Neurology thread

[gothamprince]

11 minutes ago, Rendu said:

Early morning, restroom ki vellinappudu okko sari kallu tiriginatlu anipisthundi... ... I fainted a few times when I was in early twenties....

it can also seizure episodes[ fits]

[Jaggadonga]

7 hours ago, gothamprince said:

ask your doubts related to neurology here

Bro......naku hands and legs lo bone cracking ekkuva vuntundi enduku? 

 

Stroke ki vache mundu symptoms enti?

 

Hands and feet tingling and numbness when I sir continuously in one position.

[gothamprince]

1 hour ago, Jaggadonga said:

Bro......naku hands and legs lo bone cracking ekkuva vuntundi enduku? 

 

Stroke ki vache mundu symptoms enti?

 

Hands and feet tingling and numbness when I sir continuously in one position.

bone cracking is due to formation of air bubbles in the synovial fluid [joint fluid] 

Stroke itself is a sudden event by definition no signs before it usually it is very important to identify the symptoms as early as possible to administer appropriate treatment that is tPA to protect the remaining brain called penumbra region in stroke . time is brain literally in this case

For easy identification of symptoms there is mnemonic called FAST

F- Facial drooping

A- Arm or leg weakness

S-Slurring of speech

T- Time to call emergency services

in very few people there can be sudden loss of vision just like black curtain falling down on the eyes [like shutter closing] called amaurosis fugax which is temporary loss of vision seen in transient ischemic attack which can be followed by stroke so this is like a warning sign

tingling and numbness on long sitting is due to pooling of venous blood in that area can cause pressure on the local nerves and reduce oxygen to it which is temporary nothing to worry

in case of further clarification i am more than happy to answer

[ambothu]

Trigeminal neuralgia - what causes it ? What are long term effects of this ? How this can be treated ?

[Variety_Pullayya]

ee seizures in kids...are they dangerous and concerning?

what are the chances a one time seizure to be diagnosed as epilepsy?

[Anta Assamey]

[gothamprince]

3 hours ago, ambothu said:

Trigeminal neuralgia - what causes it ? What are long term effects of this ? How this can be treated ?

Trigeminal neuralgia  patients has episodic severe pains in lips, gums, cheek or chin usually lasts few seconds to minutes that recur frequently they may occur spontaneously or by movement of affected area by speaking, chewing, smiling

may also while touching during washing of face, brushing teeth or exposure to cold wind

compression of the trigeminal nerve which is sensory supply to most part of the face by the nearby artery mostly superior cerebellar artery is now believed to be the source of the pain 

this type of pain can also be seen in multiple sclerosis which can affect trigeminal nerve

coming to long term affects maybe the pain can become more severe as the thickness of compressing blood vessels can increase with age or can remain the same which is already severe enough

THERAPY: drug therapy with carbamazepine is first line of choice  if not effective other drugs like lamotrigine or phenytoin can be tried

if drug therapy is not sufficiently effective then surgical therapy like microvascular decompression which relieves pain on trigeminal nerve is the most common

other options like gamma knife radiosurgery are also available

[gothamprince]

2 hours ago, Variety_Pullayya said:

ee seizures in kids...are they dangerous and concerning?

what are the chances a one time seizure to be diagnosed as epilepsy?

Any seizure episode which most commonly occur start in children or young adult should be evaluated very thoroughly , every seizure is concerning

Epilepsy by definition is two or more unprovoked seizures

Seizures has many causes including structural causes like malformations of the brain and overlying structures and metabolic causes like hypoglycemia[ low glucose], hyponatremia[ low sodium ], etc and conditions like stroke ,encephalitis[ brain infections], head injury

all the seizures caused by correctable causes like low sugar etc even though multiple doesn't come under epilepsy as they should be identified and treated to prevent further occurance

The term unprovoked which is in definition of epilepsy is that the cause of seizure is unknown etiology or preexisting brain lesion like tumors, stroke lesion, or progressive neurological conditions like multiple sclerosis as these have most chances of recurrence

so every seizure should be thoroughly evaluated for correctable causes like low sugar or infections in the brain then treated accordingly if no correctable acute causes are found then should be approached like highly probable to be epileptic and should be treated with anti epileptic drugs

and before everything else first it should be confirmed as seizure episode thorough history as many conditions can mimic seizures

[pichhipullayya]

Neuropathy  long term side effects enti ? my brother got it post Cancer treatment..Initially sensitivity, pain chala undevi..slowly hands and legs and some parts of body Desensitize ayyayi antaadu... His oncologist says its normal..

day to day life ibbandi ledu kani anything to worry about ?

[gothamprince]

8 hours ago, pichhipullayya said:

Neuropathy  long term side effects enti ? my brother got it post Cancer treatment..Initially sensitivity, pain chala undevi..slowly hands and legs and some parts of body Desensitize ayyayi antaadu... His oncologist says its normal..

day to day life ibbandi ledu kani anything to worry about ?

what was the cancer had and what treatment he underwent?

both chemotherapy and radiation therapy can cause neurological dysfunction

drugs like vincristine can cause peripheral neuropathy start from toe of the foot and spreads upward mostly affecting pain and temperature sensation this is dose dependent this is to be decided by the oncologist after careful history and examination that when the drug should be stopped due to toxicity

mild toxicity will be slowly but completely resolved. In greater toxicity it may progress to muscle weakness and some amount of residual sensory loss after the stoppage of treatment

cisplatin can cause both sensation and muscle loss too and also hearing will be reduced

so please mention the drugs taken by your brother

 

[pichhipullayya]

59 minutes ago, gothamprince said:

what was the cancer had and what treatment he underwent?

both chemotherapy and radiation therapy can cause neurological dysfunction

drugs like vincristine can cause peripheral neuropathy start from toe of the foot and spreads upward mostly affecting pain and temperature sensation this is dose dependent this is to be decided by the oncologist after careful history and examination that when the drug should be stopped due to toxicity

mild toxicity will be slowly but completely resolved. In greater toxicity it may progress to muscle weakness and some amount of residual sensory loss after the stoppage of treatment

cisplatin can cause both sensation and muscle loss too and also hearing will be reduced

so please mention the drugs taken by your brother

 

Velcade, Decadron,Revlimid,Gabapentin , there are few more these are the ones i have photos of when i filled in pharmacy. Chemo was Melphalan

[rmJU72]

might be a general question…what are the common neurological problems and tests to do to preventatively detect them for aging parents.

[BonguBooshanam]

Treatment options for Occipital Neuralgia ? Severe neck pain radiates to head and shoulder. Pain will be worse when radiates to head almost just above eye. Any non invasive treatment options ?

[Barney_Stinson]

@gothamprince  may be or may not be related to you 

So when i try to sleep, almost at 99% of falling asleep, my brain is too cautious of letting my body sleep, however at this point mind awakes me and causes headache, i have history of migraines and also SAD..thoughts ?

[gothamprince]

On 6/8/2023 at 11:08 AM, pichhipullayya said:

Velcade, Decadron,Revlimid,Gabapentin , there are few more these are the ones i have photos of when i filled in pharmacy. Chemo was Melphalan

 

On 6/8/2023 at 11:08 AM, pichhipullayya said:

Velcade, Decadron,Revlimid,Gabapentin , there are few more these are the ones i have photos of when i filled in pharmacy. Chemo was Melphalan

based on the treatment you have mentioned he must have had multiple myeloma the bortezomib is known to cause neuropathy so in general given subcutaneously and given weekly to minimise but still may get it

in addition multiple myeloma itself cause neuropathy so gabapentin was given to reduce neuropathic pain

is he not a transplant candidate as he is receiving melphalan what are the reasons?

if the oncologists says nothing to worry then it's fine or else he would have changed the drug or reduced it's dose