Dr Stefan Schumacher

Dr Stefan Schumacher
Neurology
Manchester


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Dr Stefan Schumacher

Neurologist in
Greater Manchester

FRCP MD


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Book online

e-Consultation

Dr Stefan Schumacher areas of expertise:

Professional statement

Dr Stefan Schumacher is a leading consultant neurologist based in Greater Manchester, who specialises in multiple sclerosis (MS), Parkinson’s disease, headaches and migraines.

Dr Schumacher was born and educated in Germany and moved to the UK in 2007 where he worked as a consultant neurologist in Salford Royal Hospital and Royal Bolton Hospital. He currently works in the private sector at the Spire Manchester Hospital and BMI Alexandra Hospital.

Dr Schumacher studied medicine in Florence, Italy and Saarbruecken and Freiburg, Germany. In Germany he worked in a number of medical centres, including Neurosurgery University Hospital, Giessen and a specialised centre for MS and Parkinson’s disease in Bad Laasphe.

For nine years Dr Schumacher was a consultant and the Medical Director of the Wicker Clinic in Bad Wildungen. His department was one of the first in hospitals in Germany to be certified by the German Society for MS. He participated in MS research and was in charge of phase 3 trials with MS medication.

Dr Schumacher was the German Deputy for medical exchange with several Arab countries such as the United Arab Emirates, Qatar, Oman and Egypt. He was a lecturer at the University Hospital Marburg and a teacher and an examiner for medical students at Marburg University.

As a passionate long-distance runner, he holds a special interest in sport-related health issues in neurology. Dr Schumacher is a member of the committee 2.5 Neurology and Sport of the German Society of Neurology and has presented in the past on scientific conferences for this committee.

Dr. Schumacher was born and educated in Germany. He is a son of a German father and English mother from Windsor/Berkshire, he was brought up bilingual.

He studied medicine in Florence, Italy and Saarbruecken and Freiburg, Germany. After graduation he worked in different medical centres in Germany incl. neurosurgery university hospital in Giessen and a specialised centre for Multiple Sclerosis and Parkinsons Disease in Bad Laasphe.
During his time in neurosurgery Dr Schumacher had a special interest in intense care medicine and was one the responsible physicians of the ITU in University Hospital Giessen/Germany which was managed by neurosurgeons and neurologists.

For 9 years Dr Schumacher was consultant and medical director of the Wicker Clinic Bad Wildungen. His special interest at that time was Multiple Sclerosis (MS) and Parkinsons Disease (PD). Dr Schumacher's department was one of the first hospitals in Germany which were certified by the German Society for MS
(" Deutsche Multiple Sklerose Gesellschaft"). Dr Schumacher participated in MS research and also was in charge of Phase 3-trials with MS medication.

Dr Schumacher is member of 3 national neurological societies: ABN (Association of British Neurologists), DGN (Deutsche Gesellschaft fuer Neurologie ) and AAN (American Academy of Neurology).

Dr. Schumacher was German deputee for medical exchange with several Arab countries such as Emirates, Qatar, Oman and Egypt.
He was a lecturer at the University Hospital , Marburg (Prof. Oertel, Neurology) and a teacher and examiner for medical students in Marburg/ University.

Dr Schumacher and his family moved to UK in 2007 and worked as a consultant neurologist in Salford Royal Hospital (prior known as Hope Hospital) and Royal Bolton Hospital. Since 1.4.2016 Dr Schumacher works part time in NHS at Salford Royal Hospital.
Dr Schumacher works 4 days weekly in 2 private hospitals in Manchester : Spire Hospital in Didsbury and Alexandra Hospital in Cheadle.

Being himself a passionate long-distance runner, Dr Schumacher has since years a special interest in sport-related health issues in neurology. Dr Schumacher is member of the committee 2.5 "Neurology and Sport" of the German Society of Neurology (DGN) and has presented in past on scientific conferences for this committee.

Chronic migraine is a very common neurological problem and often patients find it very difficult coping with this condition. Dr Schumacher has a special interest in new treatments for this.. BOTOX (Botulinum toxin type A) is now recommended as an option for the prophylaxis of adults suffering from chronic migraine (NICE Guidance 2012). This is a very interesting new treatment for migraine sufferers and Dr Schumacher is planning  this treatment soon for private patients in BMI The Alexandra Hospital in Cheadle.

 

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 Credentials

GMC: ‍6158328

 Professional experience

• Consultant Neurologist, Spire Manchester Hospital, Manchester (present)
• Consultant Neurologist, BMI The Alexandra Hospital, Cheadle (present)

 Sub-specialties

• Headache
• Migraine
• Epilepsy
• Parkinson's disease
• Multiple Sclerosis 
• Neuropathic pain
• Abnormal gait
• Acquired brain injury
• Alzheimer's disease
• Amnesia
• Amyotrophic lateral sclerosis (ALS)
• Arm pain
• Ataxia
• Back pain
• Brain metastasis
• Brain tumour
• Cerebrovascular accident
• Cerebrovascular disease
• Chorea
• Chronic headache
• Cluster headaches
• Cognitive impairment
• Cognitive Neurology
• Consciousness disorders
• CT scan (CAT)
• Dementia
• Dizziness
• Dystonia
• Epilepsy
• Essential tremor
• Huntington's disease
• Instability and falls
• Loss of consciousness
• Memory disorder
• Memory test
• Mild cognitive impairment (MCI)
• Movement disorders
• Muscular dystrophy
• Myasthenia gravis
• Myelitis
• Narcolepsy
• Neuralgia
• Neurological disorders
• Neurological treatments
• Neuromuscular disease
• Neurorehabilitation
• Obstructive sleep apneoa
• Oncology Neurology
• Paraneoplastic syndromes
• Parkinsonism
• Restless legs syndrome
• Second medical opinion
• Secondary Parkinsonism
• Sleep Problems
• Spasticity
• Spinal cancer
• Stroke
• Tension headache
• Tourette's syndrome
• Traumatic brain injury
• Vascular dementia
• Vertigo
• Whiplash
• Neuro-sport injuries
• Botulinumtoxin injections for migraines

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 Teaching posts

• Previously a lecturer at the University Hospital, Marburg
• Previously a teacher and an examiner for medical students at Marburg University
• Academic lecturer and examiner for Medical School Manchester , Year 3, 4 and 5.

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 Education

• Neurology, Salford Royal Federation Trust (2007)
• Medical dissertation 1995, Ruhr University Bochum, Germany "MR findings in Alzheimer's patients-a comaprison study with normal aged patients." Supervision : Prof. FL Welter, Bochum.

 Professional membership

• Association of British Neurologists (ABN)
• American Academy of Neurology (AAN)
• Deutsche Gesellschaft für Neurologie ( DGN)
• British Medical Association (BMA)

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Languages spoken

  • English
  • German
  • French
  • Italian

Diseases, Medical Tests and Treatments

Epilepsy

What is epilepsy? Epilepsy is a neurological disorder that causes recurrent seizures in the person suffering. These seizures appear when groups of ...

Headache

What is a headache? A headache is one of the most common day-to-day pains felt by people. Headaches come in different forms and vary in their inten ...

Migraines

What is it? A migraine is a type of headache occuring due to a chronic nervous system disorder. It is a debilitating headache which normally comes ...

Multiple sclerosis

What is multiple sclerosis? Multiple sclerosis (MS) is an autoimmune condition, in which the immune system mistakenly attacks the insulating la ...

Neuropathic pain

What is neuropathic pain? Neuropathic pain is a neurological disorder in which people experience intense chronic pain due to nerve damage. It often results from an injury or disease of the peripheral or central nervous system. Neuropathy can exist without pain, in the same way that pain can exist without evidence of nerve injury. Neuropathic pain, therefore, can be defined as a sensation or unpleasant emotional experience associated with dysfunction or injury of the nervous system. What are the symptoms of neuropathic pain? This pain usually causes numbness and pain in the hands and feet, as well as tingling or burning. Along with pain, other symptoms may appear, such as: Insomnia Constipation Lack of appetite Anxiety Vomiting Weakness Discomfort in the mouth Acute pain or a stinging sensation What causes neuropathic pain? Peripheral neuropathic pain, or chronic neuropathic pain, is a result of damage to the peripheral nerves. This damage can be caused by: Nutritional imbalances Alcoholism Toxins Infections Autoimmunity Amputation Diabetes Diseases, such as kidney failure or cancer Trauma to the nerves Shingles Thyroid problems How is neuropathic pain treated? The treatment for neuropathic pain can vary according to each case. These are the treatments available: Medication: The first thing that specialists recommend are certain medications (e.g. antidepressants, NSAIDs, painkillers). Physiotherapy: To reconstitute the muscles so they can move normally and with less pain. Psychological therapy: pain can cause stress in the patient. This therapy helps the patient to manage the pain and resulting stress. Nerve blocks: local anaesthesia or steroid injections are administered at the origin of the pain, providing temporary relief. Medical devices: implantable devices can modulate pain signals before reaching the brain. ...

Parkinson's

What is Parkinson's? Parkinson's disease is a neurodegenerative disorder that affects the neurons that produce dopamine. Normally this disorder develops slowly in people from 55 to 65 years of age. What are the symptoms of Parkinson’s? This disorder causes a progressive deterioration of certain brain functions in the patient that manifest with various symptoms, including: A tremor in the arms and or legs Limb rigidity Balance problems Urinary problems Depression Speech can be affected Symptoms present differently in each patient and experiences of this disorder can be very different. What causes Parkinson’s? The exact cause of Parkinson's is unknown, however, it can attributed to a loss of nerve cells in the part of the brain called the substantia nigra. This loss of cells causes a reduced production of dopamine which is needed to regulate movement. However, it is not known what causes this loss of nerve cells. Parkinson’s disease can run in families, and passed from parent to child, however, this is a rare way to inherit the condition. Can Parkinson’s be prevented? Since the cause of this disease is not known, there is no known way to prevent it. What is the treatment for Parkinson’s? There is no known cure for Parkinson’s, however, treatments can help to manage and relieve symptoms and improve quality of life. Treatments include physiotherapy and occupational therapy, medication and in some cases surgery (deep brain stimulation). One of the important parts of the treatment is physical rehabilitation, which consists in the maintenance of muscle tone and motor functions, hence why daily physical activity is important. ...

Abnormal gait

What are gait abnormalities? Gait abnormalities are alterations in the way of walking, usually due to injuries or pathologies of the spinal cord, brain, legs or feet. They can affect the speed at which you walk, and lead problems with consistency, symmetry or movements that are not synchronised. A gait takes place following a repetitive cycle in which different structures of the central and peripheral nervous system are involved. This cycle can be affected by neurological diseases or musculoskeletal factors that affect gait and balance. Since a wide range of conditions can cause gait abnormalities, there are correspondingly many types of gait abnormalities: Parkinsonian gait: characterised by a rigid way of walking with the torso inclined, walking with quick but small steps. Hemiplegic gait: usually caused by a brain injury or a stroke that causes the patient to walk with one leg and with the torso flexed to the side. Myopathic gait: a gait characterised by swinging to compensate for weakness in the pelvic area. Antalgic gait: a gait that develops in response to pain in a limb Ataxic gait: an unsteady gait with a tendency to stumble, as a result of damage to the motor neuros in the brain Steppage gait: one or both legs lift higher than normal to compensate for damage to the deep peroneal nerve Symptoms of changes in the gait Gait abnormalities may appear suddenly, if someone has suffered an injury or brain damage due to stroke. Other gait abnormalities may be more difficult to notice because they develop over time, due to an underlying progressive neurological condition. Parkinson’s is a common example of a progressive gait abnormality. Medical tests for gait abnormalities To diagnose gait abnormalities, a physical examination is carried out that includes semiological analysis of gait and associated neurological signs. To be able to detect alterations, the following is taken into account: central or peripheral motor problems with the legs and feet balance disorders pain changes to the size of steps taken Complementary investigations can also be performed to help make a diagnosis of an underlying condition. These can include: CT scan X-ray MRI scan Nerve conduction studies Treatments for gait abnormalities Treatment for gait abnormalities may require the involvement of a number of different specialists, such as a geriatrician, a neurologist, or occupational therapist. The neurologist is likely to oversee and coordinate your treatment. Treatmen may include: treatment of the underlying conditoin (e.g. medication to mitigate symtoms of Parkinson’s, or surgery to repair damaged bones and joints) physiotherapy to help correct the gait walking aids such as leg braces, a walking stick, or a walking frame, to make walking easier if there are limits to how much the gait abnormality can be treated ...

Acquired brain injury

Acquired brain injury, often abbreviated to ABI, refers to damage sustained to the brain at any time during a person’s lifetime, as opposed to a genetic or congenital disorder or damage occurring while in the womb. An acquired brain injury can have temporary or permanent affects on a person, causing impairments in cognitive, physical, emotional and behavioural functioning. Acquired brain injury is usually broken down into two forms, each with a number of different causes associated. The two forms are:   Traumatic brain injury (TBI) A TBI is any form of sudden physical damage to the brain. This can be caused by any number of ways, such as a closed head injury, which is when the head forcefully impacts with an object. This could be due falling, sports injury, violent crime, or most commonly a motor vehicle accident. Another type of traumatic brain injury is called a penetrating head injury, which is caused by an object piercing the skull and damaging the brain, such as a gunshot wound. Non-traumatic brain injury A non-traumatic brain injury is one caused by an illness or through substance abuse. For example, conditions such as stroke, brain tumours, lack of oxygen, brain haemorrhage, encephalitis, poisoning, alcohol or drug abuse. To name a few of the possibilities.   What can acquired brain injury lead to?   An acquired brain injury can lead to any number of detrimental effects on the person, depending on the position of the injury on the brain and the severity of the injury. Examples of the kinds of effects that an acquired brain injury can cause include physical changes such as problems walking, standing, sitting. Cognitive changes such as problems with vision or hearing, decision making, comprehension, becoming easily distracted, affecting judgement, and confusion. There may also be emotional changes such as depression, anxiety, anger management problems, sadness and frustration. The person may also suffer chronic pain such as multiple headaches.   How are acquired brain injuries managed?   There is not a single comprehensive way that acquired brain injuries are treated. Treatment depends on the injury, the symptoms, and also the age of the patient, as paediatric acquired brain injury may be treated much differently. The patient will have to go through a bespoke, multidisciplinary rehabilitation programme to attempt to improve on any functions lost due to the injury. A number of specialists will be required, depending on the extent of the symptoms, these specialists can include physiotherapists, occupational therapists, speech and language therapists, psychologists, and pain specialists. As children’s brains are still developing, the approach to paediatric acquired brain injuries may differ. Because the brain is still in development, some of the injuries may not appear until later in the child’s life as the brain continues to develop. To make an appointment to see a specialist about acquired brain injury, click here. ...

Alzheimer's disease

What is Alzheimer's disease? Alzheimer's disease is a degenerative brain disorder that severely affects certain mental functions of the patient and interferes with their daily lives. It is the most common form of dementia in the UK. This disease has different stages: Mild stage: The disease still goes unnoticed because the patient suffers minor memory problems. In addition, signs of apathy, isolation and mood swings may appear. Moderate stage: The disease is evident, and the patient will have difficulties performing daily activities such as shopping or cooking. In addition to memory loss, there will be a lack of reasoning. Severe stage: All areas related to cognitive function are affected. The patient loses the ability to speak and to recognise people around them. Generally the patient will be in a state of constant disorientation. What are the symptoms of Alzheimer's disease? At the beginning of the disease, the patient shows small memory losses such as difficulty remembering recent things or names of people. These symptoms get worse until they are unable to recognise close family members and have difficulty reasoning, speaking, reading and writing. The main neurological symptoms are: Inability to retain new information. Inability to remember personal information such as birthdays or profession. Alteration in reasoning capacity. Aphasia Apraxia Loss of spatial capacity Changes in character and personality. What causes Alzheimer's disease? Alzheimer's is caused by the degeneration of connections between brain cells, as well as genetic, lifestyle and environmental factors. Although the exact cause is unknown, the effect of the disease is the damaging and killing of brain cells. A brain in an Alzheimer’s patient has fewer connections between brain cells than in the brain of a healthy person. There are also certain risk factors for Alzheimer’s, including:  Age: usually affects people over 60-65 years old. Sex: more women are diagnosed with Alzheimer’s. Family heritage: it is estimated that 40% of Alzheimer's patients have a family history. Genetic factor: several mutations in the gene of the amyloid precursor protein (APP) or in that of presenilin 1 and 2. Environmental factors What is the treatment for Alzheimer's disease? There is currently no cure for Alzheimer’s disease, but some drugs can help delay the disease and its symptoms. Activities and support also play an important part in the care of Alzheimer’s patients.  ...

Amnesia

What is amnesia? Amnesia is a disease that is characterised by memory loss. Facts, information and experiences can be forgotten, but generally people suffering from amnesia still know who they are. Amnesia can be temporary (transient global amnesia) or it can be permanent. Amnesia can result from damage to the brain through injury or illness, however, dissociative amnesia can result from emotional trauma or stress.   What are the symptoms of amnesia? The main symptoms of amnesia are either difficulty learning new informing (anterograde amnesia) or difficulty remembering past information and events (retrograde amnesia). People with amnesia may also have the following symptoms: Isolated memory loss False memories Confusion / disorientation The main symptom of amnesia is the loss of access to memory. When the memory loss is more serious and extensive it can lead to a deterioration in the interpersonal and work relationships of the person, antisocial behaviour with which he tries to alleviate the social pressure he feels when he is unable to relate in society.   What causes amnesia? Memory requires many parts of the brain, and if any of these parts are damaged due to injury or disease, then memory can be affected. Such amnesia is known as neurological amnesia and can be caused by: Degenerative brain diseases (e.g. Alzheimer’s) Stroke Inflammation of the brain (due to infection, virus or cancer) Oxygen deprivation to the brain Brain tumours Seizures Certain sedative medication Alcohol abuse Head injuries (e.g. car accidents, sports injuries) Dissociative amnesia is psychological and can result in a temporary loss of memory of personal identity. This can be caused by emotional stress or trauma.   Can amnesia be prevented? Amnesia can be prevented in some cases by making certain lifestyle choices, such as: Wearing a helmet when cycling and a seatbelt when driving Avoid excessive alcohol consumption If you think you might be suffering from a stroke, seek immediate medical attention.   What is the treatment for amnesia? In most cases, amnesia resolves without treatment. However, if an underlying physical or mental disorder is present, it should be treated if possible. Psychotherapy can be effective in some patients and hypnosis is a way of remembering certain episodes that have been forgotten. Family support is very important to help the patient improve. Working with an occupational therapist helps you acquire new information to replace lost memories or to acquire new information. ...

Amyotrophic lateral sclerosis (ALS)

What is amyotrophic lateral sclerosis? Amyotrophic lateral sclerosis (ALS) is a degenerative disease. It is a disease of neurons in the brain, the brain stem, and the spinal cord that control the movement of voluntary muscles, leading to disability. ALS affects approximately 5 in every 100,000 people in the world. It is also known as Lou Gehrig's disease. Prognosis The prognosis is poor. Normally, the disease leads to death 3-5 years after the diagnosis. There are exceptions: it has been calculated that 1 in 4 survive beyond 5 years from the diagnosis. There are also cases that survive longer, usually with the aid of respiratory support. Symptoms Symptoms do not usually occur before the age of 50. The most common symptom is loss of muscle strength and coordination, that gradually worsens. This weakness initially affects legs and arms, and as the disease progresses, other parts of the body are affected. Muscle weakness causes the following symptoms: Difficulty breathing Problems climbing stairs, walking or lifting objects Difficulty swallowing; drooling; nausea Hoarseness and voice changes Problems talking, more slowly Neck muscles can no longer support the weight of the head, which droops Other symptoms that may occur are depression, muscle rigidity (spasticity), muscle contractions (fasciculations), muscle cramps and weight loss. Dementia is rare; the majority of people with the disease can think normally and have intact senses. Medical tests If any of the above-mentioned symptoms occur, a physical examination will be done to determine whether: Weakness is present, normally in a specific area. Tongue fasciculations Muscle spasms or tremor Rigid or clumsy gait Stronger or weaker reflexes in the joints Difficulty controlling crying or laughter Loss of gag reflex Other evaluations may include the following: Blood tests to rule out other diseases Assess breathing to determine whether the lungs are affected Check if there is a disease or injury of the neck Electromyography to determine if there are nerves or muscles not functioning correctly Check whether there is a family history of the disease CT scan or MRI scan of the head Analyse swallowing Lumbar puncture What are the causes of amyotrophic lateral sclerosis? In most cases, the cause is not known. It has been calculated that one in 10 cases is due to a genetic defect. Can it be prevented? The disease cannot be prevented. Treatments for amyotrophic lateral sclerosis There is no specific cure for ALS. The disease must be treated by a multidisciplinary team and the aim is to delay symptoms and to improve the patient’s quality of life. Rehabilitation and physiotherapy may be important for improving muscle function and overall health. A wheelchair and various orthopaedic devices may be necessary to help muscle function. Which specialist treats it? ALS should be treated primarily by a neurologist; however many specialists will participate including physiotherapists, speech therapists and gastroenterologists. ...

Arm pain

What causes arm pain? Arm pain has a number of causes, including: Muscle injury – also known as a strain, generally caused by overexertion Ligament injury – also known as a sprain Bone fracture – caused by impact or a fall Injuries from overuse – some sports or occupations involve using the same muscles and tendons over and over again, leading to the tendons becoming inflamed. Nerve compression – sometimes the nerves in your arm can become impressed, perhaps due to injury or the normal ageing process. This can lead to pain and tingling down your arm. Cardiovascular issues – shooting arm pain associated with tightness in the chest is often a sign of a heart attack. More generally pain that comes on after any physical exertion can occur as a result of coronary heart disease When should I see a doctor? You should seek emergency medical treatment if: you have arm pain that has come on suddenly and is accompanied by a feeling of tightness or heaviness in your chest you think you might have fractured your arm you experience severe pain and swelling How is arm pain diagnosed? Diagnosis depends on the nature of your symptoms. If you go to the hospital with severe arm pain and tightness in your chest, you will have a number of urgent tests to check if you are having a heart attack. If you think you might have fractured your arm, your doctor is likely to refer you for an X-ray to see the bones inside your arm. Otherwise, if you go to the doctor with pain that doesn’t seem to go away, you will need a thorough physical examination. This will look at where the pain is, when it occurs, and what movements are restricted due to the pain. You may then be referred for detailed scans, such as a CT scan or MRI scan, to look at the muscles, tendons and ligaments in your arm. How is arm pain treated? Most arm pain injuries can be treated at home, by making sure you: Take a break from using your arm Placing an ice pack on the area that is sore three times a day for 15-20 minutes Reducing swelling by using a compression bandage and keeping the arm elevated You may need specific treatment depending on the cause: For tendon injuries or repetitive strain injuries it may be recommended that you follow a program of physiotherapy to restore the arm and prevent strain in the future. You’ll be given advice on how to properly warm up before using your arm for strenuous activity such as lifting, swinging (in golf or tennis for example) or holding it up to play an instrument. For nerve compression, you may benefit from surgery to decompress the nerve · If a tendon has been ruptured or you suffer a complex fracture, it may be necessary to have orthopaedic surgery to make sure the arm heals properly ...

Ataxia

What is ataxia? Ataxia a term for a group of neurological disorders that affect balance, coordination and speech. There are different types of the disorders that can affect people in different ways. Any part of the body can be affected by ataxia but overall people have difficulties with: Balance and walking Speaking Swallowing Writing Eating  Vision   What are the different types of ataxia? There are many different types of ataxia, which can be divided into three main categories: Acquired ataxia – this type of ataxia may occur due to injury to the brain or from a stroke or other disease of the brain that affects movements and coordination. Hereditary ataxia – this runs in the family and is inherited. Symptoms develop slowly. Idiopathic late-onset cerebella ataxia (ILOCA) – in this type of ataxia the cerebellum (a certain part of the brain) is progressively damaged due to unexplained causes. These ataxias are rare and begin around the age of 50 and worsen with time.   What causes ataxia? Ataxia is the result of damage to a part of the brain (cerebellum) but can also be caused from damage to other parts of the nervous system. There are many underlying conditions that can cause ataxia, such as multiple sclerosis, or excessive alcohol consumption. Many ataxias are inherited because of defects in certain genes. The commonest inherited progressive ataxia is Friedreich’s ataxia.   What are the symptoms of ataxia? The signs of ataxia include: Poor coordination Inability to walk steady Difficulty with eating, writing or tasks such as buttoning a shirt Change in speech, slurring  Involuntary back and forth eye movements Trouble swallowing Loss of balance   How is ataxia treated? There is no cure for ataxia and supportive treatment to control symptoms is required. This helps to improve and help cope with living with ataxia. Treatment may include: Speech and language therapy Physiotherapy Occupational therapy Medication – to control muscle, bladder, heart and eye problems.   What is the outlook for ataxia? The outlook on life with ataxia depends on what type that a person is coping with. Some types are able to remain stable or even improve over time. Unfortunately, most will get progressively worse over many years. Life expectancy is short for people with hereditary ataxia with people living into their 60s. In some severe cases, the condition can be fatal in childhood. Doctors can treat the underlying cause with medication. There is ongoing research to find a cure for ataxia.   ...

Autism

Autism, or autism spectrum disorder (ASD), refers to a range of similar conditions that affect a person’s social skills, communication, interaction, interests and behaviour. There are many types of autism, which are caused by different combinations of genetic and environmental influences. According to the NHS, it is estimated that about 1 in every 100 people in the UK has ASD and that more boys are diagnosed with the condition than girls. There is no cure for ASD but there is a range of therapies and interventions such as speech and language therapy, as well as occupational therapy, which is available to help children and parents. What are the symptoms of autism? People with autism usually have problems with social interaction and communication. In really young infants, some children do not make any vocal sounds. Older children have problems and difficulties with making eye contact, facial expressions, body language and gestures when interacting with other people. They also tend to ignore both familiar and unfamiliar people. There is an overall lack of awareness and interest in interacting with other children and they tend to play alone. The overall symptoms of autism at any age include: Avoids eye contact Prefers to be alone Delayed language development Repeats the same words and phrases Easily upset by small changes in routine or surroundings Highly restricted interests Repetitive behaviour Intense reactions to sounds, smells, tastes, colours and light   What causes autism?   The exact cause of ASD is not known but there are several difficult genetic and environmental factors that are involved. There have been extensive investigations into the belief that the MMR vaccine caused ASD but large-scaled studies around the world with millions of children and researchers have found no evidence of the link between the two. Researchers accept that autism is caused by abnormalities in the structure or function of the brain. Experts are still uncertain about all of the causes and believe that there are multiple causes, with genes playing a major role. What is the treatment of autism? There is no cure for autism but there are specialist interventions that help with educational and social development. It may take some time to recognise which intervention will work best for a child because each person with autism is affected differently. Some interventions involve hours of intensive work. A team of specialists should make a detailed assessment of a child. Local autism teams ensure that every child has a case manager to manage and coordinate the treatment, care and support and the transition into adult care. There are parent support programmes, which offer in-depth advice for those who have a child recently diagnosed with ASD. In some cases, medication may be prescribed to treat some symptoms or conditions associated with ASD. These include sleeping problems, depression, epilepsy, attention deficit hyperactivity disorder (ADHD) and aggressive behaviour. ...

Back pain

Pain in the lower back is a pathology caused by various factors, such as excessive stress or poor posture. Less common is the lower back pain caused by more serious problems like herniated discs. The most common cause of lower back pain is because the lumbar spine, the final segment of the spine, has endured excessive weight. The main symptom of this injury is pain that is usually located in the lower back, sometimes reaching the legs. This pathology may cause alterations in the different structures that form the backbone such as ligaments, muscles, spinal discs and vertebrae. In addition, lower back pain can be accompanied by a muscular contraction in the area, limiting mobility in this section of the body. ...

Brain metastasis

Brain metastasis is a type of cancer starting elsewhere in the body, and spreading to the brain. The tumour types that most often develop metastases in the brain are melanoma, lung carcinoma, breast carcinoma and cancer of the kidney. Other cancers either never spread the brain, or very rarely do. When brain metastasis occurs, the tumour in the brain causes inflammation and intracranial pressure. ...

Brain tumour

Brain tumours are a proliferation of cells that grow and multiply abnormally in the brain, they can be malignant or benign. They grow in blood vessels, cranial nerves, glands, bones, brain parenchyma or embryonic remains, and can develop either by pressing against areas of the brain or by invading the surrounding tissue. Symptoms of brain tumours include hand tremors, changes in mood, dizziness, unsteadiness and impaired alertness. Surgery is one of the most common measures to reduce the pressure that is affecting the brain, however, treatment depends on where the brain tumour is located, and the patient’s health. Radiation therapy and chemotherapy are used when surgery has been ruled out or has not achieved the desired results. ...

Cerebrovascular accident

What is a cerebrovascular accident? A cerebrovascular accident is the medical term for the common term ‘stroke’. A cerebrovascular accident occurs when blood flowing to a particular part of the brain is halted by a blood vessel rupturing, or by some blockage. This starves the brain of oxygen and as a result, brain cells die.  What causes a cerebrovascular accident? Strokes can be caused in different ways, the commonest being when a blood vessel becomes blocked by a blood clot, preventing oxygen from getting to a part of the brain. Clots can travel up to the brain from other parts of the body, or form in a blood vessel in the brain. Strokes can also happen when blood vessels rupture in the brain (meaning they haemorrhage), or in the membrane which surrounds the brain. This stops blood from getting to the brain as it normally would. What are the symptoms of a stroke? The most common symptoms of stroke can be identified and remembered using the acronym FAST, which stands for: Face: is one side of the face drooping? Arm: is one arm weak, and does it drift downward if the person raises their arms? Speech: is their speech slurred, or does it sound abnormal? Time: make sure to call 999 and go to A&E if these symptoms present Other stroke symptoms include: Dizziness Difficulty when walking Blurred vision A headache which comes on suddenly and is often accompanied by nausea or vomiting Problems speaking coherently or difficulty understanding others Imbalance, loss of co-ordination Paralysis or numbness, usually on one side of the body, in the face, arm, or leg Symptoms usually come on suddenly and while they may not be severe at first, they get worse over time, so it is important to recognise symptoms of stroke to ensure it is treated as soon as is possible. What is the treatment for a cerebrovascular accident? Depending on the type of stroke, treatment differs, and it also differs depending on the area of the brain affected. Strokes are often treated with medication which attempts to dissolve the blood clot and prevent further clotting. Medication can also reduce blood pressure, and certain drugs can lower the pressure in the brain which is caused by the bleeding. Sometimes surgery is recommended when bleeding is particularly severe. This will remove the excess blood, and in other cases it may be used to repair the rupture. Can a stroke be prevented? You can reduce your risk of developing a stroke by trying to keep as healthy as possible. Some conditions also increase the risk of developing a stroke, so it is important to manage medical conditions properly and as recommended. You can help prevent strokes by: Drinking in moderation Eating healthy Exercising regularly Not smoking  ...

Cerebrovascular disease

What is cerebrovascular disease? The word cerebrovascular is made up of two parts, in which ‘cerebro’ refers to the large part of the brain and ‘vascular’ refers to the arteries and veins. The term cerebrovascular disease refers to a group of conditions that can lead to a cerebrovascular event, such as a stroke or a mini-stroke, an ischemic stroke or a transient ischemic attack (TIA). These events affect the blood vessels and blood supply to the brain.   What causes cerebrovascular disease? There are a number causes of cerebrovascular disease, which includes atherosclerosis. Atherosclerosis is a condition in which high cholesterol and arterial inflammation of the brain cause cholesterol to build up into a thick plaque that obstructs the flow of blood to the brain. This is what causes an ischemic stroke or transient ischemic attack. Atherosclerosis can also cause blood clots in an already-narrow artery, leading to a thrombotic stroke. A clot may also break off in the body and travel up to the brain, blocking a small artery there and is known as an embolism. It can be difficult to detect cerebrovascular disease before an attack happens but risk factors can play a role in causing this too, such as hypertension, smoking, obesity, ischemic heart disease and uncontrolled diabetes.   What are the symptoms of cerebrovascular disease? The signs and symptoms of cerebrovascular disease depend on where the blockage or the damage occurs. The most common symptom include: • Severe headache • Dizziness, nausea or vomiting • Face paralysis on one side • Weakness on one side • Mental confusion and disorientation • Slurred speech • Loss of half vision • Lack of balance • Passing out   How is it diagnosed? Any cerebrovascular event is an emergency and 999 must be contacted. At the hospital, the patient will have a physical evaluation and their medical history will be assessed. A physical examination includes neurological, motor and sensory deficits such as a change in vision, reflexes and muscle weakness. A cerebral angiography, vertebral angiogram or carotid angiogram may be used, with which a dye is injected into the arteries to reveal any clots. A CAT scan will help to diagnose and detect haemorrhagic strokes and an MRI scan detects strokes. An electrocardiogram can detect cardiac arrhythmia, which is a risk factor for embolic strokes.   Can cerebrovascular disease be prevented? There are health behaviours that help in reducing the risk of a stroke, which includes: • Stop smoking • A healthy diet • Controlling high blood pressure • Lower blood cholesterol • Exercising • Losing weight if overweight • Regularly visiting the doctor for check-ups • Lowering stress levels • Reducing alcohol intake   How is it treated? Treatment of cerebrovascular disease depends on what type of the disease a patient has. Overall, the treatment centres on improving the brain’s blood flow. Most cases are treated with medications such as blood pressure medications, blood thinners and cholesterol medications.   ...

Chorea

Chorea What is chorea? Chorea is an abnormal involuntary movement disorder characterised by rapid movement of the hands or feet that are similar to dancing. These movements can range from minor and fidgety movements to movements that are more expansive, they can be fast or slow and the person can sometimes be seen to be moving in pain. The word chorea comes from the Greek word choros meaning to dance. What causes this pathology? There are many associated conditions or suspected causes of chorea, for example, Huntingdon’s disease can cause chorea symptoms. Other genetic disorders can also cause the condition, while a streptococcal infection or rheumatoid fever can have the after effects of bringing on chorea symptoms especially in children and adolescents. There are other associated disease like AIDS and other immune, endocrine and metabolic diseases that can bring on the symptoms of chorea. There is a specific type of chorea that only occurs in pregnancy (chorea gravidarum), and subsides once the women has given birth. How is chorea treated? Because of the diverse causes and factors associated with the disease, the treatment must first involve an accurate diagnosis of the cause and origin of the particular case. Some diseases like Huntingdon’s have no known cure, while other cases can be treated with medication that affects the dopamine receptors in the brain, others with electrode treatment like deep brain surgery and others with antibiotics.   ...

Chronic headache

What is a chronic headache? Chronic headaches, also known as chronic daily headaches, are headaches experienced 15 or more days each month for more than three months duration. Chronic headaches can be different types of headache subtypes, including migraines, tension headaches and hemicrania continua headaches. Prognosis: Due to the consistency of having headaches, chronic headaches can be very disabling, requiring lots of time taken off work and responsibilities. Having chronic headaches is also likely to increase the risk of certain mental health problems, such as depression, anxiety and sleep problems. If the headaches are caused by an underlying condition, treatment of this should relieve the headaches. However, if there is no underlying condition, treatment focuses on relieving pain. Symptoms of chronic headaches: Chronic daily headaches occur for 15 or more days each month for at least three months in duration. You may experience short-lasting or long-lasting headaches. Each subtype of headache has their own set of symptoms. Chronic tension headaches: Pain that feels like pressing or tightening Affects each side of the head Pain is mild to moderate Chronic migraines: Pain is pulsating or throbbing in nature Pain can be moderate to severe Affects one or both sides of the head May cause sensitivity to light, nausea or vomiting Hemicrania continua: Affects one side of the head Continuous with no pain-free periods Nasal congestion Drooping eyelid Redness or tearing in the eye of the affected side Pain is moderate with spikes of more severe pain Medical tests to diagnose chronic headaches: In order to understand the cause behind your chronic headaches, a doctor will likely perform or CT or MRI scan. They will also take a detailed history of your headaches and your general medical history. What are the causes of chronic headaches? Primary chronic daily headaches do not have an underlying condition. Non-primary chronic daily headaches can have underlying causes, including: Infection (e.g. meningitis) Brain tumour Traumatic brain injury Intracranial pressure imbalance Vascular inflammation around the brain Stoke Having frequent headaches is also more commonly associated with: Obesity Females Depression Sleep problems Anxiety Overuse of caffeine or pain medication Can chronic headaches be prevented? The following measures can help to avoid chronic headaches: Have enough sleep Avoid overuse of painkillers Exercise regularly Reduce caffeine intake Avoid skipping meals Manage stress Treatments for chronic headaches: Treatment focuses on relieving pain if there is no underlying condition to treat. This may include: NSAIDs (nonsteroidal anti-inflammatory drugs) Beta blockers – used to treat migraines Anti-seizure medication – can treat migraines and chronic daily headaches Antidepressants – tricyclic medications are shown to help reduce pain from chronic headaches, and treat accompanying depression or anxiety. Botulinum toxin – injections of Botox can help to relieve pain from daily headaches for some people. Which type of specialist treats chronic headaches? Chronic headaches are treated by a range of specialists, depending on their cause. They may be treated byneurologists, psychiatrists or pain management specialists. ...

Cluster headaches

Cluster headaches are a highly concentrated and intense type of headache. They are more common in men than women and tend to happen in one particular season of the year. ...

Cognitive impairment

What is a cognitive impairment? The concept of cognitive impairment encompasses an alteration in one or more of the cognitive functions for processing and remembering information, including perception, attention, language and memory. The most frequent cognitive alterations include delirium, amnesia, dementia, Alzheimer's disease and Parkinson's disease. Some acquired impairments and disorders also cause cognitive impairment (such as stroke or head injury). Cognitive developmental disorders that affect the area of language and attention, such as ADHD, are also common in children. Symptoms of cognitive impairment: These disorders often begin to manifest themselves as difficulties with attention, concentration and orientation. When the disorder progresses, there is also a breakdown in thought processes and perception. Other common symptoms of these conditions are difficulty walking and maintaining balance, drowsiness, tiredness, personality changes, and an inability to remember things. What causes cognitive impairment? Old age is the main cause of cognitive impairment, but how you reach old age determines whether or not you will develop it. Loss of social relationships influence the development of this disorder, since social isolation can result in poor self-care and memory loss. Psychological changes also influence cognitive disorders, as stress and depression wear out neurons and lead to memory loss. Can cognitive impairment be prevented? To prevent cognitive impairment, it is important to do stimulating exercises that keep the cognitive functions active. These usually include daily activities like reading the newspaper, keeping accounts or doing crossword puzzles. You should also maintain relationships with your family and friends and watch the news so that you know what’s going on around you. How can cognitive impairment be treated? An early diagnosis of these pathologies is important so that the most appropriate treatment can be started as soon as possible to prevent further deterioration. Treatment includes cognitive stimulation, eating a healthy diet, and regular physical exercise. ...

Cognitive stimulation therapy

Cognitive stimulation includes all activities to stimulate and improve cognitive functioning: memory, language, attention, concentration, reasoning, abstraction, and arithmetic operations. The aim is to improve or maintain cognitive functioning and reduce dependence, working on the capabilities that the patient still retains, while attempting to avoid the frustration of being ill. ...

CT scan (CAT)

What is a CT scan? A computerised tomography (CT) scan, also known as a CAT scan, works by combining numerous X-ray images that are taken from different angles and processing them through a computer to produce a cross-sectional image of different parts of the body. CT scans can be used to take images of bones, blood vessels and soft tissues and provide much more detail than regular X-ray images. What does a CT scan involve? CT scans are carried out in just a few minutes, and can take up to 30 minutes to complete. During a CT scan, you lie down on a table that slides in and out of the CT machine. You rest your head on a pillow and you may be strapped to the table to help you stay in position. If your head is being scanned, a special head cradle might be used. Whilst you are being scanned, the CT scan technician stays in an adjacent room and will communicate with you via intercom. In some instances, you might be given a contrast dye which highlights certain tissues for the technician.  What is a CT scan for? A CT scan is often used for diagnostic reasons, for example, they are used a lot when dealing with patients who have been injured and might have internal damage. A CT scan is also used for the following: To locate a tumour or blood clot To guide procedures, such as surgery, biopsies or radiation treatment To diagnose bone and muscle disorders To determine if there is any internal bleeding present  To check how effectively a treatment is working To examine conditions affecting the heart and its blood vessels (coronary CT scan) How can you prepare for a CT scan? It may be necessary to remove certain clothes and accessories before a CT scan, depending on which part of the body is being scanned. Usually you will have to avoid food and drink a few hours before having a CT scan.  What does it feel like during a CT scan? A CT scan is painless; however, it usually requires you to remain very still, which can sometimes be challenging, particularly if the patient is a child or in pain. Movement can blur the images, so it is important to stay still during the scan. Sometimes the patient can be given a mild sedative to help them relax.  What happens with the results? Once your scans are complete and the images are ready, the radiologist will write a report which is then shared with your doctor, who will discuss the results with you. Results can be processed either within a few days or a few weeks.  ...

Dementia

Dementia is the progressive loss of cognitive functions, mainly due to brain damage caused by strokes or Alzheimer’s. It greatly affects the patient´s ability to function in everyday life. It mainly affects memory, language (aphasia), attention, visual skills, praxis and executive functions such as problem solving or inhibition of responses. ...

Dizziness

Dizziness occurs when the brain does not receive enough blood, when there is a drop in blood pressure, or as a result of dehydration. The most serious diseases that may be associated with dizziness are arrhythmias, shock or heart attack. ...

Dystonia

What is dystonia? Dystonia is a type of movement disorder characterised by uncontrollable muscle contractions. The result is an involuntary twisting of of body parts and abnormal postures. This condition may affect just one muscle, a group of muscles or the entire body.  What are the symptoms of dystonia? The symptoms of dystonia can vary and can be mild or severe. Common early symptoms include: cramping of the foot speech difficulties a dragging foot when walking excessive blinking Symptoms of dystonia can  be worse with stress or fatigue, and with the constand muscular contractions, pain and discomfort is common.  What causes dystonia? There are no specific causes of dystonia and it is not fully understood as a condition, however, it is thought that it can be attributed to chemical imbalances in the part of the brain called the basal ganglia. The basal ganglia is responsible for initiating muscle contractions, and if the nerve cells here are not communicating properly, muscle contractions can become involuntary and uncontorllable.  Dystonia can either be hereditary from parents, or it can be acquired if the basal ganglia is damaged. Damage to the basal ganglia can result from: oxygen deprivation infection brain trauma stroke tumour lead of carbon monoxide poisoning reactions to certain drugs What is the treatment for dystonia? Treating dystonia depends on the severity and the part of the body affected. A fairly new treatment for dystonia makes use of botulinum toxin (Botox) injections which is injected into the affected muscles. Botox help as it blocks the chemical called acetylcholine which produces muscle contractions. With repeated injections, some control can be regained over the muscle contractions.  In more severe cases of dystonia, deep brain stimulation can be carried out as a treatment. This involves an electrode being implanted into the affected brain area which is connected to a stimulator that emits electric pulses which aim to reduce the number of involuntary muscle contractions.  There are also medications which can help dystonia patients by controlling the chemical miscommunications happening in their brain which causes the muscle contractions. Finally, there are physical therapy, speech therapy and stress management techniques that can help dystonia patients manage their symptoms.  ...

Essential tremor

What is essential tremor? Essential tremor, or familial tremor, is a progressive neurological pathology. It is a movement disorder characterised by a rhythmic movement or shaking of the hands, head, legs, or even the voice. It is estimated that 1 in 20 people over the age of 40, and 1 in 5 people over the age of 65 suffer from essential tremor. It most commonly affects people over 40 but it can occur at any age. There are two main types of essential tremor: Kinetic tremor : this occurs during a voluntary movement (for example, bringing food or an object to the mouth). Postural tremor: occurs while maintaining a position against gravity (extending the arms and holding them in that position, bringing the hand or arm closer to the body, etc.). Most people with essential tremor have both postural tremor and kinetic tremor. Essential tremor is often associated with Parkinson's disease. This is somewhat justified, as motor symptoms are the primary manifestations of Parkinson's, the most common being tremor. However, even if you have involuntary tremors this does not mean that you have Parkinson's. In fact, it is important to consider these differences between essential tremor and Parkinson's: Tremor in Parkinson’s occurs when you are at rest, but essential tremor occurs when you are physically active or moving around. Other motor symptoms are associated with Parkinson's including stiffness and slowness Essential tremor affects the head, but in Parkinson’s the head is unaffected Prognosis of the disorder Essential tremor is not life-threatening, but it does affect the quality of it. People who suffer from essential tremor may lose the ability to perform simple tasks, such as driving or going to work. Medical tests for essential tremor Your medical history will be taken and a physical and neurological examination performed. The physical examination will assess: Whether the tremor occurs when the muscles are in action or at rest The location of the tremor (where in the body it occurs) The nature of the tremor (frequency and extent of the tremor). The neurological examination will evaluate any alterations in balance, speech anomalies, and increased muscle stiffness. Additional tests may help determine any functional limitations. A common test for essential tremor is to ask you to draw a spiral. This evaluates your psychomotor skills. Your ability to write by hand and grasp certain objects, as well as exercises such as touching the tip of your nose with your finger, are also used to evaluate an alteration of the motor system. What causes essential tremor? Essential tremor is the consequence of abnormal communication between different parts of the brain. However, the exact cause of this miscommunication is unknown. Essential tremor is hereditary in most cases. It is estimated that a child of a parent with essential tremor has a 50% chance of inheriting the gene. However, not everyone who inherits the gene will develop the disorder. Can it be prevented? Essential tremor cannot be prevented – it is a neurological disorder that develops without warning. However, it can be prevented from severely affecting your life, in that you can adapt your daily life to make it as comfortable as possible. It is best to use objects that are solid, easy-to-grasp and close securely, and deep containers so that you can avoid filling them to the brim and the contents spilling out. Shaking is reduced when using heavy objects with large handles. There are also other already adapted everyday items that can be useful (cutlery or pens, for example), as well as electric toothbrushes, and velcro to fasten your shoes more easily and make your life easier. Treatments for essential tremor There is currently no treatment that cures essential tremor or prevents it from developing. Treatment for essential tremor is aimed at reducing the severity of the symptoms and improving the functioning of the locomotor system. This is combined with medication, usually antiepileptics, anticonvulsants and psychotropic drugs that have a mild sedative and relaxing effect. If you do not respond well to medication, and symptoms make your day-to-day life difficult, deep brain stimulation and locally focused ultrasound will be recommended. Which specialist treats it? The specialist who treats essential tremor is the neurologist. Neurology is the specialty that studies, diagnoses, prevents and treats diseases of the central nervous system (brain and spinal cord) and the peripheral nervous system (nerves and muscles in your body).   ...

Huntington's disease

Huntington’s disease is a hereditary disease classified as a motor disorder. Due to the progressive nature of the neurons, the patient may suffer from multiple symptoms such as muscular rigidity, slow movements, altered posture, and balance, difficulty speaking and concentrating, and psychiatric disorders such as recurrent thoughts about death or social isolation. Generally, the disease manifests its first symptoms in people between the ages of 40 and 50. Although it has no cure, nor can the deterioration be prevented, there are treatments with medicines available to control the symptomatology.      ...

Memory disorder

What is memory loss? Memory loss, also known as amnesia, is unusual forgetting. It is a common disorder as people get older. With memory loss, the person cannot remember recent events of the past. Memory loss can occur for a short period of time and then resolve. This is known as transient memory loss. However, depending on the cause, memory loss may not improve and actually get worse over time. What symptoms does memory loss present? The symptoms of memory loss that should be noted are: Difficulty carrying out daily activities Difficulty paying attention Mental confusion Depression Headaches Vision problems Difficulty understanding language Slow movements Causes of memory loss A considerable memory deficit can be due to other diseases such as Alzheimer's or senile dementia. Likewise, it can also be a consequence of other disorders, such as depression. Memory loss can be caused by many factors. It can result from an injury to the brain, which is caused by or is present after: Brain tumours Oncological treatments such as radiotherapy or chemotherapy Serious brain infections Hydrocephalus Transient ischemic attack (TIA) or stroke Concussion or head injury At other times, memory loss may be related to mental health problems such as depression, bipolar disorder or after a traumatic or stressful experience. Other causes of memory loss can be: Epilepsy Consumption of alcohol or other drugs Low levels of nutrients or vitamin B1 or B12 Parkinson's, multiple sclerosis or Huntington's disease What is the treatment for memory loss? Although there is no treatment available to recover lost memory, the help of a speech therapist can be very useful to provide daily exercises designed to exercise memory. In addition, patients affected by memory loss need a lot of support from their family and friends to carry out their daily routines, especially if they need to take medication or follow a certain type of diet. ...

Memory exercises

Memory exercises are activities to recover and enhance the cognitive functions of patients. The aim is to improve the functionality of the patient in everyday life.   ...

Memory test

Memory tests evaluate the ability of short and medium term memory. They are used to detect a possible loss of memory and its associated disease. Identifying the memory´s capacity is critical to establishing memory exercises that can help recovery.Sometimes memory loss is a consequence of depression. It may be difficult to differentiate between memory loss and confusion due to this disease.   ...

Mild cognitive impairment (MCI)

What is mild cognitive impairment? Mild cognitive impairment is a stage of ageing that is marked by memory failure and objective memory impairment. This cognitive impairment does not affect the performance of daily activities, nor does it meet the criteria for dementia. It is an age-related pathology, since it occurs in 1 in 10 people over 65 years of age. The disorder occurs to a different extent in men and women and is more common with advancing age. Symptoms of mild cognitive impairment: The usual symptoms of mild cognitive impairment are difficulty in acquiring new memories, without losing knowledge or forgetting your life story. In general, the symptoms are: Being unable to remember what you did two or three days ago Being unable to remember social commitments or doctor's appointments Frequently forgetting where you have left or stored things Repeating the same question more than once in the same conversation or forgetting important details that were discussed Mixing up or changing the order of dates or recent events Having less patience and being more irritable when interacting with other people What causes mild cognitive impairment? The clearest cause of mild cognitive impairment is age, as difficulty remembering is associated with advancing age. Other causes associated with this deterioration are genetic factors, which also play an important role in the transition from mild cognitive impairment to dementia. Cardiovascular risk factors also play a role, as cardiovascular diseases can affect cerebral blood vessels. Lifestyle habits are also important, as obesity and alcohol or substance abuse affect the brain. Can mild cognitive impairment be prevented? Mild cognitive impairment can be prevented by maintaining brain health. This is why it is important to maintain certain habits that ensure brain activity and keep the brain active, such as: Participating in social activities or activities that are new and challenging for the brain. It's also important to read on a regular basis and to find a hobby that you can do every day. Engaging in regular physical activity for at least 30 minutes a day to prevent brain atrophy. Eating a healthy diet and controlling cardiovascular risk factors. Getting 8 hours’ sleep every day and avoiding ongoing stress, as chronic stress directly affects the generation of new memories. To control the evolution of the disorder, you should see your doctor at the first sign of symptoms. How can mild cognitive impairment be treated? There is currently no treatment for mild cognitive impairment, but evidence shows that maintaining mental and physical activity and eating a healthy diet reduces the risk of mild cognitive impairment. ...

Movement disorders

What are movement disorders? Movement disorders refer to either an excess of movement or an impairment of movement. There are many different types of movement disorder, but they are neurological conditions which affect different parts of the body, causing abnormal movements which are either involuntary or voluntary. Some movement disorders include Parkinson’s, ataxia, Huntington’s disease, and tourette’s syndrome. What are the symptoms of movement disorders? There are many different movement disorders, which all come with their own set of symptoms or characteristics. Movement disorders affect the speed of movements, making them quicker, or slower in some cases, how fluidly someone can move, and how easily they are able to move. Other symptoms of particular disorders include tremors and jerks, twitches, and tics. What causes movement disorders? Movement disorders are neurological conditions, so the cause is most frequently a defect in a certain area of the brain, or in the base of the brain (cerebellum). These defects are often acquired through genetics, but abnormal movements can also be caused by stress, drugs, alcohol consumption, and chronic disease. Some disorders, such as Parkinson’s, are called neurodegenerative conditions, and these are often genetic. How are movement disorders treated? Movement disorders are generally treated through medication and drug therapy. As there are many different types of movement disorder, each one needs the correct clinical diagnosis and treatment is prescribed for the individual case. Certain movement disorders have been treated using therapies which use electrodes to stimulate affected areas of the brain. Specific diets and nutrition has also proven useful in the case of some movement disorders such as Parkinson’s. Exercise can help to stop the patient from losing muscle mass, and it can also improve mobility. ...

Myasthenia gravis

What is myasthenia gravis? Myasthenia gravis is a neuromuscular autoimmune system disease affecting the skeletal muscles. It is a long-term condition which can affect various parts of the body, largely the eyes, the face, and the swallowing muscles. Prognosis The prognosis of patients with myasthenia gravis is generally good, providing they receive the right treatment. The mortality rate for myasthenia gravis in the early 1900s was at around 70%, but this figure has now dropped to around 3-5%. Symptoms of myasthenia gravis Myasthenia gravis causes muscle weakness and worsens as the muscles are used.  Symptoms usually improve with rest. Muscle weakness may vary, but the symptoms of myasthenia gravis progress over time and usually peak within a few years of the onset of the disease. Myasthenia gravis can damage any muscle that you control voluntarily, but it affects some muscle groups more than others. Medical tests for myasthenia gravis For the specialist to make a correct diagnosis of the disease, they will perform different medical tests. They will also analyse your symptoms and review your medical history. The various tests include:   Neurological examination Edrophonium test Ice pack test Blood tests Repeated nerve stimulation Single-fibre electromyography Imaging tests Pulmonary function tests. What causes myasthenia gravis? There are several factors that can lead to myasthenia gravis. Firstly, antibodies: in every human body, nerves communicate with muscles by emitting chemical substances called neurotransmitters that join their corresponding muscle cell receptors at the neuromuscular junction. With this disease, the immune system creates antibodies that destroy or block many muscle receptors of a neurotransmitter called acetylcholine. As a result, with fewer receptors the muscles receive fewer nerve connections, leading to weakness. The thymus may be another cause: scientists believe that the thymus, the gland that forms part of the immune system and is located at the top of the chest under the breastbone, can increase or maintain the production of antibodies that block acetylcholine. Other causes: some cases of myasthenia gravis have nothing to do with antibodies that block acetylcholine or the receptor of a specific muscle. In other words, this type of myasthenia will lead to seronegative myasthenia gravis. Antibodies against another type of lipoprotein receptor-related protein can affect the onset of the disease. Myasthenia gravis can also be due to genetic factors. However, there are certain risk factors that can worsen the damage caused by myasthenia gravis, including: fatigue, complications with another disease, stress and medications such as beta-blockers, quinidine gluconate, quinidine sulphate, quinine, phenytoin and some anaesthetics and antibiotics.  Can it be prevented? There are currently no known measures to prevent myasthenia gravis, because the specific causes of this type of autoimmune disease are still unknown. Treatments for myasthenia gravis Specialists may use different treatments, either alone or in combination with other techniques, to relieve the symptoms of myasthenia gravis. These include: Medication Cholinesterase inhibitors Corticosteroids Immunosuppressants Intravenous therapy Plasmapheresis Intravenous immunoglobulin Monoclonal antibodies Surgery Video-assisted thymectomy Robotic thymectomy. Which specialist treats it? A neurologist is generally the specialist responsible for treating myasthenia gravis, but others may be consulted depending on the treatment path.  ...

Myelitis

What is myelitis? Myelitis simply means inflammation of the spinal cord. It is not a disease in itself but a symptom of a range of conditions, so diagnosis can be a complex process. Myelitis is often referred to as transverse myelitis, but this refers to inflammation across the left and right side of the spinal cord. Not all cases of myelitis are transverse – sometimes only one side of the spinal cord is affected. What are the symptoms of myelitis? Depending on the location of the inflammation, myelitis can cause the following symptoms: tingling in the legs or arms loss of strength in the legs or arms loss of sensation pain in the lower back problems with bladder or bowel control fever The symptoms might develop over a few days, in other cases the onset may be several weeks or months. How is myelitis diagnosed? Diagnosing myelitis is complex, as the symptoms can be indicative of many other conditions. You will be asked about the nature of your symptoms and how long you have had them for. Your doctor is then likely to refer you for tests, such as an MRI or CT scan, a spinal tap, or blood tests, to rule out conditions such as spinal stenosis, slipped disk, lupus, HIV or a spinal tumour. What causes myelitis? Myelitis can occur as a result of: infections – including tuberculosis, syphilis, viral infections, and fungal infections autoimmune conditions – including Sjogren’s syndrome multiple sclerosis Polio is a form of myelitis caused by the poliovirus, but this disease has been almost eradicated through an effective vaccination programme. In many cases of myelitis, the cause is unknown and you will be diagnosed with “idiopathic myelitis”. Can myelitis be prevented? It’s possible to prevent some of the infections which can lead to myelitis, but for idiopathic myelitis there is no known prevention. Myelitis affects people of all ages, and there is no specific risk factor which predisposes you to it. How is myelitis treated? Steroids can help to reduce inflammation in your spine and may be given as an initial treatment. If the doctor suspects you have a viral infection, they may give you antiviral medicine. If an autoimmune condition is suspected, plasma exchange therapy might be recommended. You may also be given medication to help with the symptoms, such as pain medicine. If the damage from myelitis is long-term you might be offered physiotherapy and occupational therapy to help you improve your physical abilities or find alternative ways of carrying out daily tasks. What type of specialist treats myelitis? A neurologist specialises in the treatment of conditions affecting the spinal cord such as myelitis. In the long term you may also be treated by a physiotherapist or occupational therapist. ...

Narcolepsy

What is narcolepsy? Narcolepsy is a neurological condition which affects your brain’s control over when you sleep. It’s a condition characterised by “sleep attacks” during the day, where you suddenly fall asleep without control. Narcolepsy is relatively rare, affecting just 1 in 2000 people, and affecting men and women equally. The cause is not clear, but it’s thought that narcolepsy can be triggered by puberty, menopause, an infection, or major psychological stress. Most people who are diagnosed with narcolepsy are between 20 and 40 years old. What are the symptoms? As already mentioned, the most well-known symptom of narcolepsy is sleep attacks during the day. Other symptoms include: excessive daytime sleepiness disturbed night-time sleep cataplexy – a sudden loss of strength and control in some muscles, resulting in slurred speech, a dropping head, and sometimes falls sleep paralysis – a sudden inability to move when falling asleep or waking up which generally lasts for a few minutes hallucinations when going to sleep or waking up automatic behaviour – doing an activity without having any memory of doing it afterwards How is it diagnosed? Diagnosis is carried out by a GP and involves ruling out other conditions which can cause similar symptoms, such as sleep apnoea, restless leg syndrome, epilepsy, or an underactive thyroid gland. To make a diagnosis, the GP will look at your sleeping patterns and medical history, and conducting some tests. The most common tests include: polysomnographic (PSG) testing – this measure the electrical activity of your brain as you fall asleep, and during sleep multiple sleep latency test (MSLT) – this measure your “sleep latency”, which is how fast you fall asleep lumbar puncture – this is used to remove a sample of your cerebrospinal fluid. People with narcolepsy often have a deficiency of the chemical hypocretin in their brain, so an examination of your cerebrospinal fluid can determine whether this is the case. How is it treated? There is a lot you can do to improve the symptoms through good sleep routines and changes to your diet . These include avoiding caffeine, not eating just before bed, keeping your bedroom at a comfortable temperature, and taking frequent naps through the day. In addition, a doctor might prescribe medication. Options include: a stimulant, such as modafinil or dexampthetamine – these help to keep you awake through the day sodium oxybate – this can help you to sleep at night and therefore tackle daytime sleepiness, and can also improve cataplexy antidepressants – these are sometimes offered as an option to treat sleep paralysis and hallucinations How will it affect my day to day life? Narcolepsy is a long term condition so it can have an impact on many areas of life. Working With good management of your symptoms, most occupations are open to people with narcolepsy. Your employer has a legal obligation under disability discrimination law to make allowances that enable you to work, such as allowing you to take naps or offering flexitime. Narcolepsy UK have some useful advice on managing work and narcolepsy here . Driving Similarly, as long as you are able to keep your symptoms under control, you will be able to drive and can get car insurance. In the UK you have to inform the DVLA that you have narcolepsy. They will issue you a fixed term driving license and check every few years that you are controlling your symptoms. ...

Neuralgia

What is neuralgia? Neuralgia refers to a severe pain which occurs due to an irritated or damaged nerve. This condition is more common in the elderly but it can affect anyone at any age. Types of neuralgia include: Post-herpetic neuralgia: occurs as a complication of shingles, resulting in ongoing pain after a herpes zoster outbreak. Trigeminal neuralgia: affects the trigeminal nerve, causing severe, re-occurring pain in part of the face. Glossopharyngeal neuralgia: affects the glossopharyngeal nerve, but is less common than other types, producing pain in the neck and in the throat. What are the symptoms of neuralgia?   The symptoms of neuralgia usually include: Acute pain: this is the main symptom of neuralgia and presents as a very intense pain felt throughout the area of ​​the affected nerve. More sensitive skin in the region of the nerve that leads to intense pain with contact. Muscle weakness where the nerve is located. Sometimes the muscles also become temporarily paralysed. What are the causes of neuralgia? In many cases the causes of neuralgia is unknown, but it can be due to some of the following factors: Chronic kidney disease. Consumption of certain medications. Infectious diseases such as herpes zoster virus, HIV or syphilis. Pressure in the nerve by some bone, blood vessel or tumour. Trauma Diabetes Porphyria Neuralgia can also be caused by an infection affecting the nerves, or result through nerve damage/injury to a nerve. However, the cause of particular types of nerve pain is not completely understood. Can neuralgia be prevented? One way to prevent neuralgia is to control blood glucose in patients with diabetes. Vaccines and antiviral drugs against the herpes zoster virus can also prevent neuralgia. Treatment of neuralgia The treatment for neuralgia will depend on the causes, the location of the nerve and the degree of pain. Pharmacological treatment for pain includes antidepressants, anticonvulsants, analgesics and patches or relaxing creams. Other treatments that can be carried out are: Physiotherapy, especially in postherpetic neuralgia. Injections of medication to relieve pain. Treatments to relieve pain such as radiofrequency, heat application, chemical injection or balloon compression. Blockage of the nerves. Surgical intervention to relieve pain. Stimulation of the nerves or the spinal cord, especially when other treatments fail to relieve the symptoms of neuralgia. In some cases stimulation of the motor cortex is performed which involves placing an electrode in the nerve, brain or spinal cord to connect it to a pulse generator. Some may find therapeutic treatments such as acupuncture help, but it is important to consult your doctor about any complementary therapies you are considering ...

Neurological disorders

What are neurological disorders? Neurological disorders affect about ten million people in the UK . Neurological disorders are diseases of the central and peripheral nervous system – the brain, the spinal cord, the cranial and peripheral nerves, the autonomic nervous system, the nerve roots, the neuromuscular plate and the muscles. There are more than 600 neurological disorders. The most common are: diseases due to defective genes, such as muscular dystrophy or Huntington's disease degenerative diseases, such as Alzheimer's or Parkinson's diseases of the blood vessels that supply the brain, such as stroke problems in the development of the nervous system, such as spina bifida brain or spinal cord injury convulsive disorders, such as epilepsy brain tumours infections, such as meningitis Prognosis of the disease The prognosis of a neurological disorder can change significantly depending on the particular disease. In the case of degenerative diseases of the nervous system, such as Alzheimer's, they can become quite severe over time, and can eventually put the patient's life at risk. Some genetic diseases are also progressive, but if spotted early on can often be treated effectively. In the case of convulsive disorders, such as epilepsy, the prognosis is usually better. A patient with epilepsy can generally manage their symptoms through treatment, although this may take several years. Some forms of brain or spine injury are life-threatening, as are cardiovascular conditions such as stroke. A brain tumour can sometimes benign, but if it is cancer it requires timely treatment to improve the chance of survival. Symptoms of neurological disorders Neurological disorders can cause a wide range of symptoms, including: headaches numbness or loss of strength in a limb dizziness fainting and loss of consciousness memory problems cognitive difficulties speech problems vision problems tremors, spasms, and involuntary contractions Medical tests for neurological disorders Medical tests may vary depending on the affectation that the patient has. There are multiple tests to evaluate the state of the nervous system, which are more useful depending on what one wants to check. The following should be highlighted: Electroencephalogram: is especially useful in brain tumors or brain or spinal cord inflammation, for example. Cerebral angiography: used to locate vascular irregularities in the brain. They can be obstructions in the blood vessels or stroke, among others. Computed tomography: very effective in the detection of epilepsy, brain tumors or cysts, brain damage by injury, etc. Magnetic resonance: this reveals to the doctor the details of organs, tissues, nerves and bones. Lumbar puncture: to obtain samples of cerebrospinal fluid and thus check the existence of bleeding or cerebral hemorrhages. Can neurological disorders be prevented? In many cases, neurological disorders are difficult to prevent, especially when they are due to hereditary factors. However, there are a number of lifestyle changes that can reduce the risk of stroke, and which are thought to reduce the risk of developing dementia later in life: do some physical exercise on a regular basis. avoid social isolation by keeping up with family and friends and getting involved in your local community avoid the consumption of alcohol, tobacco and illegal drugs get a good night’s sleep (6-8 hours a day) maintain a balanced diet with plenty of fruit and vegetables avoid brain injuries by using the necessary protection on the road or when doing extreme sport avoid medical risk factors such as high blood pressure, high cholesterol, stress, exhaustion, obesity, or diabetes Treatments for neurological disorders There are multiple treatments for neurological disorders, which can vary depending on the condition. Normally, the main treatment consists of neurorehabilitation, which aims to restore, minimise or compensate functional deficits that the patient may have, but setting realistic expectations as to what is possible. In some cases it is possible to mitigate some symptoms with medication or surgery. Overall, treatment aims to improve the quality of life of patients suffering from a neurological disorder, so that they can have the greatest possible independence. In all neurological disorders, an early diagnosis is vital, so that the specialist can establish the most appropriate treatment in each case. ...

Neurological treatments

In the field of neurology, specialists have developed a wide range of treatments to treat conditions such as dementia, Parkinson’s disease, epilepsy, motor neuron syndrome, tumours in the head or spine, or brain trauma. The precise combination of treatments depends on the condition that a patient has, but collectively, the main types of treatment are as follows: Medication – researchers have developed a wide array of medication to combat the symptoms of various neurological disorders. With medication, we can slow down Alzheimer’s disease, manage the symptoms of epilepsy, and help patients with Parkinsons’ regain control over their movements. Painkiller medication can be particularly helpful for people suffering from nerve pain due to a tumour or injury. However, we do not yet have medication that can cure neurological conditions such as dementia or Parkinson’s. Physiotherapy and occupational therapy – patients living with a movement disorder can benefit from physiotherapy to help build their strength and mobility in spite of neurological barriers, and occupational therapy to come up with new strategies for accomplishing day-to-day tasks. The patient is unlikely to fully restore their movement, but this kind of treatment can help prevent their condition from getting in the way of daily life. Speech and language therapy – some neurological disorders such as dementia, Parkinson’s, and stroke, can make eating, swallowing and even breathing more difficult. A speech and language therapist can support the patient to maintain control over these functions. Surgery – some conditions such as a brain tumour, spinal tumour, or spinal stenosis, can press on the nerves and pose a significant risk to someone’s ability to move. In extreme cases, nerve damage can cause someone to lose function over their bowels, or become completely paralysed. To prevent this outcome surgery may be necessary to remove the tumour or decompress the spine. Deep brain simulation – a deep brain simulator is like a pacemaker for the brain. It sends out signals within the brain to interrupt other signals that may be causing neurological symptoms such as tremor or stiffness. The deep brain simulator is implanted with a surgical procedure and remains in the brain for a number of years. This is a relatively early treatment compared to other treatments in the field of neurology, and its potential applications are not yet fully known. Treatment is constantly evolving and in the future neurologists are likely to have a better understanding of how to tackle abnormal signals and manage symptoms more effectively. Surgery is likely to be less invasive and more effective at removing tumours without damaging the nearby nerves. In addition, more work needs to be done in identifying the root causes of neurological disorders. What is the aim of neurological treatment? If you are diagnosed with a long-term neurological condition, treatment aims to manage the symptoms and slow down the condition’s progression. If, however, you have suffered an injury, the aim of treatment will be to restore your abilities as much as possible. This kind of treatment program is known as neurorehabilitation. What kind of specialist provides neurological treatments? If you have a neurological condition the main specialist overseeing your care will be a neurologist, and they will be able to prescribe you medication where needed. Depending on other treatment you need, you may also come into contact with the following specialists: physiotherapists occupational therapists speech and language therapists neurosurgeons ...

Neuromuscular disease

What is neuromuscular disease? The term “neuromuscular disease” refers to a group of conditions affecting the nerves that control muscle function in the voluntary muscles (the muscles we can control, such as those in the arms and legs). They may also impair the transmission of sensory information to the brain. While the various different types of neuromuscular disease work in different ways, all of them can be debilitating, as they damage or kill these neurones (nerve cells), causing a breakdown of communication between the brain and the muscles. The end result is often muscle atrophy – the muscles waste away, leading to a number of highly unpleasant physical symptoms that seriously affect quality of life. Neuromuscular diseases can be sub-divided into: Myopathies, e.g. congenital myopathy, distal myopathy, metabolic myopathies, etc. Motor neurone diseases, e.g. Amyotrophic lateral sclerosis (ALS/Lou Gehrig’s disease), spinal muscular atrophy, etc. Muscular dystrophy (MD) Ion channel diseases, e.g. Anderson-Tawil syndrome Mitochondrial diseases, e.g. Friedrich’s ataxia (FA) Neuromuscular joint diseases, e.g. myasthenia gravis Peripheral nerve diseases, e.g. Guillain–Barré syndrome Demyelinating diseases, e.g. multiple sclerosis (MS)   What are the symptoms of neuromuscular disease? Typically, all neuromuscular diseases will cause fatigue and muscle weakness, which becomes more pronounced as the conditions progress. Other symptoms will depend on the type of neuromuscular disorder, and the part (or parts) of the body affected. Some common symptoms to most of these conditions include: Loss of muscle mass Twitching Cramps, aches and pains Numbness or tingling Loss of balance Trouble controlling movement Drooping eyelids Difficulty swallowing Difficulty breathing/diaphragm weakness Double vision The end point of most neuromuscular diseases is weakness of the respiratory muscles, and the subsequent respiratory failure. For this reason, respiratory physicians are usually involved in treatment. Symptoms can begin at any stage of life, depending on the type of disease. As there are many types of neuromuscular disease, it is essential to receive a proper diagnosis from a doctor.   Causes of neuromuscular disease Different neuromuscular disease have different causes, but most are thought to either be genetic (either passed down through families or caused by spontaneous gene mutation) or autoimmune (in which the body’s own immune system malfunctions and attacks the nerves or muscles). In some cases, other factors may be involved, such as exposure to chemicals or poisoning, inflammatory muscle disorders, such as polymyalgia rheumatic, or even certain bacterial infections.   What is the treatment for neuromuscular disease? At the current time, there is no known cure for any neuromuscular disease, nor any way to prevent it from happening. There are treatments for some specific types of neuromuscular disorder, such as pyridostigmine for myasthenia gravis, or replacement therapy for Pompe disease; however, for most neuromuscular diseases, treatment is focussed on managing the conditions, and making the patient’s quality of life as good as possible. This may be done via medication, physical therapy, and, in certain cases, surgery. Non-invasive ventilation is often required in the later stages, as the muscles that control breathing deteriorate. Researchers continue to look for a solution, with a lot of work going into researching genetic therapies and new medications in the hope that one day we will be able to cure neuromuscular disorders. ...

Neurorehabilitation

Neurorehabilitation is a medical process aiming to aid recovery from neurological disorders and injuries to the nervous system. Neurorehabilitation begins after the acute stage of treatment for brain injury ends, and helps the patient to recover improve function and cognitive abilities, and to compensate for any brain function alterations resulting from injury or the subsequent treatment.   What is neurorehabilitation used to treat?   Neurorehabilitation is commonly used to treat such conditions as stroke, cerebral palsy, Parkinson’s disease, traumatic brain injury, multiple sclerosis, post-polio syndrome and Guillain-Barre syndrome.   What does neurorehabilitation involve?   Neurorehabilitation involves a set of therapeutic techniques, and begins with tests of integral neurophysiology, for example, electromyograms and electrocephalograms (EEG) to give a full assessment of the needs of the patient. Using this assessment, the neurorehabilitation team will aim is to promote the skills of the patient, and attempt to get them as much independence as possible. This involves a number of approaches to treatment that not only aims for physical improvement, but also a holistic approach to cater for social, cultural and psychological aspects to their personality to lead to improvements in self-esteem and to help the patient feel more confident about their abilities. Neurorehabilitation not only focuses on teaching and training the patient to improve abilities, but also has a focus on nutrition and the patient’s daily routine in order to best facilitate the road to recovery.   Areas of neurorehabilitation   Neurorehabilitation can focus on the different aspects needed to improve recovery. Using physiotherapy, occupational therapy, psychological therapy, speech and language therapy and vision therapy techniques where necessary, the patients overall ability can be improved. A physiotherapist can improve any physical function problems resulting from the brain injury or disease, while occupational therapists can help to teach new techniques to help the patient return to work and complete daily necessary tasks. For any problems with speech resulting from the brain injury, or commonly from a stroke, a speech and language therapist can help to overcome these difficulties, and also with any problems with swallowing or eating. A vision specialist will also help if sight is affected. A dietician can help to improve the patients eating regime and diet, which can become problematic following injury.   New developments in neurorehabilitation   With new developments in technology, come new developments in the way neurorehabilitation is provided. Greater imaging techniques allow for an improved assessment, while virtual reality and video games can provide new options for improving cerebral development and rehabilitation. New developments in robotic technology offer new options for physical development and stimulation following brain injury. ...

Paraneoplastic syndromes

Paraneoplastic neurological syndromes are all side effects that occur in the body from cancer but are not caused directly by the disease or by treatments to alleviate it. These are side effects of cancer, most notably the Lambert-Eaton syndrome, considered a rare disease that weakens the nervous system and causes weakness in the limbs, especially the legs. This kind of weakness, predominantly in the morning, may be accompanied by dry mouth, muscle pain and diarrhoea. It also tends to occur more frequently in patients already suffering from other ailments such as encephalomyelitis, subacute sensory neuropathy and limbic encephalitis, among others. ...

Parkinsonism

What is Parkinsonism? Parkinsonism is a general term that refers to a group of neurological disorders that cause movement problems similar to those seen in Parkinson's disease, such as tremors, slow movement and stiffness.     What are the symptoms of Parkinsonism? The most common symptoms of this condition: Tremors, especially in the hands Decreased facial expressions or difficulty making facial expressions Paralysis or weakness of muscles Difficulty controlling or initiating a movement Muscle stiffness Weakened voice A person who has Parkinsonism will also have another disorder that causes additional neurological symptoms. These symptoms may be dementia, confusion or memory loss, problems associated with balance and muscle spasms. What are the causes of Parkinsonism? Parkinson’s disease is the most common neurodegenerative cause of Parkinsonism. Other causes of Parkinsonism include: Brain injury Encephalitis; inflammation of the brain, most commonly caused by a viral infection Diffuse Lewy body disease; a neurodegenerative disorder characterized by dementia HIV/AIDS Multiple system atrophy (MSA), a fatal neurodegenerative disease causing slowness of movement and impaired speech, among other symptoms Meningitis; inflammation of the membranes surrounding the brain and spinal cord can trigger symptoms of Parkinsonism Stroke Progressive supranuclear palsy; an uncommon brain disorder that affects movement, balance and speech. Wilson's disease; a disorder in which copper builds up in the body, causing tissue and organ damage Carbon monoxide poisoning Brain damage caused by anaesthetic drugs Mercury poisoning and other chemicals Certain medications used to treat mental disorders or nausea MPTP (a contaminant in some psychoactive drugs) Narcotic overdose Can Parkinsonism be prevented? Parkinsonism can be prevented by treating the conditions causing Parkinsonism mentioned above or controlling the intake of medications that could potentially cause it. What is the treatment for Parkinsonism? If the cause of Parkinsonism is drug-related, the drug may be suspended or exchanged for another. Also, by treating conditions, such as infections or strokes that cause Parkinsonism, symptoms of the disease can be reduced or terminated. Drugs may be recommended to alleviate the symptoms of the disease, however, treatment always focuses more on the additional disease that a person has. Doctors often recommend physical and occupational therapy because they can help a person keep their muscles strong and improve balance.  ...

Restless legs syndrome

What is restless legs syndrome? Restless legs syndrome (RLS) is a nervous system disorder that causes an irrepressible urge to get up and walk or move the legs. As such, this is also considered a sleep disorder as it can cause significant sleep disruption in those with RLS. Anyone can suffer from this syndrome, although it is more common in patients with diabetes, Parkinson's, renal diseases and iron deficiencies. What are the symptoms of restless leg syndrome? The main symptom of restless leg syndrome is the unpleasant sensation in the lower part of the legs and the irresistible urge to move the legs. People with RLS may experience: Burning sensation Itching Pain Palpitations All of these symptoms make it difficult to sleep. A lack of sleep can cause daytime drowsiness, anxiety, depression, confusion or difficulty thinking clearly. What causes restless leg syndrome? The exact cause of restless legs syndrome is not known. It can be related to other conditions such as: Chronic kidney disease Diabetes Lack of iron Parkinson’s Peripheral neuropathy Pregnancy Multiple sclerosis What is the treatment for restless leg syndrome? Restless legs syndrome cannot be cured, and treatments look to relive the symptoms. The first step in treating RLS is making dietary changes, as certain substances can make it worse, such as caffeine, alcohol and nicotine. It can also help to stretch the legs regularly, and taking measures to reduce stress. Certain medications can also help, but are not widely prescribed for treating RLS. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals.  ...

Sleep problems

Sleep problems are all those behaviors related to sleep disturbance, such as difficulty falling asleep, falling asleep at inappropriate times, too much sleep or have abnormal behaviors during sleep. The most common forms are insomnia (difficulty sleeping), sleep apnea (interrupted breathing during sleep), restless leg syndrome, among others. There are various treatments to solve this kind of problem, but often have to maintain regular sleep habits. ...

Spasticity

What is spasticity? Spasticity is a muscle disorder that involves an abnormal increase in muscle tone. Muscle tone is the amount of tension we have in our muscles, and “normal” muscle tone is the natural level of tension that is required to hold ourselves up. An increase in the tension in the muscles causes them to become stiff and can result in involuntary muscle spasms. How common is it? Spasticity is common among people with certain long-term neurological conditions : it is present in 28-38% of patients with stroke, 41-66% patients with multiple sclerosis, and 13% of patients with traumatic brain injury. What are the symptoms? The symptoms of spasticity can include: muscle tightness / rigidity muscle tiredness uncontrollable isolated muscle spasms, or a series of involuntary spasms (clonus) exaggerated tendon reflexes contracture (permanent contracture of the muscles) pain from tense muscles or from spass In some patients these issues can lead to sleeping difficulties, changes in posture, and decreased functional abilities (such as walking or going to the toilet). What causes spasticity? Spasticity is caused by damage to nerve cells in the spinal cord or brain. Aside from trauma to the brain or spine, there are a range of conditions which can result in nerve damage, including: multiple sclerosis stroke cerebral palsy amyotrophic lateral sclerosis Krabbe disease Regardless of the cause, some things can make spasticity worse. These usually involve unpleasant sensations, such as infections, extremes of temperature, constipation, skin irritation, or even stress and anxiety. How is it diagnosed? Diagnosis involves a thorough evaluation of your medical history, including the symptoms you have experienced, the conditions you have been affected by, and the medication you take. Because some conditions that cause spasticity are linked to our genes, you will be asked about your family’s medical history. Finally, the doctor will conduct a physical examination, looking at your muscle movements, your range of motion, and monitoring over time the frequency of spasms and clonus. They will also look at what activities you are struggling with and to what extent your abilities are limited. To prepare for your appointment, it can be helpful to think about: how your symptoms vary during the day what you do to make the symptoms better what makes the symptoms worse How is it treated? Treatment aims to improve your mobility, reduce pain, and ultimately help you to better carry out the tasks that are important to you. Treatment can involve: exercises – these will be tailored to your needs to stretch and strengthen your muscles medication – this can include tablets which target the entire body to relax the muscles, and injections to target specific muscle groups surgery – this is sometimes recommended for tendon release, or to implant a pump which administers muscle relaxant medication on a continuous basis The right mix of treatment will vary from patient to patient. This is because each person’s priorities are different, and because some people will respond better to certain treatments than others. ...

Spinal cancer

What are spinal tumours? Spinal tumours are the abnormal growth of cells on the vertebrae. Cancerous tumours of the spine are not very common, however, the spine does have other more frequent types of cancer that affect it. One in four cancer patients develop a tumour that metastises in the spine which causes pain and possible functional injuries. Not all spinal tumours are cancerous. There are three types of tumour, which are: Spinal, primary, and metastatic tumours Intramedullary tumours: that develop in spinal cord cells Extramedullary tumours: that develop in the network of cells surrounding the spinal cord. Prognosis: Spinal tumours may compress the medulla or the nerves. This results in a loss of movement and limb sensitivity. The tumour can sometimes be fatal, depending on where it is located, which is why early detection is so important. What are the symptoms? Spinal tumours can cause a variety of symptoms, especially if they grow. They can affect the spine, nerve roots, blood vessels, and the bones surrounding the spine. Some common symptoms include: Pain near the tumour Back pain that usually gets worse at night Loss of muscle sensitivity, particularly around the joints Difficulty walking Affected sensitivity Paralysis in parts of the body Medical tests: An MRI scan is quite often used to check the progression of the tumour. This test is useful for diagnosing the tumour early on, which means that chances of not interrupting spinal functions are higher. X-rays are useful to rule out other degenerative conditions or fractures caused by the tumoural invasion, but they do not play a key role in diagnosing these types of tumour. A CT scan or a biopsy can be carried out to rule out a spinal tumour or help determine its location. What causes them? Spinal tumours are not very common, and the reason for them is unknown. Some specialists believe that genetics may play a role in developing tumours, although it is not clear if these faulty genes are inherited or if they develop over time. How can they be prevented? These types of tumour tend to be treated quickly to avoid central nervous system damage. Early detection is the best prevention. What is the treatment? The main aim of the treatment is to get rid of the tumour. Depending on the method used, it can be a challenging surgery. The main option is normally to remove the tumour by surgery. If this isn’t enough or the tumour cannot be completely removed, then other treatments will be considered. These include radiotherapy and chemotherapy. What specialist should I see? A neurosurgeon is the specialist who tries to prevent, who diagnoses, assesses, and treats issues of the central and peripheral nervous system. These conditions may sometimes require surgery. ...

Stroke

What is a stroke? A stroke is the sudden interruption of blood flow to the brain, depriving the brain cells of oxygen which causes the brain cells to rapidly die. Stroke is a serious medical condition and should be treated as an emergency as earlier action can help reduce the amount of damage done to the brain. Depending on where the stroke occurs and how much of the brain is damaged will determine a person’s ability to recover. The existing types of stroke are Transient Ischemic attack (TIA), ischemic stroke or a haemorrhagic stroke. What are the symptoms of a stroke? The key symptoms of stroke can be remembered with the acronym ‘F.A.S.T’: Face – one side of the face may have drooped down and they are unable to smile. Arms – they might not be able to lift both arms, or complain of numbness in one arm. Speech – speech can be slurred, or they might not be able to speak at all. Time – if any of the above symptoms are witnessed you must call an ambulance and seek immediate medical attention. Additional symptoms include: Difficulty swallowing (dysphagia) Paralysis of one side of the body Blurred vision Confusion Loss of balance A sudden, severe headache Loss of consciousness What causes a stroke? There are three types of stroke: Ischemic stroke – blood supply is blocked due to a blood clot disrupting the flow of blood to the brain (thrombotic stroke). Blood flow may also be blocked by fatty deposits and cholesterol (embolic stroke). Haemorrhagic stroke – a damaged or weakened blood vessel that supplies the brain ruptures. This is usually due to either high blood pressure or an aneurysm (weakness in the blood vessel wall). Transient ischemic attack (TIA) – these are known as mini-strokes as blood supply to the brain is only stopped temporarily. They can be a warning sign of an eventual major stroke and should be treated urgently. The following are risk factors for having a stroke: Poorly managed diabetes High cholesterol Obesity Hypertension (high blood pressure) Smoking and excessive alcohol consumption Atrial fibrillation (irregular heartbeat) Coronary artery disease (narrowing of arteries due to plaque build-up) Older age Can a stroke be prevented? As with other pathologies, the prevention of stroke can be achieved by eliminating everyday life risk factors such as smoking, excessive alcohol consumption, high blood pressure, diabetes, high cholesterol levels, obesity and certain diseases such as atrial fibrillation and coronary artery disease. What is the treatment for a stroke? Treatment for a stroke will depend on the type of stroke suffered and which part of the brain was affected. Medications can be administered that help dissolve blood clots and reduce cholesterol and blood pressure. Surgery to remove blood clots might also be recommended or surgery to address brain swelling and cerebral bleeding resulting from a haemorrhagic stroke. ...

Tension headache

What is a tension headache? A tension-type headache (TTH) or tension headache is a type of headache that usually radiates from the lower back of the head, causing a persistent, dull pain. The duration and frequency of TTH attacks or episodes depends on your individual case: when it is sporadic, an attack usually lasts 30 minutes to several hours, but can last several days. Chronic TTH can involve long-lasting and/or recurrent headaches that occur frequently over a period of weeks, months, or even years. Tension-type headaches can be classified according to its frequency: Infrequent episodic: a headache occurring occasionally or once a month Frequent episodic: from one to 15 attacks per month Chronic: occurring more than 15 times a month   What are the symptoms? The symptoms of tension-type headache are a persistent, dull headache on both sides of the head. The pain can be mild to moderate and it usually affects the occipital area. Furthermore, you may also develop sensitivity to light and sound. You may experience a pain that is usually described as if the head were being squeezed in a vice.   How is it diagnosed? There is usually no need to see a doctor if you only suffer headaches occasionally; however, if your headaches are severe or you get them several times a week, you should see your GP. TTH can be diagnosed by simply describing the symptoms you are suffering from. If the doctor suspects a more serious condition is behind your headaches, they may send you for tests, such as CT or MRI scans.   What causes tension headaches? It is not clear yet what causes tension-type headaches; however, it has been hypothesised that they may be caused by a prolonged contraction of the muscles on the lower back of the head, of the forehead, temples, neck and shoulders. TTH may be triggered by stressful events, anxiety or depression, which is why it may be regarded as a psychosomatic condition. Furthermore, tension-type headaches can also be associated with problems of the mandibular joint, hormone imbalance, poor posture and misuse of medications.   How are tension headaches treated? Chronic TTH tends to be treatment resistant, but frequent and infrequent tension-type headaches can be treated with medication, biofeedback therapy, and massage therapy. Other treatments, such as cognitive-behavioural therapy and stress management techniques, may be beneficial as well.   Which doctor should I see? If you are suffering from repeated or chronic tension-type headaches, you should see your GP. Depending on the nature of the headaches, you may be referred to a specialised neurologist, psychologist or dental practitioner. ...

Traumatic brain injury

What is traumatic brain injury? Traumatic brain injury (TBI), or intracranial injury, is when a head injury causes damage to the brain. This may be caused by any sort of bump, blow, or jolt, and commonly results from vehicle collisions, falls, or violent incidents. While the term “head injury” is a broad term that can include damage to the scalp or skull, the term “traumatic brain injury” specifically refers to damage to the brain. Brain injuries are should always be taken seriously, and it is advisable to go to the hospital if you have suffered any kind of blow to the head, particularly if you feel ill or experience symptoms of TBI (see below). The worst brain injuries can result in permanent brain damage, or even be fatal.   What are the symptoms of a traumatic brain injury? The mildest type of TBI is a concussion. While these are not usually serious, it is still a good idea to be checked out at a hospital, and perhaps even monitored overnight. Symptoms include: Headache Neck pain Ringing in the ears Dizziness Tiredness Temporary trouble remembering things or concentrating More severe intracranial injuries can cause the same symptoms, plus other, more serious ones: Nausea Vomiting Seizures or convulsions Slurred speech A headache that does not go away, or even gets worse Dilated pupils or pupils with unequal levels of dilation (unequal size) Weakness/numbness in the limbs In children too young to communicate what is wrong, you should look out for symptoms such as: Continual crying/inability to be consoled Irritability Change in sleeping habits Change in eating habits Change in attention span Loss of interest in favourite games or toys   Complications of traumatic brain injury Severe complications can occur immediately after traumatic brain injury, and patients can slip into comas or enter vegetative states. There may also be nerve damage or fluid build-up in the brain. Patients recovering from a TBI may experience long-term effects on their intellectual and communicative skills, including memory, judgement, concentration, ability to learn, ability to understand speech or writing, their own ability to speak or write, or ability to notice or understand the nuances in conversation.   What can cause a traumatic brain injury? The most common causes are violence, sports, falls, and vehicle collisions. Motorbike accidents carry a high risk of TBI. Domestic violence and child abuse have been reported as causing traumatic brain injuries, as have work-related accidents. TBI is the leading cause of death and disability in war zones, due to injuries caused by firearms and explosions. In younger children, the most common cause of TBI is falling over, while in older children falls and traffic accidents are both leading causes.   How can TBI be prevented? Head injuries can often be avoided by using safety equipment and common sense. Use seatbelts in vehicles that have them, don’t drink and drive, and wear a helmet when cycling, skateboarding, or doing similar activities. Use protective headgear when engaging in contact sports, baseball, or other sports that carry a risk of head injury. Older adults can reduce the risk of falling by having handrails installed in the bathroom and on both sides of the stairs, getting regular exercise and vision check-ups. To prevent head injuries in children, keep them away from playing on high places, like balconies or fire escapes, install safety gates around the house (for younger children), and keep stairs free of clutter.   What is the treatment? A CT scan or an MRI may be used to scan the brain to assess the situation. Mild TBIs, such as concussion usually require no treatment, but the patient requires close monitoring in case of secondary injury or complications. Over-the-counter pain medication may help any headaches. In the case of serious TBIs, emergency care focusses on maintaining blood pressure, preventing further injury, and ensuring the patient has adequate blood and oxygen supply. Medication, such as diuretics and anti-seizure drugs may be needed to prevent or limit secondary damage immediately after an injury. Sometimes, emergency surgery is required – this could involve removing clotted blood (hematomas) that are putting pressure on the brain, repairing fractures in the skull, removing pieces of skull from the brain, or opening a window in the skull to reduce pressure on the brain. Significant brain injuries may need rehabilitation in the long term, as patients may need help recovering their mental faculties – some may even need to relearn how to walk and talk. There are a number of support groups for people recovering from a traumatic brain injury, and many sources of help and advice to aid recovery. ...

Vascular dementia

What is vascular dementia?  Vascular dementia is a type of dementia caused by impaired blood flow to the brain. There are two types of vascular dementia:  Multi-infarct dementia, when dementia or brain damage is caused by numerous smaller strokes (blockages of blood to the brain). Single-infarct dementia, which is when a single stroke causes dementia or brain damage, depending on the part of the brain affected. The following can result - aphasia (loss or alteration of language that causes difficulties for speech and linguistic comprehension) and apraxia (a decrease in the ability to perform certain movements). What are the symptoms of vascular dementia?  The symptoms of vascular dementia can manifest gradually or progress after a small stroke.  The preliminary symptoms of dementia are:  Difficulty performing easy tasks Getting lost in familiar surroundings Language problems  Changes in mood  Loss of social skills As the dementia gets worse, the symptoms are more evident and the ability to take care of oneself diminishes.  Some of these symptoms are:  Changes in sleep patterns  Difficulty performing basic tasks such as cooking, choosing the appropriate clothes or driving  Forgetting facts and details of your own life Depression  Difficulty reading or writing  Using the wrong words  Hallucinating or violent behaviour What causes vascular dementia? Vascular dementia is caused by a reduction in blood flow to the brain. This can result from: blockages or narrowing of blood vessels in the brain multiple small strokes  a bigger single stroke that cuts flow of blood to part of the brain Can vascular dementia be prevented?  The key to preventing vascular dementia is maintaining your cardiovascular health, as a healthy heart generally means you have healthy blood vessels in your brain. The following can help with this: maintaining a healthy blood pressure avoiding type 2 diabetes, or managing it well no smoking exercising regularly eating a low-fat diet What is the treatment for vascular dementia?  There is currently no cure for vascular dementia, but treatment can slow down its progression. Treatment also cannot reverse the loss of brain cells caused by this condition. Treatments focus on the underlying cause – often improving poor cardiovascular health with diet, lifestyle changes and medications. Certain psychological therapies might be used as well.  ...

Vertigo

Vertigo is characterised by a feeling of imbalance arising from the inner ear (vestibular system). When a sudden movement or a rapid change of the position of the head occurs, it can result in vertigo. The most common symptoms is dizziness which can also be caused by diseases or disorders such as arrhytmia or Ménière's disease.   The Vertigo is a sensation of instability of self or spinning objects in the environment, which is accompanied by malaise, fever, nausea, vomiting, loss of balance and feeling faint. It can be temporary or last days, and is usually caused by an alteration of the ear, the ear nerve connection to the brain or the brain itself. Also, the origin of these alterations may be an infection in the ear, lack of blood pressure, medications, skull fractures, brain tumors, pressure changes or loud noises, among others. There are different types of vertigo, classified according to the location of the problem that originates or feelings of the patient, ie if you notice instability of your body or if the environment that is spinning. The treatment involves the administration of drugs, as a function of the underlying cause dizziness, and the realization of a set of physical exercises. ...

Whiplash

What is whiplash? Whiplash is an injury to the neck caused by a sudden movement of the head (backwards and/or forwards) which stretches and damages the soft tissues in the neck (they are sprained). Whiplash is commonly caused by car accidents. What are the symptoms of whiplash? The symptoms of whiplash usually take a few hours to develop and include: Neck pain Neck stiffness Difficulty moving your head Shoulder and arm pain Headaches Lower back pain Dizziness Difficulty sleeping Muscle spasms Pins and needles Symptoms will usually worsen over the first few days following the injury. Recovery from whiplash can take a few weeks, a few months or longer in some cases.   What causes whiplash? Whiplash is caused by a sudden movement of the head, either forwards, backwards or sideways. The most common causes of whiplash are: Car accidents A blow to the head, such as in boxing or rugby A fall where the head is jerked suddenly How can whiplash be diagnosed? In general, damage to the soft tissues of the neck (muscles and ligaments) cannot be seen on a standard x-ray scan. Therefore, a diagnosis is usually made based on a physical examination which looks for muscle spasms and tenderness. What is the treatment for whiplash? Usually whiplash will get better on it own, however, it can help to keep the neck mobile (neck braces are not recommended), to take painkillers to manage any pain and to carry out special stretches and exercises. Physical therapy can also be recommended for whiplash patients. It can also help to apply ice to the neck the first 24 hours following injury. ...

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