Media Release

Mangaluru, Jul 27: A general physician can surely treat a wide variety of health issues ranging from the common cold to metabolic disorders like hypothyroidism. However, some afflictions require specialized care and diagnostic assistance. This includes conditions of the nervous system like stroke, seizures, Parkinson’s, multiple sclerosis, and brain tumors.

For these conditions, a family doctor will surely recommend that one consults a neurologist.

Dr Rajesh Shetty, consultant neurologist and medical director, First Neuro Brain & Spine Super Speciality Hospital, Mangaluru answers a few questions regarding neurology and neurological disorders.

1. What a neurologist does?

Ans: A neurologist is a doctor who diagnoses, treats and manages disorders of the brain and nervous system (brain, spinal cord, nerves and muscles). Your brain is your body’s command centre. It controls your thoughts, feelings and actions. Every thought is translated to action via the spinal cord, nerves and muscles.

2. There is this word ‘nara’ that is commonly used in local parlance. Many look at the blue veins on hands and perceive them to be nerves. What are nerves and how the nervous system works?

Ans: This is a very valid question. The blue vessels, like the ones that you see on your wrists, are not nerves, they are veins. They carry impure blood back to the heart, which purifies it and sends them out to the body through arteries. Veins and arteries are like the pipeline carrying blood whereas nerves are like electric cables that carry electrical impulses between the brain and the rest of your body. Nerves help you feel sensations and instruct the muscles to move and act. Nerves are not visible to the naked eye.

Hence, I’d describe a neurologist as the body’s electrician.

3. So when does a person need to consult a neurologist?

Ans: Since a neurologist treats disorders that affect the brain, spinal cord, and nerves, we need to be alert when we experience memory loss, difficulty with speech and movement, severe headaches, difficulty with balance, numbness and weakness in limbs, Here I would like to stress on strokes.

A stroke can cause sudden difficulty with speech, and paralysis of one side of the body. Sudden trouble seeing in one or both eyes. Sudden dizziness, loss of balance, or lack of coordination are the other symptoms of stroke.

The first hour is considered to be the most crucial or in other words the golden hour because stroke patients have a high chance of survival and prevention of long-term brain damage if they receive medical treatment and drug therapy within the first 60 minutes of the onset of symptoms. If the patient is brought to the hospital within 4 and a 1/2 hours, we are able to reverse the stroke and prevent paralysis.

Bring the patient to the hospital at the earliest. That’s why we say, TIME IS BRAIN.

4. What are the special services offered by First Neuro Brain & Spine Super Speciality Hospital, Mangaluru?

Ans: First Neuro Hospital has a 24x7 Stroke Centre with trained specialists who can open a blocked artery within 4 to 6 hours and reverse the paralysis, so as to prevent lifetime disability. The hospital has advanced diagnostic services, including CT/ MRI, Advanced Neuro Cathlab.

First Neuro is the largest stroke receiving hospital in this region. We cater to 8 districts, accounting for a population of almost 2 crore people. We hope to create a healthier society through education and awareness.

Overall, the introduction of this exclusive Neuro Hospital in Mangaluru represents a significant step forward for the health care sector in the region, and has the potential to make a positive impact on the lives of hundreds of patients and their families.

Seizure or epilepsy: “Fits is the common term used for seizures. There is much misconception about this condition. It is not a communicable or mental health condition. It can be treated with anti-seizure medications that can efficiently manage the symptoms to the point where the condition barely interferes with life. I know of people in public life such as films and even sports, who have the condition but lead a normal life, with continued follow-up. What is needed is medical intervention when you observe obvious signs or other symptoms such as stiffness or tingling in arms and legs. Insertion of metal objects or cloth pads into the mouth, should be avoided,” says Dr Raghavendra B S, Consultant Neurologist, First Neuro Brain and Spine Super Speciality Hospital.

In case of a seizure, neurologists can do tests and imaging to find the cause. They can also diagnose long-term seizure conditions, such as epilepsy, prescribe medications and treatments to help control your seizures.

Chronic headaches can be a significant source of discomfort and can significantly impact a person's quality of life. If you're experiencing chronic headaches, it's essential to consult with a health care professional, preferably a neurologist, who specializes in diagnosing and treating neurological conditions.

Here are some key points about chronic headaches and their association with neurology:

Types of Chronic Headaches: Chronic headaches refer to headaches that occur for 15 or more days per month for at least three months. The two most common types of chronic headaches are chronic migraines and chronic tension-type headaches.

A. Tension-Type Headaches: Tension-type headaches are the most common type of headaches, often described as a mild to moderate, non-throbbing, band-like pain around the head. Chronic tension-type headaches occur on 15 or more days per month.

Triggers: Chronic headaches can have various triggers, including stress, certain foods or drinks, lack of sleep, hormonal changes, environmental factors, and underlying medical conditions. Identifying and managing these triggers is an essential part of headache management.

Neurological Evaluation: When you consult a neurologist for chronic headaches, she or he will conduct a thorough evaluation to understand your symptoms, medical history, and potential triggers. This evaluation may include a neurological examination, review of imaging studies (such as MRI or CT scan), and other diagnostic tests to rule out underlying neurological conditions that could be contributing to your headaches.

Treatment Options: Treatment for chronic headaches typically involves a combination of lifestyle modifications, preventive medications, and acute or rescue medications to manage pain during episodes. Lifestyle modifications may include stress management techniques, regular sleep patterns, dietary adjustments, and regular exercise. Preventive medications aim to reduce the frequency and severity of headaches, while acute medications provide relief during headache episodes.

Other Neurological Conditions: Chronic headaches can sometimes be associated with underlying neurological conditions such as intracranial hypertension, trigeminal neuralgia, or occipital neuralgia. A neurologist can evaluate and diagnose these conditions based on your symptoms, examination, and appropriate diagnostic tests.

Remember, it's crucial to consult with a health care professional to receive an accurate diagnosis and develop a tailored treatment plan for your chronic headaches.

B. Migraine is a neurological disorder characterized by recurrent moderate to severe headaches, often accompanied by other symptoms such as nausea, vomiting, sensitivity to light and sound, and visual disturbances. Migraines can significantly impact a person's daily life and require proper management. Here are some key points about migraine and its treatment:

Acute Treatment: Acute or symptomatic treatment aims to alleviate the pain and associated symptoms during a migraine attack. Over-the-counter pain relievers like ibuprofen or aspirin can be effective for mild to moderate migraines. For more severe migraines, triptans (e.g., sumatriptan, rizatriptan) are commonly prescribed medications that work by constricting blood vessels and reducing inflammation in the brain.

Preventive Treatment: Preventive treatment is recommended for individuals with frequent or severe migraines, usually defined as having migraines on 4 or more days per month. Preventive medications are taken regularly to reduce the frequency, duration, and severity of migraine attacks. These medications include beta-blockers (e.g., propranolol), antidepressants (e.g., amitriptyline), anti-seizure medications (e.g., topiramate), and botulinum toxin injections (Botox) for chronic migraines.

Lifestyle Modifications: Certain lifestyle changes may help in managing migraines and reducing their frequency. These can include identifying and avoiding trigger factors such as specific foods (e.g., chocolate, caffeine, aged cheeses), bright lights, loud noises, irregular sleep patterns, stress, and hormonal fluctuations. Regular exercise, adequate sleep, stress reduction techniques (e.g., relaxation exercises, meditation), and maintaining a routine can also be beneficial.

Alternative Treatments: Some individuals find relief from migraines through alternative treatments such as acupuncture, biofeedback, cognitive-behavioral therapy (CBT), and herbal supplements (e.g., butterbur, riboflavin). While these approaches may work for some people, their effectiveness varies, and it's important to discuss them with your health care provider before incorporating them into your treatment plan.

Complementary Therapies: Complementary therapies can be used in conjunction with conventional treatments to enhance overall well-being and migraine management. These can include stress management techniques, relaxation exercises, yoga, massage, and applying cold or warm compresses to the head or neck during a migraine attack.

Patient Education and Support: Education about migraine triggers, symptoms, and management strategies is crucial. Migraine support groups and online communities can provide valuable information, resources, and emotional support for individuals living with migraines.

It's important to consult with a health care professional, preferably a neurologist or headache specialist, to receive an accurate diagnosis and develop an individualized treatment plan tailored to your specific needs. They can guide you in choosing the most appropriate treatment options based on the frequency and severity of your migraines and any underlying medical conditions you may have.

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS), which includes the brain and spinal cord. It is characterized by inflammation, demyelination (damage to the protective covering of nerve fibers), and the formation of scar tissue (sclerosis) in various areas of the CNS.

The exact cause of multiple sclerosis is not known, but it is believed to involve a combination of genetic and environmental factors. The immune system, which normally protects the body against infections, mistakenly attacks the myelin sheath, the fatty substance that surrounds and insulates nerve fibers. This results in disrupted communication between the brain and the rest of the body.

The symptoms of multiple sclerosis vary widely among individuals and can change over time. Common symptoms include fatigue, difficulty walking, numbness or tingling in the limbs, muscle weakness, problems with coordination and balance, vision problems (such as blurred or double vision), dizziness, and problems with bladder or bowel control. MS can also cause cognitive changes, such as problems with memory and concentration, as well as emotional symptoms like depression and anxiety.

There are different types of multiple sclerosis, including relapsing-remitting MS (RRMS), primary progressive MS (PPMS), secondary progressive MS (SPMS), and progressive-relapsing MS (PRMS). RRMS is the most common form, characterized by periods of relapse (worsening of symptoms) followed by periods of remission (partial or complete recovery). PPMS is characterized by a gradual worsening of symptoms from the onset, without distinct relapses or remissions. SPMS initially follows a relapsing-remitting course, but eventually transitions into a steadier progression of symptoms. PRMS is the rarest form, characterized by a progressive worsening of symptoms with occasional relapses.

There is currently no cure for multiple sclerosis, but there are treatments available to help manage the symptoms, slow the progression of the disease, and improve the quality of life for individuals with MS. These treatments may include medications to reduce inflammation, manage symptoms, and modify the immune response. Physical therapy, occupational therapy, and speech therapy can also be beneficial in managing specific symptoms and maintaining functional abilities.

It is important for individuals with multiple sclerosis to work closely with health care professionals, including neurologists and other specialists, to develop a comprehensive treatment plan that addresses their specific needs and goals. Ongoing research is being conducted to better understand the underlying mechanisms of MS and develop new therapies for the management and treatment of the disease.

Parkinson's disease is a chronic and progressive neurodegenerative disorder that affects the central nervous system. It primarily affects the motor system, leading to symptoms such as tremors, stiffness, slow movement, and difficulty with balance and coordination. However, Parkinson's disease can also cause a range of non-motor symptoms, including cognitive impairment, depression, sleep disturbances, and autonomic dysfunction.

The exact cause of Parkinson's disease is unknown, but it is believed to involve a combination of genetic and environmental factors. The primary characteristic of the disease is the loss of dopamine-producing cells in a region of the brain called the substantia nigra. Dopamine is a neurotransmitter involved in the regulation of movement, and its deficiency leads to the motor symptoms associated with Parkinson's disease.

While there is no cure for Parkinson's disease, there are various treatment options available to manage the symptoms and improve the quality of life for individuals with the condition. The mainstay of treatment is medication, typically involving levodopa, which is converted into dopamine in the brain. Other medications, such as dopamine agonists, MAO-B inhibitors, and COMT inhibitors, may also be prescribed to enhance dopamine levels or address specific symptoms.

In advanced cases of Parkinson's disease, deep brain stimulation (DBS) surgery may be considered. DBS involves implanting electrodes into specific areas of the brain and connecting them to a device similar to a pacemaker, which delivers electrical impulses to modulate abnormal brain activity and alleviate symptoms.

In addition to medical treatments, various lifestyle modifications and therapies can help manage Parkinson's disease. Physical therapy, occupational therapy, and speech therapy can improve mobility, balance, and communication skills. Regular exercise, a balanced diet, and sufficient rest are also important for overall well-being.

It's worth noting that research on Parkinson's disease is ongoing, and there is ongoing exploration of potential new treatments and therapeutic approaches. Clinical trials are conducted to test new medications, interventions, and technologies that may improve outcomes for individuals with Parkinson's disease.

Pediatric neurology is a medical specialty that focuses on the diagnosis and treatment of neurological disorders in children. It deals with the study and management of disorders affecting the nervous system, including the brain, spinal cord, nerves, and muscles in infants, children, and adolescents.

Pediatric neurologists are specialized Physicians (Pediatricians) who have undergone intensive additional training in the field of child neurology. They are skilled in evaluating and managing a wide range of neurological conditions that affect children, such as epilepsy, Neuro developmental disorders, neuromuscular disorders, genetic disorders, metabolic disorders and neuro emergencies.

One of the key aspects of pediatric neurology is the understanding of the unique differences between the developing nervous system of a child and that of an adult. Children's brains undergo rapid growth and maturation, and they may present with distinct symptoms and responses to treatment compared to adults. Pediatric neurologists employ a comprehensive approach to diagnose and treat their young patients, taking into consideration the child's age, development, and specific needs.

Pediatric neurology encompasses a wide range of disorders, including:

Epilepsy: Pediatric neurologists diagnose and manage epilepsy, a neurological disorder characterized by recurrent seizures. They may prescribe anti-seizure medications and develop individualized treatment plans for each child.

Developmental Delay: Children who experience delays in reaching developmental milestones, such as walking, talking, or cognitive skills, may be evaluated by a pediatric neurologist to determine the underlying cause and provide appropriate interventions.

Cerebral Palsy: This condition affects movement and muscle coordination, often resulting from damage to the developing brain. Pediatric neurologists work closely with other health care professionals to provide early intervention, therapy, and management strategies for children with cerebral palsy.

Neuromuscular Disorders: Conditions such as muscular dystrophy, peripheral neuropathy, and myasthenia gravis fall under the realm of pediatric neurology. These disorders affect the muscles and nerves, leading to weakness, impaired mobility, and other related symptoms.

Headaches and Migraines: Pediatric neurologists evaluate and treat children experiencing recurrent headaches or migraines, often employing a combination of lifestyle modifications, medications, and other therapeutic approaches to alleviate symptoms.

Neurodevelopmental Disorders: Conditions like autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability are also within the scope of pediatric neurology. Pediatric neurologists collaborate with other specialists to provide comprehensive care and support for children with these conditions.

Pediatric neurology involves various diagnostic techniques and tools, including detailed medical history assessment, physical examinations, neurological evaluations, neuroimaging studies (such as MRI or CT scans), electroencephalography (EEG), and genetic testing. These tools help pediatric neurologists identify the underlying cause of a child's neurological symptoms and develop an appropriate treatment plan.

The treatment strategies in pediatric neurology aim to identify the problems early, minimize symptoms, improve the child's quality of life, and promote optimal neurological development. Depending on the specific condition, treatment approaches may include medications, physical therapy, occupational therapy, speech therapy, specialized diets, and in some cases, surgical interventions.

Pediatric neurologists work closely with a multidisciplinary team of healthcare professionals, including pediatricians, neurosurgeons, geneticists, neuropsychologists, and therapists, to provide comprehensive care for their patients. They also collaborate with the child's family to ensure proper education, support, and ongoing management of the neurological condition.

In summary, pediatric neurology is a specialized field of medicine dedicated to the diagnosis and treatment of neurological disorders in children. The goal is to provide optimal care, improve outcomes, and enhance the quality of life for young patients and their families.

Neurosurgery

Head injuries

If there is a head injury, a neurosurgeon might be needed to help determine the extent and put down a treatment plan. They might need surgical procedures sometimes to save the lives followed by prolonged period of medications.

“One wishes our two-wheeler riders wore helmets. These can really reduce the severity of head injuries,” says Dr Skanda Moorthy, Neurosurgeon, First Neuro Brain and Spine Super Speciality Hospital. “Just last week we had an emergency case. A 23-year-old was brought in with severe head injury. If he had worn a helmet the intensity of the damage and hence the extent disability could have been reduced.”

Brain Tumours

Patients may experience a variety of clinical symptoms like headache, vomiting, weakness of limbs or difficulty in speech and on evaluation may get diagnosed with brain tumours, in most of the cases brain tumours require surgical procedure for the removal of the same. This may be followed by other modes of treatment depending on the type of tumour which is present. Early detection and prompt treatment at an early stage can definitely reduce the extent of damage to the brain.

Spine diseases

Patients with a variety of spine diseases have symptoms like back pain which may radiate along the legs or arms, they may have weakness of the limbs, decreased sensation or incontinence for passing urine or stools.

Dr Skandamoorthy says prompt diagnosis is very important especially considering the extent of misconception and malpractice that is present around the various spine diseases. We see a lot of patients who, instead of getting proper medical care at an early stage, fall prey to quacks suggesting various kinds of oil massages or other forms of treatment even before diagnosing the exact reason for the symptoms seen. Once the correct diagnosis is made, the treatment may be either rest with medications and proper physiotherapy or surgical, so as to get rid of that which is causing problems to the spinal cord and nerves.

Also, if you’ve been having increased forgetfulness, trouble concentrating, and brain fog, a neurologist can test for dementia and prescribe medications to help slow down the condition.

Interventional Neuro Radiology

Interventional neuroradiology, also known as neurointerventional surgery or endovascular neurosurgery, is a specialized field that combines radiology and neurosurgery to diagnose and treat diseases of the central nervous system (CNS) using minimally invasive techniques. It involves the use of catheters, wires, and other devices inserted through blood vessels to access and treat the affected areas of the brain and spine.

Interventional neuroradiologists are skilled physicians who have undergone specialized training in both radiology and neurology or neurosurgery. They work closely with a multidisciplinary team of neurologists, neurosurgeons, anesthesiologists, and other medical professionals to provide comprehensive care for patients with neurovascular disorders.

The primary focus of interventional neuroradiology is the treatment of cerebrovascular diseases, such as aneurysms, arteriovenous malformations (AVMs), and stroke. Procedures performed include:

Aneurysm coiling: This technique involves inserting small platinum coils into an aneurysm through a catheter to promote blood clotting and prevent rupture.

Embolization: It is used to treat AVMs or arteriovenous fistulas (AVFs) by blocking abnormal blood vessels using glue-like substances or small metallic particles.

Thrombectomy: This procedure involves removing blood clots from cerebral arteries to restore blood flow and prevent further brain damage in acute ischemic stroke.

Angioplasty and stenting: It is performed to treat narrow or blocked blood vessels by inflating a balloon and placing a stent to keep the vessel open.

Interventional neuroradiology offers several advantages over traditional open surgical approaches. It is less invasive, leading to shorter hospital stays, reduced pain, and faster recovery times for patients. Additionally, the precise targeting of affected areas reduces the risk of damage to healthy tissues.

However, interventional neuroradiology procedures require a high level of expertise and advanced imaging technology, such as fluoroscopy, angiography, and 3D reconstruction, to guide the catheter through complex blood vessels within the CNS.

Overall, interventional neuroradiology plays a vital role in the diagnosis and treatment of various neurovascular disorders. Its continuous advancements have significantly improved patient outcomes and continue to contribute to the field of neurosurgery and neurology

Neurorehabilitation is a specialized field of health care aimed at restoring or improving the functioning of individuals with neurological conditions or injuries. It focuses on the rehabilitation of the nervous system, which includes the brain, spinal cord, and peripheral nerves. This branch of medicine utilizes a multidisciplinary approach to address the complex needs of patients, combining various therapeutic interventions, technologies, and strategies.

Neurological conditions or injuries can result in a wide range of impairments, including motor deficits, sensory loss, cognitive challenges, and communication difficulties. Neurorehabilitation aims to promote recovery, enhance independence, and improve the quality of life for individuals affected by these conditions.

The process of neurorehabilitation typically begins with a thorough assessment by a team of healthcare professionals, which includes physiatrists, occupational therapists, physical therapists, speech therapists, and psychologists. They work together to develop an individualized treatment plan tailored to the specific needs and goals of each patient.

Physical therapy plays a crucial role in neurorehabilitation by addressing motor impairments and promoting mobility. It involves exercises and activities that help improve strength, balance, coordination, and a range of motion.

Occupational therapy focuses on enhancing the ability to perform daily activities, such as self-care tasks, work-related tasks, and leisure activities.

Speech therapy is employed to address speech and language difficulties that may arise from neurological conditions, while cognitive rehabilitation targets cognitive impairments such as memory, attention, and problem-solving skills.

Neurorehabilitation is a continuous process that requires time, effort, and commitment from both the patients and their caregivers. It focuses not only on the physical recovery but also on emotional support, education, and the development of coping strategies. The ultimate goal is to maximize functional independence and improve the overall well-being of individuals affected by neurological conditions, enabling them to participate more fully in their daily lives.

By combining scientific knowledge, clinical expertise, and patient-centered care, neurorehabilitation offers hope and possibilities for individuals with neurological conditions to regain their abilities and lead independent lives.

Contact:

First Neuro Brain & Spine Super Specialty Hospital
Kannur Village, Padil Post, Mangaluru - 575007
Contact details: 0824-2276633/4293333 Mob:9343442488/ 9663054411
Email: info@firstneuro.in
Web: www.firstneuro.in