Spasticity affects more than 12 million people worldwide.
Spasticity is a common neurological condition, in which certain muscles are steadily contracted. As a result of this continuous contraction, muscles become rigid, and this interferes with movement, speech, and gait. It is believed that spasticity is a results from damage to the region of the brain that is responsible for controlling voluntary movements. More than 12 million people worldwide are affected by this condition. In fact, about 80% of people with Cerebral Palsy have spasticity. Similarly, studies also show that about 80% of people with Multiple Sclerosis have varying degrees of spasticity.
Some common conditions that may lead to spasticity include:
- Traumatic Brain Injury (TBI)
- Spinal Cord Injury (SCI)
- Brain Damage (from lack of oxygen)
- Lou Gehrig’s Disease
There are several treatment options available for this condition, including BTA Injections (Botulinum Toxin). This treatment option works by blocking the release of acetylcholine, thereby relaxing overactive muscles. Dr. Supriya Thiruyarayanan has advanced the use of Botox for Chronic Migraines at TIND’s Headache Clinic in Plano. This is one type of procedure she performs to help treat spastic muscles.
Source: “Spasticity .” American Association of Neurological Surgeons , www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity.
Yoga is not only a great form of exercise, but it also provides several health benefits for the brain. A yoga routine involves a series of poses and breathing exercises that help strengthen the muscles and improve the cardiovascular system. There are certain poses that have been shown to have a relaxing effect on the mind. In particular, Child’s Pose has been shown to have a calming effect on the adrenal glands, and can help reduce the feelings of stress. Yoga can help reduce stress and improve brain power. In a study conducted by the University of Illinois, even a short twenty minute yoga session was shown to have incredible capabilities of improving brain power. The participants in this study performed better on cognitive tests when they had previously performed yoga exercises. One reason yoga is believed to be so beneficial for the brain is because it also brings union between the body and mind. According to a study by University of Waterloo, mindful meditation can help improve the brain’s conscious processing and energy levels. This can result in improvements on certain tasks that require sustained focus. For a healthy brain, exercise and a healthy diet are essential. Yoga is a great form of physical and spiritual activity for the brain, and has been proven to provide increased brain power, reduced stress, and better memory. At Texas Institute for Neurological Disorders, we recognize the holistic health benefits yoga has on the health of the brain. Each month, we have partnered with the Isha Foundation to offer a meditative beginner level yoga class. Our next class is March 17th at our Sherman Clinic from 10am-11:30am. Please visit our Events page for more information or to RSVP for the next class.
An EMG stands for Electromyogram, and this test is used to calculate the electrical activity of muscles. This testing is important to determine how quickly nerves are transmitting signals, as problems with nerve transmission can potentially lead to pain and numbness. An Electromyogram Test is often used to help diagnose certain neurology related diseases.
•Muscle pain or cramping
•Certain types of limb pain
EMGs can also be used to detect abnormal electrical activity of muscles that can occur in many diseases and conditions: including muscular dystrophy, inflammation of muscles, pinched nerves , peripheral nerve damage (damage to nerves in the arms and legs), amyotrophic lateral sclerosis (ALS), myasthenia gravis, disc herniation, and others. When the test is conducted, a neurologist or tech, will place electrodes on areas related to where the patient has been experiencing pain. An electrical current is transmitted from the electrodes, which may result in a spasm/twinge sensation. Following the exam, the neurologist will explain the results of the Electromyogram Test to the patient, and will be able to use those results to help determine the cause of symptoms.
At Texas Institute for Neurological Disorders, our neurologists are trained to properly diagnose and assess results from an EMG test. In addition, they can determine if an EMG test is needed based on symptoms experienced by patients. For more information about the diseases our neurologists treat, visit our Services & Speciality webpage.
Sleep is essential for proper brain functioning and overall health. It is commonly thought that sleep is necessary for the brain to organize and store memories. When sleep is disrupted in any way, there can be some serious consequences, and ultimately our mind and overall health is severely affected. On average, about 30 to 40 million Americans have difficulty sleeping! Sleep disorders can have a detrimental affects on health, and can lead to some serious consequences if left untreated.
Many people report feeling irritable and moody when they do not receive enough sleep. This can make it more challenging for those with sleep deprivation to pay attention, which can significantly affect the ability to retain information. In fact, a recent study reported that sleep deprivation can slow down a person’t judgement as much as being intoxicated. This is because inadequate sleep disrupts the communication between neurons, and as a result, those lacking sleep often experience mental lapses. Another study, which looked at the more long term results of sleep deprivation, reported similar findings. This study observed the behavior of more than 30,000 people over a period of 18 months, and reported that even one night of insufficient sleep is associated with 1.2 percent slower performance. Overall, the study suggested that the insufficient sleep can decrease performance and productivity. The reason sleep deprivation results in difficulties with memory and paying attention is because the neurons are seriously affected when the body does not receive enough sleep. A recent study conducted on patients with epilepsy reported that cell activity, specifically in the temporal lobe region of the brain, was significantly affected by sleep deprivation. The more tired the patients became, the slower the neurons fired. This study suggested that certain regions of the brain are more affected by lack of sleep, and neurons respond slower in those experiencing sleep deprivation.
As these studies suggest, sleep deprivation can have serious consequences in both the short and long term. This means it is important for those that have difficulty sleeping to seek medical evaluation and treatment. An occasional night of poor sleep is not something to worry about, but if the issue becomes chronic and you start experiencing several nights of disrupted sleep, it may be worth seeing a sleep specialist. A sleep specialist can help determine what is causing sleep deprivation and will be able to recommend helpful treatment options. At Texas Institute for Neurological Disorders, Dr. Indu Mayakrishnan, M.D., is certified in Sleep Medicine and can provide a medical evaluation and treatment for those experiencing sleep deprivation and sleep disorders. Adequate sleep is essential for the brain and overall health of the body, and if you are concerned about a sleep disorder or are having difficulties with sleeping, the right treatment can help! Call our scheduling office at 844-754-8463 to schedule an appointment with our sleep specialist.
With Halloween coming up, it may be tempting to give into those sugar cravings, but research shows that eating too much sugar can be more harmful than we think. Excessive sugar consumption can lead to memory deficiencies, sugar addiction, and overall health deficiencies.
The American Heart Association recommends no more than 25 grams of added sugar per day for women and 38 grams for men. However, most Americans consume much more than the recommended amount of sugar per day. Many Americans prefer the convenience of processed and packaged foods, which often are high in sugars. The best way to limit the consumption of foods high in sugars is by eating a natural diet consisting of real foods. The brain uses energy in the form of glucose to fuel cellular activities. However, a high sugar diet can lead to excess glucose in the brain and studies have linked excess glucose consumption to memory and cognitive deficiencies. Another reason sugar is harmful to the brain is because it effects certain neurotransmitters which can result in sugar addictions. Dopamine is a neurotransmitter in the brain and some of the processes it controls include: mood, behavior, learning, and memory. Drug addiction and Parkinson’s disease are some examples of conditions associated with disrupted dopamine levels. Sugar can also disrupt dopamine levels as the brain becomes used to high levels of sugar. In fact, both the gene expression and availability of dopamine receptors can be altered in certain areas of the brain from consuming too much sugar over a long period of time. The effect sugar has on dopamine and dopamine receptors makes it addictive and is why it is often so difficult to eliminate sugar from the diet. Not only is sugar harmful to the health of the brain, but it is also harmful to the overall health of the body. Too much sugar can lead to tooth decay and cavities, leading to oral health problems. In addition, excessive sugar can lead to weight gain and increases the risk of developing Type 2 Diabetes. Insulin is a hormone that helps to metabolize sugar in the body, but if there is too much sugar in the body then insulin resistance can occur. Eventually, insulin resistance may lead to Type 2 Diabetes.
Excessive sugar consumption is harmful to brain health, and can lead to memory deficiencies, sugar addiction, and decline in overall health. To keep your brain healthy, consume sugar in moderation and within the recommended guidelines. If you are concerned about too much sugar affecting your health, talk with your doctor or a medical professional. If you are a neurology patient and are looking for a neurologist that incorporates a holistic approach to medicine, then visit Dr. James Francesconi’s webpage to find out more about how he uses a holistic approach to treating neurological disorders.
A Pediatric Neurologist has specialized training to treat disorders of the central and peripheral nervous system in children under the age of eighteen. Here are some examples of neurological disorders treated by a Pediatric Neurologist:
-Behavioral Disorders, such as ADHD
ADHD stands for Attention Deficit Hyperactivity Disorder, and can affect the ability of children to do well in school and with other tasks. In order to determine, if your child has ADHD, a medical examination and diagnosis is required. Some common symptoms of ADHD include: difficulty focusing, struggling to properly understand others, temper tantrums, fidgetiness, daydreaming, mistakes, and problems staying organized. If your child is experiencing some of these symptoms, it may be a good idea to have them evaluated by a pediatric neurologist to find out if ADHD is a cause of the symptoms. Headaches are common in both children and adults. Sometimes kids may experience headaches due to certain medications, skipping meals, or dehydration. A pediatric neurologist can help determine why your child is experiencing headaches, and can help relieve the pain that comes from experiencing headaches. Cerebral Palsy is a physical disability that affects movement. This disease can occur if there is damage to the brain during or after pregnancy. Each case of Cerebral Palsy is different and symptoms can vary from each individual. Although there currently is not a cure for Cerebral Palsy, there are ways to treat and manage this neurological disorder. Epilepsy is a disease of the nervous system which results in seizures. It is possible for seizures to occur in both adults and children, but diagnosing seizures in children requires a more specialized approach. There are approximately 3 million Americans with Epilepsy which makes it the most common brain disorder in children. EEGs (Electroencephalograms) can be used to determine the type of seizure and the likelihood of recurrence. Autism is an example of a developmental disorder in children. Autism is defined by having difficulty in communicating and forming relationships with other people. Typically, signs of autism occur in the early stages of childhood development.
Dr. Mohamad Al-Rifai is a Pediatric Neurology Specialist at Texas Institute for Neurological Disorders. He treats all aspects of Pediatric Neurology but has special interest in: childhood epilepsy, pediatric behavioral problems, developmental disorders, and childhood headaches. Dr. Al-Rifai sees patients in the following clinics: Richardson, McKinney, Sherman, Frisco, and Denison. Dr. Uma Saligram treats Pediatric Neurology patients 8 years and older for concussions, seizures, and headaches. Dr. Saligram sees patients at our Keller and Ft. Worth clinics. Our Pediatric Neurology Specialists can help make sure your child receives the neurology care they need.
In order to perform optimally, the brain requires an abundance of energy which it receives through essential nutrients. In fact, the brain uses 20% of the energy used by the entire human body. This means that not only does your brain require a lot of energy to function, but it also needs to receive the right kind of energy. Unfortunately, we live in a society in which we prefer quick and convenient food sources. However, these “fast foods” are not the best kinds of foods for your brain, and can actually have some negative consequences on brain health.
Although there have been some efforts to improve the health quality of fast food, there are still health risks involved when choosing these types of foods. Fast food is highly processed and lacks key nutrients, which means it is essentially empty calories. These empty calories don’t do much in terms of providing nutrients to the body and brain. In addition, fast foods high in sugar can lead to serious health complications, particularly diabetes, and more recently there have been implications that high sugar diets can lead to Alzheimer’s Disease.
If you want to keep your brain healthy, then make sure you include these nutrients in your diet (courtesy of Developing Human Brain):
- Magnesium: Magnesium is necessary for several chemical reactions in the body. Some examples of foods rich in magnesium are: nuts, pumpkin seeds, black beans, leafy greens, avocado, brown rice, and spinach.
- Vitamin B12: This vitamin is necessary for the construction of the myelin sheath on nerve cells. A deficiency in this vitamin could result in neuropathy and pain.
- Thiamine: Thiamine is important for its mood regulating functions. In addition, this vitamin helps to regulate the production of ATP so your body receives the energy it needs to perform necessary cellular functions. A headache may be a sign of a deficiency in thiamine.
- Omega 3 Fatty Acids: omega 3 fatty acids are very important for brain health. They are important for memory, behavioral functioning, and may help reduce inflammation. Today, our diets are higher in omega 6 fatty acids, which do not have the brain health benefits provided by omega 3 fatty acids. Therefore, it is especially important that you make an effort to include omega 3 foods in your diet. Some examples of foods that are high in omega 3 fatty acids are: olive oil, salmon, walnuts, flax seed, and eggs.
By providing your brain with the proper nutrients, not only do you improve the health of your brain but also the health of your entire body.
(Part 1 Classification, Causes and Triggers)
Headaches are one of the most common medical complaints; most people experience them at some point in their life. They can affect anyone regardless of age, race, and gender. The World Health Organization (WHO) reports that almost half of all adults worldwide will experience a headache in any given year.
Classification of headaches:
Headaches can be divided into Primary or Secondary headaches
Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive.
This includes the blood vessels, muscles, and nerves of the head and neck. They may also result from changes in chemical activity in the brain.
Common primary headaches include migraines, cluster headaches, and tension headaches.
Secondary headaches are symptoms that happen when another condition stimulates the pain-sensitive nerves of the head. In other words, the headache symptoms can be attributed to another cause.
A wide range of different factors can cause secondary headaches. These include:
- Eating something very cold can lead to a “brain freeze.”
- alcohol-induced hangover
- brain tumor
- blood clots
- bleeding in or around the brain
- carbon monoxide poisoning
- sinus headaches
- teeth-grinding at night
- overuse of pain medication, known as rebound headaches
- panic attacks
Causes of Primary headaches
There are several but 3 main causes of Primary Headaches
- Tension headaches
Tension headaches are the most common form of primary headache. Such headaches normally begin slowly and gradually in the middle of the day. The person can feel:
- as if they have a tight band around the head
- a constant, dull ache on both sides
- pain spread to or from the neck
Tension-type headaches can be either episodic or chronic. Episodic attacks are usually a few hours in duration, but can last for several days. Chronic headaches occur for 15 or more days a month for a period of at least 3 months.
A migraine headache is very many times genetic in nature and may cause a pulsating, throbbing pain usually only on one side of the head. The aching may be accompanied by:
- blurred vision and spots or sparklers in front of the eyes
- nausea and/or vomiting
- light and noise sensitivity
- sensitivity to certain smells.
- sensory disturbances known as auras
- sometimes weakness, numbness, speech and vision problems mimicking strokes
Migraine is the second most common form of primary headache and can have a significant impact on the life of an individual. According to the WHO, migraine is the sixth highest cause of days lost due to disability worldwide. A migraine can last from a few hours to between 2 and 3 days. Sometimes they can last days when they are called status migrainosis.
- Cluster headaches
Cluster headaches usually last between 15 minutes and 3 hours, and they occur suddenly once per day up to eight times per day for a period of weeks to months. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years. The pain caused by cluster headaches is:
- very severe
- often described as sharp or burning
- typically located in or around one eye
The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny. Usually people have tearing on the affected side.
There are multiple other primary headaches and include:
- exercise induced headaches
- orgasmic or sex headaches
- cough induced headaches
Most common foods that trigger migraines
- Chocolate, 75 percent
- Cheese, particularly aged cheese, 48 percent
- Citrus fruits, 30 percent
- Alcohol, particularly red wine and beer, 25 percent
An additional list of foods that trigger migraines
- Ham, hot dogs, other cured or lunch meats (prepared with nitrates)
- Monosodium glutamate, MSG, commonly found in Chinese foods, soy sauce and packaged foods
- Aspartame and other artificial sweeteners
- Asian foods
- Canned foods
- Snack foods
- Fatty foods
- Ice cream and other frozen foods
- Food dyes
- Coffee, tea, cola (other items containing caffeine and caffeine withdrawal)
- Dairy products, yogurt
Alcohol and migraines
Roughly a third of migraine sufferers say that alcoholic beverages can trigger their migraine attacks. A tenth of migraine sufferers say alcohol is a frequent or consistent trigger.
Migraines and stress
Emotions & Stress
Anxiety, stress, excitement, worry, anger and other emotions can spark a cascade of symptoms in most people. In those who suffer from migraines, these emotions can trigger a migraine attack.
Migraines and stress
Some sufferers consider stress the most common cause of migraines. Several studies place stresses near the top of the list as the trigger most often named by migraine sufferers. Many studies show that 60 percent to 70 percent of those with migraines cite stress as a regular trigger.
Stress can come in many forms: pressure at work to complete a project, excitement about an upcoming wedding, a traffic jam making you late for an appointment or a family conflict. During stressful moments, the brain releases chemicals, including adrenaline, as the body goes into self-preservation mode. When the brain senses stress it prepares for “fight or flight.” These chemicals cause a range of changes in the brain and body, including muscle tension and dilation of blood vessels. These chemicals are activated in the brain when you have a migraine. For a person who suffers from migraines, these reactions to stress can trigger a painful migraine.
Stress can come in many forms, both negative and positive. Events that are taxing and worrisome, surprisingly have similar effects on some migraine sufferers as events that are happily stressful such as a big job promotion or anticipation of an exciting date. Stress can also make an existing migraine worse.
For some people who battle migraines, the attack doesn’t start during the stressful or emotional event. Instead, the migraine symptoms may start after the stressful event has passed, during what is called the “let-down period.” This occurs after a period of high stress or pressure ends and the individual relaxes. These migraines happen often on the weekend or at the beginning of vacations when everything has calmed down.
Environmental migraine triggers
Different factors in the environment – some which the migraine sufferer is unable to control – may lead to a migraine attack. As with many issues related to migraines, it is unclear how these changes in the surroundings lead to migraines. Some researchers believe that people with environmentally-induced migraines are more sensitive to influences in the atmosphere. Changes in the environment have also been blamed on allergies, pain and fatigue.
How do weather changes cause migraines?
For ages, people have reported being able to “feel” an oncoming thunderstorm. This, researchers believe, is a result of a buildup of positive ions in the air which may raise the body’s serotonin. Serotonin is known to be linked to migraines. There are also people who experience seasonal migraines, which means they have far more migraines during certain times of the year.
Types of environmental triggers
- Weather changes including: temperature changes, extreme heat or extremely cold weather, humidity, barometric pressure changes and storms
- Odors, pollution and smells including: smog, cigarette smoke, perfumes and chemical odors
- Lights, such as: bright lights or glaring lights, fluorescent lights, flashing lights or screens
- High altitude
- Flying, jet lag, travel or motion
- Dusty conditions
- Dry conditions
- Patterns, including: stripes, checkers or zigzag lines
Exercise – Physical Activity
One of criteria for diagnosing migraines is that the pain and discomfort worsens with physical activity. For people with tension headaches, the head pain is not aggravated by routine physical activity. Also, physical activity triggers migraines. Sometimes it is everyday activities that launch an attack, other times heavy activity is to blame. Terms such as “weight-lifter’s headache” or “sports-related migraine” are used to describe it because the pain and symptoms arise after physical exertion or effort. Many people who suffer from persistent migraines avoid certain physical activities hoping to prevent migraine attacks.
Types of physical activity that triggers migraine attacks
- Walking up and down stairs is a common complaint. Many migraine sufferers say this trigger aggravates their migraines.
- Head movement commonly makes migraines worse. In some people, abrupt head movements can trigger an attack.
- Bending over or rising can also worsen head pain. Some people describe throbbing pain, or explosions of pain.
- Exerting a lot of energy may also trigger migraines in certain sufferers. Lifting heavy objects or working out vigorously
- Changes in sleep schedules can also trigger migraines. This can be a problem if you get too little or even too much sleep. The best way to manage this is to stick to a regular sleep schedule, so your body is properly rested but not too much so. This means maintaining the same sleep routine on the weekends and on vacation. Jobs that require irregular shift work should probably be avoided to prevent migraine attacks. Even so, for some who suffer from migraines, sleep is the only way to stop the symptoms.
- Coughing and sneezing are thought to increase pressure inside the head, which can lead to migraines. This increase in pressure is called the Valsalva’s maneuver, which is sometimes done deliberately by closing the mouth, pinching the nose and exhaling. It is done to equalize pressure in the ear, for example, if pressure builds while flying. However, there is the risk of applying too much pressure to the middle ear and causing damage.
There are several possible reasons for why physical activity can lead to a migraine. For heavy activity, the reasons might be:
- Extreme exercise
- Altitude, which might prompt migraines because of low oxygen
- Low blood sugar
Hormones, the powerful chemicals that send signals throughout the body, play a large role in women with migraines. Hormones serve as migraine triggers in numerous stages of hormonal activity throughout a woman’s menstrual cycle and throughout her life.
Women experience hormonal changes when they:
- first begin menstruating
- begin their monthly menstrual cycle
- end their monthly menstrual cycle
- take oral or other hormonal contraceptives
- are pregnant
- first enter menopause
- take any form of hormone therapy
- are further along in menopause
Since migraines and hormones are related and because women have several fluctuations in hormones, it’s no wonder that some 70 percent of migraine sufferers are women. Migraines can be triggered by or made worse by the hormonal changes a woman experiences. Studies show that women complain of more severe head pain, migraines that last longer and cause more disability than men with migraines.
What causes migraines in women
Changes in the hormone estrogen are thought to trigger reactions in the brain the lead to migraines in women. The amount of estrogen circulating in a woman’s drops right before the start of the monthly menstrual cycle. Some women have migraines that are closely tied to their period. These are called menstrual migraines. They usually occur right before or in the very first days of the menstrual cycle and improve after menopause. In one study, 62 percent of women reported that their migraine symptoms improved after they stopped having their monthly menstrual cycle. However, in 18 percent in that study said the migraines got worse.
Pregnant women and migraines
Pregnancy offers a reprieve for most women who suffer from migraines. Because estrogen levels gradually rise during pregnancy, many women say their migraine symptoms improve. However, after the pregnancy ends, when the hormone levels drop suddenly, the migraine symptoms can return immediately.
How to prevent hormonal migraines
Keeping a migraine journal will help you discover when during your cycle the migraines occur. For some women, taking an over-the-counter or prescription pain reliever a few days before the start of their menstrual cycle helps prevent the migraine attack. Consulting a migraine expert will help determine what’s best for your migraines.
Sex stirs up lots of emotions, chemicals and other reactions within the body. Therefore, it’s understandable how sexual activity can be a migraine trigger. It is sometimes called “coital headache.” Sex-related migraines are usually unpredictable and don’t occur with each sexual experience. This type of migraines occurs most often in people ages 20 to 60, and most commonly first occurring around age 40.
Migraine sufferers and sexual intercourse
The head pain and other migraine symptoms can sometimes arise with sexual activity and with masturbation. Men get migraines after sex. Sexual activity triggers migraines in men four times as often as it does in women. because of the alterations in blood pressure.
Migraines and other types of head pain may occur:
- During the escalation of activity lead up to sexual intercourse
- During sexual intercourse itself, pre-orgasmic
- After climax, which is called orgasmic
- In the base, occipital region of the head
- Gradually and increase along with sexual excitement
- With throbbing pain
For head pain to be blamed on sex, the International Headache Society says the pain must:
- Be brought on by sexual arousal
- Have pain on both sides
- Be prevented or lessened by stopping sexual activity before orgasm
- Not be caused by any other disorder
Possible reasons for sexually – induced migraines
The reason behind the head pain may be related to contracting muscles during sex. The attacks may be avoided by working on relaxing neck and jaw muscles during sexual activity. The explosive pain has been blamed on the rapid increase in blood pressure and heart rate during sexual climax.
If the head pain is the worse ever experienced or resembles a “thunderclap” of pain, seek immediate medical attention. The pain may be a symptom of an un-ruptured aneurysm.
Why is treatment of migraines so important?
Migraines are a common headache disorder. More than 37 million people in the United States suffer from migraines. Two to three million migraine sufferers are chronic. More than 11 million people blame migraines for causing moderate to severe disability. More than 90% of people who suffer migraines miss work or cannot function normally during a migraine attack.
Ways to treat an acute migraine attack
For patients with milder and infrequent migraines, sometimes an over the counter NSAID, such as naproxen, is sufficient to treat the migraine. NSAIDs can increase the risk of gastrointestinal hemorrhage, so they must be used as infrequently as possible. Naproxen is a better option than Ibuprofen, because naproxen is effective for a longer time compared to ibuprofen. (more…)