Neurologist deals with diagnosing and treating diseases of the brain, spinal cord, peripheral nerves and muscles. Our team has the best Neurophyscian in Delhi NCR. Dr Abhinav Gupta is the best Neurologist in Delhi NCR (Noida, Vaishali, Ghaziabad and Gurgaon).
Best Neurological Treatment is available for
Presents with symptoms such as weakness, numbness of any part of body , facial deviation, speech disturbances or Vision changes due to damage to any part of brain, usually resulting from an interruption of blood supply or by a hemorrhage (bleeding) in the brain
If you have one of these problems, you may be tempted to go straight to a neurologist rather than a primary care doctor. Sometimes it can be difficult even for medical professionals to determine whether a neurologist or different doctor is best for you. Having a primary care physician helps ensure that someone is responsible for coordinating your medical care. This can prevent information from being lost and tests from being unnecessarily repeated. Coordinated medical care also reduces the likelihood of drug interactions or overdoses.
- However, if you already have a diagnosed neurological condition, are unhappy with the care your primary doctor is providing, or simply would like another opinion, then seeing a neurologist is reasonable.STROKE
Dr Abhinav Gupta is the best stroke doctor in Delhi.
Why and How to diagnose Stroke ?
It is a life threatening emergency. Every minute counts
The faster we act more brain we are able to save so every one should recognize the symptoms given below and save ones near and dear.
FAST is an acronym used as a mnemonic to help detect and enhance responsiveness to stroke victim needs.
Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services.
The FAST Acronym to identify stroke symptoms
Rush to nearest Hospital with CT scan. TIME IS BRAINSigns
There are two main types of stroke:
Ischaemic Stroke – Can be caused by a blood clot/emboli formed in the heart (atrial fibrillation) or carotids and travelled to the brain or by atherothrombosis( built up and rupture of fatty deposits in arteries of the brain).
Haemorrhagic Strokes– are caused by a rupture of the blood vessels that causes bleeding within the brain. It can either be caused by very high BP damaging small blood vessels or due to a bulge in brain arteries (Aneurysm) which ruptures causing it to bleed. The affected part of the brain swell and become non functional . Though hemorrhagic strokes account15% of all strokes, they are the cause for around 40% of all stroke related deaths.
Tranisent Ischaemic Attack (TIA) : This is third type a more minor stroke but very important where a blood clot temporarily interrupts blood flow. The signs and symptoms recover completely after some time usually within 24 hours. TIA is a major risk factor for future strokes.
Risk factors for stroke
- High blood pressure
- Cholesterol levels
- Excessive alcohol intake
The symptoms of both strokes are similar, a diagnosis requires both physical examination and brain scans.
CT scan: Should be done at the earliest as it will help in diagnosing the type of stroke .Once the type and severity is known further treatment can be planned for different type of strokes. The treatment of different type of strokes differ,
Treatments for Ischaemic Stroke
Ischaemic strokes can be treated using clot busters called Alteplase that dissolves the clot and restores blood to the brain..
It is an interventional procedure used to remove the clot using various devices to restore blood flow in large arteries.
Anticoagulants are types of drugs that manipulate the blood coagulation process
After the clot has been dissolved or removed, most people will be offered aspirin, which as well as being a painkiller, is also an antiplatelet that reduces the chances of another clot forming.5,6
If your blood pressure is too high, you may be offered medicines to lower it including thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, beta-blockers or alpha-blockers.
If the level of cholesterol in your blood is too high, you will be advised to take statins to reduce it.
Some ischaemic strokes are caused by the narrowing of the artery in the neck called the carotid artery caused by atherosclerotic fatty deposit build-up. In this case surgery may be offered to remove the atherosclerotic plaque build-up
Treatment for Haemorrhagic strokes
The second type of stroke is haemorrhagic where blood bleeds out of a weakened artery in the brain. Haemorrhagic strokes can be treated with both surgery and medication. Sometimes blood from the brain will need to be surgically removed in a procedure known as a craniotomy. In addition, medication will be offered to lower their blood pressure, and if anticoagulants were taken before the haemorrhagic stroke their effects will need to be reversed.
Rate controllers (antiarrhythmic drugs)- rate-control medications help slow the heart rate to its regular beating pattern These medications are used for most patients to relieve the symptoms of AF. Rate control is the initial approach adopted in treating elderly patients and those with minor AF symptoms.8
Rhythm controllers (antiarrhythmic drugs)- rhythm controllers help re-establish and maintain the heart’s rhythm. These medications are recommended for young symptomatic patients and in patients with AF in whom other corrective measures have not been successful.9
Electrical cardioversion – low energy shocks are given to the heart to try to return it to a normal rhythm.
Radiofrequency or catheter ablation – this procedure aims to block the abnormal parts of a heart’s electrical rhythm. These techniques are used when medicines or cardioversion do not work.
Talking to Your Doctor About Stroke
What to expect
Once a stroke has been confirmed, a doctor or neurologist will ask you questions about the symptoms or problems you are having and you should feel free to ask them questions too. They will probably ask questions about your general lifestyle, health and diet and talk to you about adjusting this to adapt to a healthier lifestyle during your period of recovery.
They will also want to know about any medication you are currently taking so please bring them or a list with you. They will make a full assessment of your condition and explain appropriate treatment options.
What questions to ask?
Why did I have a stroke?
How often should I come back for check-ups with my doctor?
I take other medications; how could these affect the medicines that I will now take for my Heart Attack or Unstable Angina?
Are there any foods or lifestyle habits, such as smoking, I need to avoid?
What are my chances of having another stroke? What can I do to prevent it?
How long will my symptoms last? Are they permanent?
How will my stroke be managed?
Are changes to my alcohol consumption necessary?
Can I drive a car?
How you might feel
Stroke can have an impact on both the person diagnosed but also on family/carers who may be worried about the health and well-being of their loved one. If you have recently been diagnosed with a stroke, it is understandable if you feel nervous, anxious or apprehensive about the condition.
Getting on with Life After a Stroke
Your stroke doesn’t have to stop your favourite pastimes.
Stroke can change lives and can have a huge impact on you and your family but there is life after having had a stroke.
With the right help and support your stroke doesn’t have to stop you from doing anything that you want to do.
Your stroke will probably cause a lot of worry and uncertainty for the people around you. Planning for the future in both financial and personal circumstances may be difficult and family members may feel overwhelmed if they suddenly have to take over things that you used to do.
Strokes can also have an enormous and sometimes strenuous effect on personal relationships and this can sometimes make you withdraw and become isolated, affecting your mood and motivation.
To reduce the impact of your stroke on your personal relationships with others it is important to share information with your family and involves them in making decisions so they know what to expect, especially when you go home, and how they can help you.
Even though your ability to do things may have changed since before your stroke, you will still be able to take part in social activities and engagements with others that you and your family can enjoy together. It is important to focus on what you can do, rather than what you can’t, and build from there.
Talk to your friends about what has happened and help them to understand about the impact has had on you. They may not realise how tired you get or that you can’t get out as much as you used to. Be open about what you need and what they can do to help you.
Seizures and Epilepsy
Infections of brain
Peripheral and Autonomic nerve diseases
What to do in a seizure
Knowing a little seizure first aid may greatly help someone having a seizure—it may even save their life. A seizure consists of disorganized, electrical discharges of the brain and has multiple causes. If someone has several seizures, their doctor may diagnose them with epilepsy. Managing these seizures requires long-term medical treatment.
It is essential to know when an individual has a seizure and what to look for. Experiencing a seizure can be a scary experience for the person experiencing them as well as the people observing it. Knowing what to do can help the seizure victim to avoid hurting himself or herself during the seizure.
What a Seizure Looks Like
Some seizures will appear differently from others, so it will depend upon the seizure disorder how the seizures will appear.
Although this list is not inclusive, here are some common symptoms seen if someone has a seizure, such as:
alteration or absence of consciousness
involuntary muscle contraction of the entire body, followed by relaxation
tongue biting due to contraction of jaw muscle
difficulty breathing and secretion of saliva from the mouth.
What to Do
Witnessing a seizure can be frightening, but there are some things you can do to help the person experiencing the seizure:
Do not panic and stay calm.
Do not attempt to move the person having a seizure to another location, since this may injure you, the person having the seizure or other bystanders.
Do not leave the person having the seizure. Stay with them until the seizure stops.
Look for bracelet tag and contact information for contact information or verification that the individual has epilepsy.
Protect the individual from any kind of injury. You can do this by moving chairs or other hard objects away from the person.
Do not attempt to open the mouth and put anything in the mouth, since this could pose a choking hazard or you could injure yourself.
Gently put a soft pillow under the head to prevent injury to the head during the seizure.
Carefully and gently turn the individual to their side and allow any fluid to come out of the mouth.
Do not attempt to give anything to drink or eat while the person is having a seizure.
Seizures usually last for a short period of time (1-2 minutes). If a seizure lasts longer than about five minutes, you should call an ambulance immediately.
How Common Are Epilepsy and Seizures?
Epilepsy and seizures can occur in any person at any age. According to the Epilepsy Foundation, 1 of 26 people develop seizures during the course of a lifetime. Furthermore, about 1 of 100 Americans have been diagnosed with epilepsy or had a single unprovoked seizure.
Vascular neurology is the specialized treatment of strokes and stroke risk factors. You may need to see a vascular neurologist during or after a stroke, or if you are at risk of having a stroke.
Vascular neurologists are often called stroke doctors because, in addition to taking care of people who have neurological conditions, they concentrate all or most of their work on taking care of people who have challenging stroke problems.
All neurologists have a great deal of experience in managing strokes. Vascular neurology requires additional subspecialty training after completion of a four year neurology residency. This subspecialty training may take between one to three years, and is focused on the latest techniques in stroke care, including interventional treatments.
There are a number of reasons why you may need to see a vascular neurologist. If have difficult to manage stroke risk factors, if you are seen in the hospital within a few hours of having a stroke, if you have an unexplained stroke, if you have recurrent strokes, and if you have unusual effects of a stroke.
Stroke Risk Factors
If you have blood vessel abnormalities in the brain, such as a brain aneurysm (a swollen section of an artery that can tear) or an arteriovenous malformation (AVM), this can increase your risk of having a stroke. the decision making about whether you should be taking a blood thinner, whether you should have a procedure to repair the blood vessel is fairly complicated, and you may need to see a vascular neurologist to asses your risks and benefits of various treatment options.
Blood clotting disorders also increase the risk of strokes, and these are generally lifelong conditions that require a long term stroke prevention treatment strategy.
Acute Stroke Management
If you are able to get to the hospital within a few hours of the beginning of your stroke symptoms, you have a better chance of recovery. Stroke treatments, including the powerful blood thinner tissue plasminogen activator (tPA), are far more effective and safe when administered within the first few hours of stroke symptoms, before permanent damage occurs.
Recognize the Symptoms of a Stroke
There are a number of common stroke risk factors. Most of the time, one or more risk factors is identified as the cause of a stroke.
If you have had a stroke without a clear cause, this is referred to as a cryptogenic stroke, and you might be referred to a vascular neurologist for further diagnostic testing, and for a plan regarding stroke prevention strategies.
If you have had recurrent strokes, such as in multi infarct dementia, you may need to see a stroke neurologist, especially if your recurrent strokes are cryptogenic.
The effects of a stroke generally involve language problems, physical weakness, or problems with vision. Sometimes, however, a person can experience unexpected personality changes, such as emotional behaviorthat seems out of character, or that doesn’t necessarily match up with the damaged area in the brain.
A stroke neurologist can help determine whether unexplained or unexpected symptoms are related to the stroke.
Young Age or High Risk
If you have a particularly high risk situation, such as a stroke during pregnancy, or if your baby has had a stroke, you may need a consultation with a stroke neurologist, who may follow you regularly to identify and manage stroke risk factors. Similarly, if your teenager has had a stroke, a stroke neurologist can help manage long term effects and focus on prevention of future strokes
When half of the face loses its ability to move, it is often a sign of a stroke. One side of the mouth droops, and it may be impossible to fully close the eye on that side as well. A smile is transformed into what looks more like a lopsided smirk.
The appearance of these symptoms is always a reason to get medical help as soon as possible, because you do not want to miss the chance to get the best medical treatment for what could be a stroke.
There’s no reason to despair entirely, though. Facial droop can also be caused by Bell’s palsy, which is much less serious than a stroke.
Bell’s palsy is named after Dr. Charles Bell, a Scottish surgeon who described the disorder in 1821. Dr. Bell was focusing on the facial nerve, also known as cranial nerve VII. Bell’s palsy is due to a sudden loss of facial nerve function, which leads to acute paralysis of half of the face and possibly other symptoms as well.
There is no clear cause of Bell’s palsy. Most people believe that it results from a viral infection that leads to inflammation of the nerve.
Bell’s palsy affects about one in 5,000 people every year. It is more common as we age. Diabetes and pregnancy also seem to increase the risk of Bell’s palsy.
How Does the Facial Nerve Normally Work?
The facial nerve does more than just signal for facial muscles to move. Parasympathetic nerve fibers for eye tearing and some salivation run through the facial nerve. The facial nerve helps control the stapedius muscle, which adjusts the mechanics of hearing in the middle ear. The facial nerve also carries taste fibers from the foremost two-thirds of the tongue.
The fibers that do all these different nerve functions break away from the nerve at different points. It may be possible for a neurologist to determine just where in the course of the nerve the trouble lies by noting what nerve functions have been lost.
Due to a quirk in the way nerves run from the brain to the face, the top part of the face receives connections from both sides of the brain, and the bottom half of the face receives connections from just one side of the brain. This fact is important in making a diagnosis of Bell’s palsy, because whereas a lesion of the nerve will usually affect both the top and bottom half of the face, a disease of the brain like a stroke will normally lead to paralysis of only the lower face.
What Else Causes a Facial Droop?
One of the most serious things that can cause a facial droop is a stroke. Other diseases that cause facial drooping include Lyme disease, neurosarcoidosis, Ramsay-Hunt syndrome and some seizures.
What Tests Are Needed to Diagnose Bell’s Palsy?
Very often, a physician can diagnose Bell’s palsy just by hearing your story and doing a thorough physical exam. The doctor may examine your hearing as well as your sense of taste to see if those parts of the facial nerve have been affected. If they have, the problem is more likely Bell’s palsy than stroke. The most important thing is to see if the upper and lower parts of the face are equally affected. If so, the facial droop is more likely Bell’s palsy than a problem with the brain itself.
Sometimes a doctor may order specific imaging tests, like magnetic resonance imaging (MRI), in order to rule out a stroke or other problems with the brain. Occasionally, an electromyogram or nerve conduction studymay be done on the face in order to confirm that the nerve is not working well, and to ensure that it is healing properly.
What Are The Chances of Recovering From Bell’s Palsy?
The chances of recovering from Bell’s palsy are very good. Many people recover in as soon as 10 days. About 85% of people will recover within three weeks, although recovery can take months in some cases. Only about 5% of patients have a poor recovery. Younger patients tend to recover more often than older patients. Only about 7% of people with Bell’s palsy will ever have another attack.
About 9% of patients who get Bell’s palsy have related symptoms afterward. Some patients may suffer from facial pain or spasm even after the ability to move recovers. Loss of taste may result as well. Unless care is taken to protect the affected eye, it may be damaged from remaining open. Sometimes when the facial nerve regenerates, branches may grow into different destinations than those with which they originally connected. The result is called synkinesis, when attempting to move one part of the face, such as the mouth, results in movement of another part of the face as well, such as the eyelid. In crocodile tear syndrome, the regenerated nerve connects the tearing of the eyes with the muscles of the mouth, so that the eyes tear whenever someone eats.
Although the chances of recovering from Bell’s palsy are good, it is important to see a doctor as soon as possible if you notice a facial droop. Bell’s palsy is a diagnosis of exclusion, meaning that more serious disorders must be ruled out before the diagnosis can be made. If that diagnosis of Bell’s palsy is made, it generally means that you are on already on the road to recovery.
If you have hand weakness or if you have been experiencing a sensation of ‘heaviness’ in one or both of your hands, there could be a number of different reasons for your problem. Sudden hand weakness is very concerning and could be a sign of a stroke which is a serious medical emergency.
However, if you have had a nagging, persistent hand weakness, you will almost certainly find out that your hand weakness is not related to a serious medical problem, such as a stroke. The most common causes of hand weakness are usually not serious or life-threatening.
Hand weakness that lasts for weeks or months is typically caused by a treatable medical problem. Most of the time, hand weakness can get worse if it is not addressed in a timely manner. This is why you definitely should not postpone getting medical attention if you occasionally have trouble moving your hand or if your hand has been gradually getting weaker.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is one of the most common causes of hand weakness, hand discomfort and hand pain.
Carpal tunnel syndrome is caused by overuse of the hand, arm or wrist, which is often related to repetitive movements such as operating machinery, computer use or typing.
Carpal tunnel syndrome results from swelling on the inside of the wrist. The swelling compresses the nerves that travel through a ‘tunnel’ of wrist bones. This results in pain, tingling, numbness, weakness, and lack of coordination of the hand. The discomfort and weakness can travel up the arm if the swelling and pressure worsens.
Your doctor, nurse practitioner or physical therapist can typically diagnose carpal tunnel syndrome by listening to your explanation of your symptoms and examining your hand and arm. Sometimes a nerve conduction study is needed to confirm the diagnosis of carpal tunnel syndrome.
Carpal tunnel syndrome is a treatable problem. Rest, ice, and over-the-counter anti-inflammatory medications usually help. A wrist brace and adjustment of the wrist motion during work can prevent carpal tunnel syndrome from getting worse. And for the most severe cases, a fairly simple surgical procedure to relieve the pressure usually takes care of the problem permanently.
Diabetes is a treatable medical illness. One of the complications of diabetes is called diabetic neuropathy. Neuropathy is an injury of one or more nerves of the body, most often affecting the hands or feet. Neuropathy can cause weakness, a sense of heaviness, trouble coordinating the movements of the affected limb, pain, tingling or a burning sensation.
Most people who have diabetic neuropathy are aware that they have diabetes, but in some instances, diabetic neuropathy can be the first sign of diabetes.
Your doctor can detect diabetic neuropathy based on your description of your complaints and a physical examination. Often, a nerve conduction study is needed to define the severity and the type of neuropathy. Blood tests can identify whether you have diabetes.
Next steps include diabetes management, which can help your symptoms of diabetic neuropathy, especially if they have not been present for too long.
While diabetes is the most common cause of neuropathy, there are a number of causes of neuropathy besides diabetes, and they all can cause hand weakness. Your doctor may need to order some blood tests to determine whether you have neuropathy related to an inflammatory illness, an autoimmune condition, a metabolic problem, a nutritional deficiency, or a medication side effect.
Most of the time, neuropathy causes numbness, pain or weakness of the hands and feet, regardless of the cause. Most neuropathies can improve if the cause is diagnosed and medically treated.
Arthritis causes pain and swelling of the joints. This can result in a sensation of weakness and trouble with movement, particularly in the hands. If you have arthritis, you might have ignored the milder, early symptoms. But arthritis can worsen over time, and for many people with arthritis, it is difficult to continue to ignore it, especially when it starts to cause weakness.
Diagnosis and Treatment
Your doctor can diagnose arthritis based on your account of hand weakness, your physical examination, and possibly blood tests and X-rays. Arthritis is a painful condition that is treatable with anti inflammatory medications and therapy, and it is not life-threatening.
Pinched Nerve (Radiculopathy)
Most people experience a pinched nerve at some point in life. The medical term for a pinched nerve is radiculopathy. As a nerve enters or exits the spine (backbone) it may be ‘pinched’ and squeezed by swelling around the spine or by pressure from the bone or joints. This typically results in pain or weakness of the arm or leg.
A pinched nerve in the neck (which is at the level of the cervical spine) may cause hand weakness because the cervical spine controls the hand. Sometimes, a pinched nerve in the neck also causes neck pain.
Your doctor or physical therapist can tell if you have a pinched nerve based on your physical examination. Usually, nerve conduction studies or imaging tests such as cervical spine CT scan or cervical spine MRI are needed to definitively identify the area and the extent of the pinched nerve.
Some people who have a pinched nerve are fortunate enough to have full improvement without any therapy or medication. A pinched nerve during pregnancy, for example, often resolves on its own without any intervention.
Usually, management of a pinched nerve requires physical therapy, which is typically very effective. Sometimes, anti-inflammatory injections or injections with pain medications are needed. In persistent situations, surgery may be necessary.
A herniated disc is a displacement of the cartilage that supports and anchors the spine. A herniated disc may press on the spine or on the nerves. Your spine and your nerves control the sensation and movement of your body. So a herniated disc in the upper part of the spine can produce pain and/or weakness of the muscles of the hand or arm.
Your doctor can diagnose a herniated disc based on your history of symptoms and your physical examination. An imaging test such as a spine X-ray, a spine CT scan or spine MRI is usually necessary to visualize how severe the problem is.
A herniated disc can be treated with physical therapy, anti-inflammatory medication, or pain medication. A herniated disc can be a persistent problem, causing nagging pain or weakness.
Surgery may be needed in some situations. However, in many situations of persistent pain and weakness resulting from a herniated disc, surgery might not repair the problem. Thus, surgery is not always the right option for herniated disc, even when the symptoms are persistent.
If you have a herniated disc, it is usually recommended to take extra care when doing physical activities, especially when it comes to lifting heavy objects.
Saturday Night Palsy
Saturday night palsy is a specific kind of nerve compression that happens after one of the nerves in the upper part of the arm, the radial nerve, is compressed, usually from sleeping in a position that presses on the nerve for hours.
Saturday Night Palsy
It is stereotypically associated with falling asleep in a slumped over position after having had too much to drink, hence the term ‘Saturday night palsy.’ However, any cause of sleeping in a position that places too much pressure on the radial nerve for an extended period of time can cause the same type of hand weakness.
The condition can resolve without medical or surgical intervention, but sometimes it is associated with serious trauma to the arm, requiring medical or surgical treatment. If you wake up with sudden hand weakness, especially if you have consumed alcohol the night before, it is vital to get medical attention immediately because you could have suffered a traumatic injury that requires immediate medical attention.
Ulnar neuropathy is damage to a nerve called the ulnar nerve. This nerve is located near the elbow and controls arm and hand movement. Mild compression of the ulnar nerve is caused by leaning on the arm, which produces a tingling sensation often referred to as bumping the ‘funny bone.’
Damage to the ulnar nerve from traumatic injury, arthritis, compression or infection causes hand and arm weakness and tingling or loss of sensation, particularly affecting the ring finger.
Beyond Carpal Tunnel: Neuropathy of the Wrist and Elbow
A Word From Verywell
If you experience sudden weakness, you need to get emergency medical attention by calling 911. While a stroke can cause hand weakness, there are a number of causes of hand weakness that are more common than stroke and less serious than stroke. Hand and arm tingling, similarly, can be triggered by a number of different causes.
If you have had gradually worsening weakness or pain for weeks or months, you are not having a stroke. Nevertheless, it is important to make an appointment to see your doctor because most of the common problems that cause hand weakness can be more effectively treated if they are diagnosed and medically managed shortly after the symptoms begin.
What Is Peripheral Neuropathy?
Neuropathy is a type of nerve damage. Peripheral nerves are thin structures located in your arms, legs and throughout your body. If you have been told that you have neuropathy, you are likely wondering what to expect.
Nerves play an important role in the body. There are two major types of nerves that send and receive different types of messages. Motor nerves tell muscles to move and sensory nerves receive input from various locations of the body, sending messages to the brain about the body’s sensations, such as hot and cold, pain and touch. These messages travel through an electrical stimulus that can rapidly send a message from one area of the body to another through the brain, spinal cord, and nerves.
Peripheral neuropathy occurs when a nerve or the myelin covering that protects a nerve becomes damaged. Here are some of the symptoms of peripheral neuropathy.
Peripheral neuropathy can cause in changes in sensation or weakness.
Sensory changes may include a lack of sensation or unusual sensations such as pain, tingling, burning, numbness or even crawling sensations. Often, peripheral neuropathy causes hypersensitivity, which is an exaggerated, usually uncomfortable perception of otherwise mild contact.
You might begin to notice balance problems if you have peripheral neuropathy. Balance problems caused by neuropathy are generally most noticeable when attempting to walk a straight line or to stand up with both feet next to each other. Neuropathy causes balance problems because the loss of sensation makes it difficult to sense where your feet are on the ground. This makes it difficult to do things that require good coordination, such as walking in a straight line.
Peripheral Neuropathy can also cause weakness of the affected arms or legs. Usually, this only occurs when neuropathy is advanced in severity. Peripheral neuropathy is usually considered a disease of both sides of the body, but it is common for one side to be worse than the other.
How Peripheral Neuropathy is Diagnosed
If you complain of hypersensitivity or if you have weakness on your physical examination, your doctor will check you for signs of peripheral neuropathy. If you have peripheral neuropathy your reflexes generally do not move as briskly as normal. This often helps doctors differentiate between conditions such as peripheral neuropathy and conditions that involve the brain or spinal cord, such as stroke or multiple sclerosis.
Diagnostic tests called Electromyography (EMG) and Nerve Conduction Study (NCV) demonstrate nerve abnormalities in neuropathy. Brain and spine imaging studies do not show abnormalities associated with neuropathy.
Your doctor may request some blood tests to help determine the cause of your neuropathy, and the results can help direct the treatment plan.
The Differences Between Stroke and Peripheral Neuropathy
When nerves are damaged, the symptoms can be quite diverse. The symptoms of a stroke are also diverse. Neuropathy can cause symptoms that seem similar to the symptoms of a stroke. So it is natural to confuse the two conditions because many of the symptoms of peripheral neuropathy and stroke overlap.
The main differences between stroke and peripheral neuropathy are:
Timing: A stroke is much more dangerous than neuropathy and usually occurs suddenly. Neuropathy on the other hand, while a serious medical condition, is generally not a dangerous emergency and develops over a longer period of time than a stroke does.
Associated Symptoms: Another important difference between neuropathy and stroke is that neuropathy does not directly cause some of the symptoms that are commonly associated with strokes, such as headaches, dizziness or vision changes.
Cause: Neuropathy is caused by nerve disease, which occurs outside the brain, while a stroke is caused by inadequate blood flow in the brain itself.
Long-Term Effects of Peripheral Neuropathy
The biggest problems with peripheral neuropathy are the long-term problems. People with peripheral neuropathy cannot adequately feel pain in the feet or hands, so when the hands, fingers, feet or toes become injured or cut, a person who has neuropathy might not even realize it. Bleeding, scabs, and even infections can result when injuries go unnoticed.
Long-term problems of stroke are quite different and can include muscle atrophy and muscle stiffness.
Causes of Peripheral Neuropathy
There are many causes of peripheral neuropathy, such as diabetes, medications, chemotherapy, kidney failure, chronic alcohol use, vitamin b12 deficiency, and some infections.
One of the most severe types of neuropathy is Guillan Barre Syndrome, also called acute demyelinating polyneuropathy. This dangerous disease is characterized by a quickly progressive tingling and weakness, usually beginning in the feet, with rapidly ascending weakness of the legs and eventually, weakness of the muscles that control breathing, causing severe, life-threatening respiratory problems.
Treatment of Peripheral Neuropathy
Neuropathy is very difficult to treat. The most effective treatment is to control the cause – whether it is alcohol, diabetes or medication. In some cases, if neuropathy is diagnosed early, medically managing the cause can reverse some or most of the symptoms. Medication for the pain and discomfort caused by peripheral neuropathy is helpful for most patients.
Signs and Symptoms of Stroke
Recognize the Signs of Stroke.
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By Rod Brouhard, EMT-P
Updated October 27, 2016
Stroke is the third leading cause of death in the United States. A wide range of people suffer from strokes annually for a couple of different reasons. With so many individuals affected by stroke, it is important to be able to recognize potential stroke symptoms as they are happening in order to get the proper help to the victim before the damage becomes permanent. If not treated in a timely manner, stroke can cause permanent brain damage. Timely recognition of the signs of a stroke could truly be the difference between life and death for the victim.
Signs and Symptoms of a Stroke
The National Institute of Neurological Disorders and Stroke (NINDS) identifies several different signs and symptoms of stroke. Keep in mind, signs and symptoms of a medical issue are not the same thing. Signs can be outwardly observed by others, while symptoms are only noticed and felt by the individual actually experiencing the medical problem. Thus, a victim may be able to express symptoms that they are experiencing to you, but you may not be able to notice them for yourself. A sudden loss of balance, on the other hand, would be a sign visible to others.
If a victim suffers from any of the following signs or symptoms of stroke, you should call 911 immediately:
Sudden numbness or weakness of face, arm, or leg, especially on one side of the body.
Sudden confusion or trouble speaking or understanding speech.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, or loss of balance or coordination
Sudden severe headache with no known cause.
Causes of Stroke Symptoms
Stroke occurs when a section of the brain is suddenly starved of oxygen. Oxygen is crucial to brain function, and any loss of oxygen can cause serious damage. Strokes can happen in two very different ways.
Ischemic stroke is a blockage of a blood vessel in the brain that results in death to the brain tissue. Usually, the blockage comes from a blood clot.
Hemorrhagic stroke occurs when a blood vessel in the brain bursts and causes bleeding in or around the brain.
Treatment of Stroke
A stroke is a true emergency, and therefore it qualifies as a good reason to call 911. Treatment for both types of stroke require early recognition and access to emergency medical care. Using medication to dissolve clots in ischemic stroke should happen within three hours of onset. When suspecting stroke signs or symptoms, be sure to take quick action.
Call 911 immediately. Be a good 911 caller and listen carefully to the call taker. Listening carefully to the 911 operator and following directions exactly can held to expedite the overall process and get help to the victim quicker.
Follow the ABC’s of First Aid. Pay close attention to the victim’s airway; stroke victims often have difficulty controlling their own airways. Make sure that the victim is breathing before undertaking any other steps.
Raise the victim’s head. Raising the head helps decrease the pressure on the brain inside of the skull.
A stroke is brain damage that results from diminished blood supply to the brain. Generally, a stroke occurs when one of the blood vessels that delivers blood to the brain becomes blocked or leaks.
A stroke causes symptoms that correspond to the area in the brain that suffers from diminished blood supply. A stroke can cause any of the following symptoms:
Weakness of one side of the body
Numbness, tingling or unusual sensations
Vision loss or decrease in vision
Blurred vision or double vision
Trouble understanding words
How the Brain Determines Stroke Symptoms
The brain is an important body organ that has many interacting regions that work to control a variety of functions- from thinking, to vision, to movement, to coordination, to sensation, to vital functions such as breathing and sustaining life. These regions work together in a coordinated, sophisticated fashion.
Proper brain function requires blood supply for the delivery of nutrients and oxygen. Blood is delivered to the brain through a group of blood vessels that travel to and through the brain. The blood vessels include the carotid arteries, the cerebral arteries, and the vertebral arteries. Each blood vessel divides into smaller blood vessels that deliver blood to a specific region in the brain. Any decrease in blood supply to a portion of the brain results in impairment of the brain functions that are normally controlledby that area of the brain. A stroke can occur if a large or small blood vessel is blocked or bleeding, preventing proper delivery of nutrients and oxygen to the destination in the brain.
Depending on the blood vessel affected by a stroke and the part of the brain that is impaired, the initial symptoms and long-term effects may differ.
How a Stroke Happens
The blood that travels to the brain through arteries carries oxygen and nutrients that allow the brain to function and survive. When blood supply to an area of the brain is diminished, even temporarily, the brain tissue may suffers from ischemia- a lack of the oxygen and nutrients it needs to function. If ischemia lasts longer than a few minutes, the affected brain tissue may become severely damaged and cease to function- which is a stroke.
TIA and Silent Stroke
The effects of diminished blood supply may last for only a short time if the ischemia is brief and quickly restored. A brief period of ischemia may result in a transient ischemic attack (TIA).
When ischemia occurs in a small region of the brain that controls functions that are also controlled elsewhere in the brain, a silent stroke, or an unnoticeable stroke, may result.
Causes Of a Stroke
The blood supply to the brain can be interrupted due to blockage, bleeding or low blood flow.
Infarct: Blockage can be caused by blood clot that develops within the blood vessel (infarct) or a blood clot that arrived from another location and lodged in the blood vessel (thrombus.)
Hemorrhage: A bleeding blood vessel in the brain can result from a rupture of a defective blood vessel or from extreme blood pressure instability. In rare instances, a severe infection or an air bubble can block a blood vessel, causing a stroke. When a blood vessel breaks and bleeds, the brain is harmed by ischemia due to interruption of blood flow. However, when bleeding or hemorrhage occurs, irritation from the blood near the brain tissue also causes pain and neurological symptoms, in addition to the stroke symptoms caused by ischemia.
What To Do In Case Of a Stroke
Recognition of stroke symptoms is important. Diagnosis may require medical specialists. Prompt diagnosis is necessary because treatment for stroke requires careful, high level, decision making. The most effective treatments for stroke are most successful when administered promptly.
Treatment of stroke consists of methods that allow reestablishment of blood supply to the ischemic brain tissue and stabilization of health and vital functions to allow for optimal recovery. Reestablishment of blood supply is tricky- in some instances, in can result in bleeding. In the initial stage of a stroke, the ischemic tissue is prone to bleeding, so extreme care must be taken with re-establishment of blood flow.
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