trend and will continue to climb as new treatment options emerge. Clinical trials and patient experiences all contribute to clinicians’ knowledge base, and the outlook is constantly improving. Review Reviewed by Prof. (Dr). V.K.Jain, Principal Director - Department of Neurosurgery, Neurosciences, Spine Surgery. 

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A brain tumour refers to an abnormal growth of cells or tissues within the brain or the skull vault. It occurs due to uncontrolled and abnormal cell division. Brain tumours can originate in the brain itself or in other parts of the body and spread to the brain. They can affect various structures within the brain, including the brain tissue, blood vessels, cranial nerves, brain meninges, skull, pituitary gland, or pineal gland.

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Cataplexy is a neurological disorder characterised by sudden and temporary muscle weakness or loss of muscle control. It is often triggered by strong emotional reactions such as stress, anger, anxiety, laughter, or joy. Cataplexy is commonly associated with type 1 narcolepsy, a chronic sleep disorder that disrupts the brain's ability to regulate sleep and wake cycles. However, it is possible for individuals to experience cataplexy without a narcolepsy diagnosis.

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Cerebral palsy is a condition that affects an individual's muscle tone, movement and posture. It is a group of disorders caused by injury to an immature, developing brain before birth. Its symptoms become apparent during infancy and preschool years. People with cerebral palsy have difficulty swallowing, eye-muscle coordination, and involuntary movements. They often have a reduced range of motion at the joints caused by muscle stiffness. The cause of the development of cerebral palsy and its effect on various body functions varies greatly. Some people can walk, while others require assistance. Some may have intellectual disabilities, while others may not. People with cerebral palsy may also have epilepsy, blindness, or deafness. It is crucial to note that cerebral palsy is a lifelong disorder. This condition has no cure. Treatment helps manage symptoms and improve function.

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Our nervous system is an incredibly complex network, responsible for orchestrating every movement, thought, and sensation in our bodies. When certain parts of this system are affected, it can lead to involuntary movements that significantly impact a person's quality of life. Chorea is one such neurological condition characterized by unpredictable, jerky movements that can interfere with daily activities.  At Max Hospitals, we understand the challenges posed by this neurological movement disorder and are deeply committed to restoring quality of life for our patients. Our team of highly experienced neurologists, neurosurgeons, and allied healthcare professionals is dedicated to accurately diagnosing chorea and developing comprehensive, tailored treatment plans focused on managing symptoms, improving function, and enhancing the overall well-being of individuals across all age groups.

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Dementia is a degenerative process characterized by loss of cognitive function eg loss of memory, thinking, reasoning, and loss of executive function which the person was able to do before the start of this process. It usually affects people older than 60 years of age. It is a process of accelerated aging of the brain. Alzheimer's Disease is the most common type of dementia.

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Dysarthria, also known as slurred speech, is a condition characterised by a loss of control over the muscles involved in speech. Individuals with dysarthria often experience weakness in these muscles, making it difficult for others to understand their speech. This condition typically arises from a breakdown in the nervous system. Nerve damage or paralysis can be potential causes of dysarthria. In some cases, certain medications can also contribute to the development of dysarthria, and it is important to consult a doctor if this occurs. Proper diagnosis and treatment, including speech therapy, can lead to improvements in speech for individuals with dysarthria.

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Dysdiadochokinesia is a medical term that is used to describe the difficulties faced by individuals while producing fast and alternative movements. Individuals can normally transition between opposing actions quickly and in a coordinated manner, such as while unscrewing a light bulb. A person with Dysdiadochokinesia, on the other hand, may notice that their muscular reaction is delayed or uncomfortable, particularly in the upper and lower limbs. Poor coordination in tapping one's finger or foot quickly, switching muscle postures from flexion (bent) to extension, and opening and closing one's hand are examples of this (straight). It is a sign of an underlying health condition, not a disease itself.

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The ability to write clearly and effectively plays a crucial role in learning and sharing ideas. However, for individuals with dysgraphia, this seemingly simple task can be a significant challenge, hindering their ability to express knowledge and ideas, leading to frustration. At Max Hospitals, we understand how dysgraphia can impact an individual’s confidence, academic progress, and emotional well-being. Our multidisciplinary team of developmental pediatricians, neurologists, educational psychologists, occupational therapists, and special educators is equipped to provide comprehensive treatment and compassionate care for both children and adults, helping them overcome the disorder and unlock their full potential.

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Dystonia is a movement disorder characterised by involuntary muscle contractions and abnormal postures. One of the major challenges with dystonia is its impact on daily life, as muscle spasms can cause significant discomfort and interfere with routine activities. At Max Hospital, patients have access to an array of therapies designed to alleviate symptoms and improve quality of life. The hospital’s approach includes medication, physical therapy, and interventions aimed at reducing muscle contractions and improving movement. A team of specialists, including neurologists and physical therapists, work closely with each patient to manage their condition more effectively and enhance their ability to perform daily tasks with greater ease and comfort.

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Epilepsy is one of the most common neurological disorders worldwide, characterised by recurrent seizures due to abnormal electrical activity in the brain. While many patients manage their condition well with medicines, others may experience frequent or uncontrolled seizures that significantly affect quality of life. At Max Hospitals, our multidisciplinary team of neurologists, neurosurgeons, radiologists, and specialised nursing staff provides advanced care for epilepsy diagnosis and treatment. With state-of-the-art technology and evidence-based protocols, Max ensures safe, precise, and effective management of epilepsy for patients of all ages.

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Witnessing a child experience a seizure can be deeply unsettling for any parent. When this happens alongside a fever, it is often due to a febrile seizure, a common and typically harmless condition in young children. While the episode may seem alarming, febrile seizures rarely cause long-term health concerns. Gaining a clear understanding of what they are, the types, and how to respond can help ease fears and build confidence. At Max Hospitals, we’re here to offer that clarity and reassurance. Our experienced paediatric specialists are well-equipped to evaluate the cause, guide you through the next steps, and provide gentle, expert care, so you feel informed, supported, and assured that your child’s wellbeing is in safe hands.

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Functional movement disorder (FMD) is a neurological condition that affects a person's ability to perform voluntary movements. It is a type of conversion disorder, which means that physical symptoms are not caused by an underlying medical condition but are a manifestation of psychological stress. FMD is a relatively common condition affecting people of all ages, but it is more commonly diagnosed in women than men.

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Headache is a common medical condition that is characterised by pain or discomfort in the head, scalp, or neck region and is one of the most common symptoms experienced by people.

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Hydrocephalus is a medical condition characterised by the accumulation of excessive amounts of cerebrospinal fluid (CSF) within the brain's ventricles. Hydrocephalus, as the term suggests, is derived from the Greek words "hydro", which refers to water, and "cephalus", which means the head. Cerebrospinal fluid is a clear, colourless, organic fluid which surrounds the brain and spinal cord. It circulates within the ventricles of the brain. It serves various essential functions, such as acting as a shock absorber for the brain and spinal cord regions, supplying multiple crucial nutrients to the brain, eliminating waste products from the brain, and regulating pressure changes in the brain. When cerebrospinal fluid accumulates around the brain's tissues, it can lead to uneven pressures on the tissues of the brain, which are present inside the skull. Accumulation of cerebrospinal fluid mainly occurs when there is either increased production of the liquid or a decrease in the rate of absorption of cerebrospinal fluid. Hydrocephalus can occur in any age group, although it is more frequently seen in infants and individuals above 60. The majority of these cases are diagnosed either at the time of birth or during early childhood. Hydrocephalus can result in brain damage leading to developmental, physical and intellectual impairments. Therefore, prompt medical attention is needed to avoid serious complications. Types of Hydrocephalus Communicating Hydrocephalus: It occurs when the flow of cerebrospinal fluid is restricted after it leaves the ventricles. In this type of Hydrocephalus, CSF can still flow between the ventricles. Normal Pressure Hydrocephalus (NPH) This form of communicating Hydrocephalus occurs among people of any age but is most common among the elderly. It is caused due to subarachnoid haemorrhage, head trauma, infection, tumour or surgery complications. However, specific individuals develop this condition due to unknown reasons. In that case, it is termed Idiopathic normal pressure hydrocephalus. Non-communicating Hydrocephalus: It is also called Obstructive Hydrocephalus and occurs when cerebrospinal fluid flow is blocked along one or more of the narrow passages that connect the ventricles. One of the most prominent causes is aqueductal stenosis, which narrows the small passage between the third and fourth ventricles in the middle of the brain.      Classification of Hydrocephalus Hydrocephalus may also be classified as congenital or acquired: Congenital Hydrocephalus is present at the time of birth and is caused by specific events during fetal development or genetic abnormalities. In very rare cases, Congenital Hydrocephalus may not cause any symptoms during childhood, but they only become prominent in adulthood and may be associated with Aqueductal stenosis Acquired Hydrocephalus: It can develop at birth or during the early childhood phase Symptoms of Hydrocephalus The symptoms of Hydrocephalus vary from one child to another and among different age groups. The following are the symptoms of Hydrocephalus: Among Infants The extra-large size of the head. Downward deviation of eyes. Vomiting Irritable Seizures Progressive increase in the circumference of the head. Sleepiness and lethargy.. Among Children Blurred or double vision. Gait abnormalities. Nausea Vomiting Lack of concentration. Seizures Urinary incontinence Lack of appetite. Adults Headache Vision issues Loss of coordination or balance. Loss of balance. Decrease in memory. Reduced concentration. Diagnosis of Hydrocephalus The following tests are required to diagnose the condition of Hydrocephalus: Neurological Examination: The neurologist tests the person's muscle strength, movement of limbs, and reflexes present to get an idea about the patient's overall condition Brain Imaging Tests: These comprise of: Ultrasound: It helps to detect Hydrocephalus before birth during prenatal examinations. Magnetic Resonance Imaging (MRI): MRI scans help detect enlarged ventricles caused by the accumulation of excessive cerebrospinal fluid. It can be carried out to detect the various causes of this condition. CT Scan: These generate less detailed images than MRI and are used for emergencies. Other diagnostic tests include: Intracranial pressure monitoring. Lumbar puncture. Spinal tap. Treatment of Hydrocephalus If left untreated, Hydrocephalus can prove fatal and life-threatening. Therefore, surgical intervention is usually required in the treatment of Hydrocephalus. The surgical intervention aims to prevent further brain damage and restore the flow of cerebrospinal fluid in the brain. Surgical procedures involved in the treatment of Hydrocephalus are as follows: Insertion of Shunt: Shunt is a long, flexible tube consisting of a catheter and a valve that helps flow cerebrospinal fluid at a desired, normal rate, particularly in the right direction. The doctor inserts one end of this shunt in the brain and the other in the peritoneal cavity. The shunt system remains in the patient's body forever and requires constant monitoring. In addition, it helps to maintain the intra-cranial pressure within normal limits. Ventriculostomy: This surgical procedure involves making a hole at the bottom of the ventricles or between the ventricles to relieve the intracranial pressure. Risk Factors of Hydrocephalus These include the following: Abnormal development of the Central Nervous System (CNS). Bleeding within the ventricles. Uterine infection during the pregnancy phase leads to inflammation in fetal brain tissues. Other factors that contribute to this condition are as follows: Brain tumour Infections of the central nervous system. Traumatic injury to the brain. Traumatic brain injury leads to bleeding in the brain. Prevention of Hydrocephalus Hydrocephalus can't be prevented, but it is certainly possible to reduce the risk associated with this condition in the following ways: Wearing helmets to avoid road traffic accidents. Getting timely vaccinations to prevent infections related to Hydrocephalus. Prenatal care during pregnancy is essential as it lowers the chances of going into premature labour. Complications of Hydrocephalus These are as follows: Intellectual disability. Developmental disability. Physical disability. Loss of life in severe cases. Outlook for Hydrocephalus In the case of children, the outlook depends on the disease's progression and the presence of any infection. A team of paediatricians, developmental therapists, physiotherapists and occupational therapists work closely with the children and help them manage their disability and reduce the long-term effects of this condition. Adults need to consult physiotherapists and occupational therapists for better outcomes. Review Reviewed by Dr. Manoj Khanal - Associate Director, Neurosciences, Neurology, Interventional Neurology.

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Lightheadedness is a feeling of fainting or passing out. It is common to feel lightheaded sometimes. However, if it occurs frequently, it may indicate a severe issue. It often occurs due to a momentary drop in blood pressure followed by a lack of blood supply to the brain. It may also occur due to dehydration or a sudden change in posture from supine to upright. The body feels heavy, unsteady, sweaty, and nauseous. Lightheadedness is not life-threatening and can be treated once the causative factor is diagnosed.

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Migraine is a type of headache that presents with a moderate to severe throbbing, pulsating pain on one side of the head. It usually has triggering factors such as missing or delaying a meal, caffeine, monosodium glutamate, cheese, inadequate sleep, and more. The headache episode may last for 4-72 hours. It may interfere with routine activities and worsen with sound, light, and strong smells.

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In multiple sclerosis, the communication within the brain, and between the brain and body is disrupted. It is caused by damage to the myelin sheath, a protective covering that surrounds nerve cells. Multiple sclerosis is a chronic, unpredictable and often disabling disease which affects the central nervous system, spinal cord and optic nerves. It is categorized as an autoimmune disease caused by the immune system attacking and damaging the nervous system. 

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Muscle dystrophy is a group of conditions that causes damage to various muscle groups in an individual. As a result, muscles become weaker and less flexible due to the loss of muscle mass, affecting an individual’s ability to walk freely and carry out their day-to-day activities. Later on, this condition can also affect the patient's other vital organs, like the heart and lungs. This specific disorder is present either at birth or during the early childhood phase. Very few forms of this condition develop during late adulthood. In this condition, gene mutation occurs, interfering with the production of proteins required to form a healthy muscle. It is more commonly seen in males than females. Types of Muscular Dystrophy Although there are more than 30 types of muscular dystrophies present among individuals, the most common ones are as follows: Duchenne Muscular Dystrophy (DMD): This is the most common form of muscular dystrophy found in boys under 2 to 5 years old. It is characterised by difficulty in walking, running and climbing stairs. Slowly, the child's other organs, like the heart and the lungs, start getting involved. Congenital Muscular Dystrophy (CMD): This is present at the time of birth, and the infant presents with weakness in the muscle, a curved spine, and stiff joints. Infants also present with learning difficulties and vision problems. Facioscapulohumeral Muscular Dystrophy (FSHD): As the name suggests, this condition affects the muscles in the face, shoulder girdle, and upper arms. It is seen in children as well as adults in the age group up to 40 years. Limb Girdle Muscular Dystrophy: This condition tends to affect the muscles in the body around the shoulder and the hips. It affects people of all age groups. Becker Muscular Dystrophy (BMD): This is the milder form of Duchenne Muscular Dystrophy, and boys are affected more frequently than girls. This condition affects the muscles of the hip, thigh and shoulder joints. The symptoms appear late in the age group of 11 to 25 years. Myotonic Muscular Dystrophy: This condition is most commonly found in adults and is characterised by the inability of the muscles to relax entirely once they contract. This condition affects males and females equally, and the symptoms appear in their late 20s. Distal Muscular Dystrophy: As the name suggests, this condition affects the muscles of arms, hands, legs and feet. The symptoms come late in life, around 40 to 60 years old. Oculopharyngeal Muscular Dystrophy: This condition causes weakness in the muscles of the face and neck, drooping of eyelids, and difficulty swallowing. The symptoms appear in a person under 40 to 50 years old. Emery-Dreifuss Muscular Dystrophy: This condition affects children under the age group of 10 years and is characterised by heart problems and overall muscular weakness. Symptoms of Muscular Dystrophy Muscular weakness is the main symptom seen in muscular dystrophy. Depending on the type of muscular dystrophy present, various muscle groups are affected accordingly. Various other symptoms of muscular dystrophy are as follows: Muscular Pain Joint stiffness Difficulties in learning Enlarged calf muscles Scoliosis Difficulty in swallowing Difficulty in walking or running Abnormal walking pattern Heart problems like Cardiomyopathy Difficulty in breathing Loss of reflexes Poor posture Thinning of bone Lung weakness Difficulty in standing Causes of Muscular Dystrophy Gene mutations are attributed to this condition, and each type of muscular dystrophy is caused by a separate set of mutations in the body. These mutations prevent the production of a protein called Dystrophin, which is responsible for building and repairing muscle groups. If Dystrophin is absent, then the muscles don't work normally. For example, in Duchenne muscular dystrophy, Dystrophin is absent, whereas, in Becker muscular dystrophy, Dystrophin is present in a relatively smaller quantity. Diagnosis of Muscular Dystrophy Muscular dystrophy can be diagnosed by performing several tests. These are as follows: Blood tests: These include checking the levels of Myoglobin, serum creatine kinase and serum aldolase Muscle Biopsy: This is done to differentiate muscle dystrophy from other muscle-related diseases. It is carried out by removing a small muscle fibre through an incision. Enzyme Test: The damaged muscles release a particular enzyme called Creatin kinase in the blood. Therefore, for a person who hasn't undergone any traumatic injury, his blood samples are checked to access elevated levels of creatine kinase. Electromyography (EMG): It measures the electrical activity of the muscle by inserting a needle electrode into the muscle to be tested. Electrical activity of the muscle is recorded as it tends to contract and relax. The changes in muscle activity can confirm muscular dystrophy. Heart Monitoring Tests: These comprise electrocardiogram and echocardiogram. These are carried out to check heart function in individuals with myotonic muscular dystrophy. Neurological Physical Examination: It checks the amount of muscle strength and reflexes present in an individual. Lung monitoring tests to evaluate lung function. Treatment of Muscular Dystrophy Although no permanent cure is involved in managing muscular dystrophy, and the symptoms worsen over a while, specific treatment options available can ease the discomfort and give some temporary relief to the patients. These are as follows: Corticosteroids like prednisone and deflazacort help to slow down the progression of this condition. Speech therapy to improve speech difficulties and problems related to swallowing. Physical therapy to improve strength in the muscles and improve their overall range of motion. Heart medications like ACE inhibitors or beta-blockers enhance the functioning of the heart. Wearing braces can help to slow down the progression of contractures and keep the muscles in a stretched state. Use of mobility aids like canes, walkers, or wheelchairs to maintain mobility and functional independence. Surgery can be done to correct spinal deformities. Complications of Muscular Dystrophy Muscular dystrophy tends to affect the muscles, heart, and lungs. As a result, certain complications are bound to happen depending on the type of muscular dystrophy present. These are as follows: Limitation in mobility. Difficulty in breathing. Cardiomyopathy Scoliosis Prevention of Muscular Dystrophy To enjoy a healthy life, the following precautions can always be kept in mind: Regular exercise. Consume a lot of fluids to avoid dehydration. Maintain healthy weight. Intake of a healthy diet. Stop smoking. Outlook of Muscular Dystrophy Muscular dystrophy is a slow-developing and progressive disease that worsens over time. Medications help protect the body's vital organs, including the heart and lungs, and physical therapy aims to improve muscle strength and breathing. The life expectancy of people with muscular dystrophy depends on the type and severity of the symptoms. On average, the life expectancy is supposed to be 30 years, but with the latest developments in the medical field, the life expectancy has gone up to 40 years. Review Reviewed by Dr. K K Jindal - Director - Department of Neurology, Neurosciences.

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Do you find yourself constantly battling with neck pain, making even the simplest tasks seem like daunting challenges? You're not alone. Neck/cervical pain, medically termed cervicalgia, is a common issue that affects millions worldwide. Unchecked neck pain can swiftly transition from a minor inconvenience to a debilitating condition, hindering your ability to work, sleep, and enjoy life to the fullest. That's why it's crucial to address neck pain with the attention, care, and treatment it deserves.  At Max Hospitals, we understand the debilitating effects of neck pain and are here to help. Our team of highly experienced orthopaedic surgeons, neurologists, physiatrists (rehabilitation physicians), physical therapists, and pain management specialists bring a wealth of experience and expertise in diagnosing and treating various neck pain conditions. We employ cutting-edge techniques and personalised care to ensure optimal outcomes for our patients. Don't let neck pain hold you back any longer – take the first step towards relief by scheduling a consultation with us today.

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Neuromodulation is a treatment that directly acts upon the nerves. It is an alteration of nerve activity by sending electrical agents directly to the targeted area. It is a pain medicine that includes non-invasive, minimally invasive, or surgical electrical therapies. Neuromodulation treatment is highly beneficial as it can treat multiple diseases and symptoms, from headache, tremors, spinal cord damage, or urinary incontinence. The treatment helps to re-establish the normal functioning of the nervous system. It is most commonly used for spinal cord stimulation to manage chronic pain. Types of Neuromodulation There are two types of neuromodulation techniques. They are: Neurostimulation: Neurostimulation provides relief by blocking pen signals before they reach the brain. An electrode is inserted to deliver low-level electrical impulses to the spinal cord, brain or nerves. The device can be turned on and off using a remote control as needed. Implanted drug pumps: A small pump is implanted to deliver medication directly to the spinal cord, where the pain signal travels. Small doses of medication are used, as the medication is directly delivered to the targeted nerve area. These pumps are effective in treating severe back pain, cancer pain, muscle spasticity, neuropathic pain, or postoperative pain. When is surgery needed? Neuromodulation treatment is generally needed if a patient doesn't benefit from non-surgical pain relief options. Physicians, neurologists, and pain management physicians may recommend neuromodulation to a patient if no other options are available. Diagnosis of Neuromodulation Neuromodulation is recommended for people who are diagnosed with: Parkinson’s incontinence Vision impairment Epilepsy Psychiatric disorders Mobility issues Gastrointestinal issues Hearing impairment Cardiovascular conditions Treatment of Neuromodulation Neuromodulation treatment works by actively stimulating the nerves to produce a biological response or directly applying pharmaceutical agents in small doses at the site. Neuromodulation techniques that use electrical current are known as neurostimulation techniques. Neurostimulation devices are used on the brain, spinal cord, and peripheral nerves. The electrical current confuses the pain signals from a nerve and replaces them with a tingling sensation. Neurostimulation is always offered on a trial basis first; a person's experience is the relief they can have permanent implantation. Before the procedure, local or general anaesthesia is given. After making an incision, an electrode is inserted in the required location. This electrode generates electrical agents that interrupt the pain transmission. This process is highly effective, quick, safe, and reversible. Neurostimulation process Spinal cord stimulation: In this procedure, local anaesthesia is given, an incision is made, and later, a small electrode is placed inside the epidural space adjacent to the spinal cord. The electrode delivers a stimulus to the affected body part. Patients can control the process through a simulator. This procedure successfully relieves the pain and is commonly used for abdominal and pelvic pain or any other chronic pain, nerve pain, or problems after spinal surgery. Intra-spinal nerve root stimulation: In this procedure, the electrodes are placed near the nerve rootlets inside the spinal cord. This stimulation is used to treat focal abdominopelvic pain syndrome, such as inguinal hernia repair. Sacral Nerve stimulation: In this simulation, electrodes are placed near the sacred nodes in the spinal foramina. This stimulation is used to treat different types of chronic pelvic pain. Pelvic pain syndromes, such as vulvodynia, proctalgia, and interstitial cystitis, can be effectively treated with sacral nerve stimulation. Peripheral nerve stimulation: Peripheral nerves are located in the brain and spinal cord that make up the nervous system. In this simulation, an electrode is surgically placed near a peripheral nerve. Through the simulation, a weak electrical current is transmitted that inhibits the painful impulses from the nerve and relieves pain within that area. This stimulation is widely used to treat pain syndrome that cannot be treated with other stimulation procedures. Dorsal root ganglion (DRG) stimulation: This stimulation is used to treat different types of pain. A dorsal road ganglion is a nerve cell cluster that communicates between the spinal cord, brain, and limbs. If this structure is damaged, it can cause chronic pain. DRG stimulation helps to disrupt the pain signal sent from the body to the brain. This procedure is useful as it relieves pain without medications or surgery. Implanted drug pump: After giving anaesthesia, an incision is made, and the drug pump is surgically implanted in the abdomen, along with a catheter that is placed inside or outside the spinal cord. The pump is connected to the catheter. The catheter carries pain medication from the drug pump to the nerves and spinal cord After the insertion, the incision will be stitched and covered with bandages. Who are the best candidates for surgery? For people who are dealing with chronic pain and when no other treatment or medications work, the doctor may consider neuromodulation. The best candidates for neuromodulation are people with: Chronic pain in the back, arms, legs, or neck. Complex regional pain syndrome. Failed back surgery syndrome. Chronic pelvic or testicular pain. Postoperative pain. Chronic neuropathic pain. How do you prepare for surgery? Follow the directions given by the doctor. Do not consume food 12 hours before the surgery. Do not drink or smoke. Consult the doctor before taking any medications. Possible Complications of Neuromodulation Neuromodulation treatment can have negative side effects and complications. It may cause: Blood clots Bleeding Infection Allergic reaction to medications Infection due to intrathecal pump Headache Spinal fluid leak Infection due to catheter Taking care of yourself after surgery Few patients may experience headaches, consult the neuromodulation doctor and take medications accordingly. Keep the incidence site clean and dry, and change the dressing at regular intervals. Use mild soap and shampoo. Take enough rest and do not lift heavy objects. Avoid strenuous physical activity. Review Reviewed by Dr. Sanjay Saxena, Senior Director & HOD, Neurosciences, Neurology.

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Neuromuscular diseases are a group of disorders that affect the nerves and muscles in the body. The nervous system, consisting of the brain, spinal cord, and nerves, works in conjunction with the muscular system, comprised of skeletal and smooth muscles, to control movement and other bodily functions. These diseases can arise from various causes, including genetic mutations, infections, injuries, or environmental factors.

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As a progressive neurodegenerative disorder, Parkinson’s disease presents complex challenges that require specialised care and comprehensive management. At Max Hospitals, we understand the criticality of Parkinson’s disease and the profound impact it can have on individuals and their families. With our dedicated team of experts in movement disorders and neurology, Max Hospitals is committed to providing compassionate and personalised care to patients living with Parkinson’s disease. From accurate diagnosis to tailored treatment plans and ongoing support, we are here to empower patients with the resources and expertise needed to manage their condition effectively and enhance their quality of life.

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Peripheral neuropathy is when the peripheral nerves don't work properly due to damage- the brain and spinal cord relay messages to the rest of the body through the peripheral nervous system. The sensation is another input the peripheral nerves may send to the brain. Individuals with peripheral neuropathy sometimes report a searing or tingling discomfort. When the underlying problem is addressed, many times, the symptoms disappear. Peripheral neuropathy is often painful, although it can be treated with medication.

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When one attempts to move or even when at rest, some muscles may suddenly tense due to a disturbance in their standard movement patterns. This is known as spasticity. Despite attempts to extend them, the muscles stay tight and stiff. Spasticity can make it challenging to get about, walk, speak, and even gait may suffer. The effects of spasticity vary widely from person to person, from a vague sense of tenseness to excruciating pain and involuntary muscular spasms in the limbs.

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Spina bifida is a congenital disability that occurs when the spinal cord and the spine are not formed properly. The severity of spina bifida depends on several factors, including the kind of defect, its size, where it occurs in the spine, and whether or not there are any other issues. Surgery is sometimes used in the early stages of treating spina bifida, but it doesn't always correct the condition. Types of Spina Bifida Spina Bifida can be of the following types: Spina bifida occulta is the most frequent and least severe spina bifida. Occult spina bifida occurs when a fistula or other opening occurs in one or more of the spinal bones (vertebrae). Individuals with spina bifida occulta may not be aware they have the disorder until it is uncovered during an unrelated imaging study Myelomeningocele: The most severe form of spina bifida is called myelomeningocele. Multiple vertebrae in the lower or middle back have openings in the spinal canal. In most cases, the membranes and spinal nerves push through this hole during delivery, producing a sac on the baby's back and exposing tissues and nerves. This may put the infant at risk for potentially fatal infections, paralysis, incontinence, and other gastrointestinal issues Meningocele: The characteristic feature of this uncommon spina bifida is the protrusion of a sac containing spinal fluid through a gap in the spinal column. Meningocele does not harm the nerves, and the spinal cord is not in the fluid sac. Babies born with meningoceles may have mild functional issues, such as those involving the intestines and bladder Causes of Spina Bifida Spina bifida has no known cause, but several things may increase a person's chances of developing it. They are: Folate deficiency: Natural folic acid (vitamin B-9) is crucial for a developing baby's health. Folic acid is the synthetic version added to certain foods and used in fortification programs. Spina bifida and other neural tube abnormalities may be brought on by a lack of folate in the body Family History: If a parent has already had a kid born with a neural tube defect, there is a small risk that they will have another child born with the same issue. If two parents have had children with the disorder, the odds of this happening to the third kid also rise. In addition, the likelihood of having a child with spina bifida is higher for women born with a neural tube defect than for women born typically. However, the vast majority of kids born with spina bifida have no known ancestors who were affected by the disorder Medications: Various pharmaceutical Anticonvulsant drugs like valproic acid, for instance, have been linked to birth abnormalities of the brain and spinal cord in unborn children. One possible explanation is that they prevent the body from adequately using folate and folic acid Diabetes: Spina bifida is more common in babies born to women whose diabetes is not effectively managed Obesity: Spina bifida and other neural tube birth abnormalities have been linked to maternal obesity before pregnancy Increase in body temperature: Hyperthermia during the first few weeks of pregnancy has been linked to an increased incidence of spina bifida. Fever or using a sauna or hot tub have been linked to a slightly increased incidence of spina bifida in unborn children Symptoms of Spina Bifida Symptoms of spina bifida may include: Problems with the bladder and bowel movements The spinal canal stays open along numerous vertebrae in the lower or middle back At birth, the membranes and the spinal cord or nerves protrude, producing a sac Tissues and nerves are generally visible, and the skin may cover the sac Diagnosis of Spina Bifida Several diagnostic tests are conducted to diagnose spina bifida before the baby is born. A few of them are: MSAFP (maternal serum alpha-fetoprotein) test: A sample of the mother's blood is collected and examined for alpha-fetoprotein (AFP), a protein generated by the infant, for the MSAFP test. A small quantity of AFP crosses the placenta and enters the mother's circulation. However, exceptionally high AFP levels indicate that the infant has a neural tube abnormality, such as spina bifida; high AFP levels may not always occur in spina bifida AFP levels test: Other reasons, such as fetal age miscalculation or numerous infants, might produce varying amounts of AFP, so the doctor may arrange a follow-up blood test for confirmation. If the findings remain high, a patient will need more testing, possibly an ultrasound exam Additional blood testing: The MSAFP test may be combined with two or three additional blood tests by the doctor. These tests are often performed in conjunction with the MSAFP test, although they aim to screen for other diseases, including trisomy 21 (Down syndrome), rather than neural tube abnormalities Ultrasound: Prenatal ultrasound is the most reliable way to identify spina bifida in kids. Ultrasound may be conducted throughout the first and second trimesters (11 to 14 weeks) (and 18 to 22 weeks). During the second-trimester ultrasound scan, spina bifida may be reliably identified. This screening is crucial in identifying and ruling out congenital abnormalities like spina bifida. A sophisticated ultrasound may also reveal indicators of spina bifida, such as an open spine or specific abnormalities in the baby's brain. In the hands of a trained professional, ultrasonography may also be used to measure severity Amniocentesis: If the prenatal ultrasound reveals that the baby has spina bifida, the doctor may do an amniocentesis. A small amount of fluid from the amniotic sac, which contains the developing baby, is taken by a needle during an amniocentesis procedure. Even though spina bifida is seldom related to genetic illnesses, this investigation may be necessary to rule out genetic diseases Spina Bifida Treatment More severe spina bifida cannot be healed since the condition causes permanent nerve damage. In addition to learning how to control their bowels and bladders, children with more severe spina bifida need to develop movement abilities. Some people may need to have catheters inserted so they can urinate. As they develop, these kids will need a variety of operations and adaptive equipment, including braces, crutches, and wheelchairs, for the rest of their lives. Spina bifida patients may need ongoing medical care, including surgery, physical therapy, and medication, to manage and avoid problems. Spina bifida may cause learning difficulties in children, particularly those who have suffered hydrocephalus. Prevention of Spina Bifida One may take specific measures to prevent the occurrence of spina bifida. They are: The recommended daily dose of folic acid for women of reproductive age is 400 mcg (0.4 mg) in a multivitamin. According to studies, if women take the appropriate folic acid supplement, their risk of having a child born with spina bifida may be reduced by as much as 75% All medications, both prescribed and over-the-counter, as well as any vitamins, minerals, herbal preparations, and other dietary supplements, should be disclosed to the doctor Use acetaminophen, often known as Tylenol®, or a generic version as soon as possible to reduce temperature Stop overheating the body in hot tubs and saunas Do everything that one can to keep diabetes or obesity under control in case of pregnancy Outlook The severity of spina bifida varies. Some individuals have no effects, while others have restricted mobility and learning. Every instance is different, and it all relies on the health conditions existing at birth. All kids with spina bifida can get help, and most can live active lives with the proper care. Consult a doctor immediately to explore treatment options for spina bifida for a child. Review Reviewed by Dr. Amit Gupta - Principal Consultant - Neuro Surgery, Neurosciences, Spine Surgery.

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A seizure that extends longer than 5 minutes, or having more than one seizure within 5 minutes, without returning to an average level of consciousness between episodes, is called status epilepticus. This medical emergency may lead to permanent brain damage or death. Status epilepticus occurs when seizures last too long or are close together, and the person doesn't recover between seizures.  Very long seizures are dangerous and even increase the chance of death and permanent brain injury. These prolonged seizures must be identified early to be treated early.

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When a stroke strikes, every minute counts. Any delay in treatment can lead to permanent brain damage, loss of movement, speech difficulties, or long-term cognitive impairments. At Max Hospitals, we provide immediate, expert care to stabilise patients, restore blood flow, and minimise brain damage. For those recovering from a stroke, our personalised rehabilitation programs help regain strength, coordination, and independence, while ongoing guidance supports long-term brain health. Even for individuals at risk, we offer preventive assessments, lifestyle counselling, and monitoring to reduce the likelihood of future strokes. With a multidisciplinary team of neurologists, neurosurgeons, therapists, and support staff, Max Hospitals is dedicated to delivering timely treatment, compassionate care, and improved quality of life for patients and families alike.

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The tethered spinal cord, also known as tethered spinal cord syndrome, is a neurological disorder caused due to tissue attachment, limiting the movement of the spinal cord. It occurs when the spinal cord gets attached to the tissue around the spine, commonly at the base of the spine. This can lead to abnormal stretching of the spinal cord, causing complications such as nerve damage, severe pain, and other conditions. The spinal cord's inability to move can cause problems and affect the daily activity growth and development of a child. Tethered spinal cord occurs commonly in children, especially children with spina bifida. The condition is treatable when diagnosed and treated early. Surgery is the most widely used treatment to detach the spinal cord from the spinal tissue.

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Vasovagal syncope, also called cardio neurogenic syncope, refers to a condition when a person faints, as the body reacts to a few triggers, such as emotional distress, physical stress, or the sight of blood. The condition triggers and causes heart rate and blood pressure to drop. This reduces the blood flow to the brain, causing unconsciousness temporarily. Vasovagal syncope is harmless and does not require treatment. But an episode of vasovagal syncope can cause injuries.

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While vertigo, that unsettling sensation of spinning or tilting of the world around you, can sometimes be a fleeting annoyance caused by a quick change in head position, like rolling over in bed, it can also be a sign of something more serious. When vertigo persists or recurs, especially for days or weeks, it's important to seek medical attention promptly. This is because persistent vertigo can indicate underlying health conditions, such as stroke or migraines. At Max Hospitals, our team of experienced medical professionals is dedicated to providing comprehensive and compassionate care for vertigo patients. We offer a wide range of diagnostic and treatment options to help you get back on your feet and feeling your best. Contact us today to schedule an appointment and let us help you find relief from vertigo.

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