Brain & Nervous System

Brain & Nervous System

MULTIPLE SCLEROSIS: Multiple sclerosis (MS) is a chronic neurological disorder, an autoimmune disease. It can be defined as damage to the insulating covers of nerve cells in the brain and spinal cord (Myelin).  Myelin is composed of protein and fatty acids that make up a protective coating for nerve fibers (axons).  In addition to causing damage to the myelin sheath, MS also damages the nerve cell bodies, as well as the axons themselves. As the disease progresses, the outermost layer of the brain, called the cerebral cortex, shrinks. MS affects people differently. A small number of people with MS will have mild symptoms with little disability, whereas others will experience worsening symptoms that will lead to increased disability over time. Most people with MS have short periods of symptoms that resolve fully or partially after they appear. These periods are followed by long stretches without noticeable symptoms. Most people with MS have a normal life expectancy.  This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs & symptoms, including physical, mental, and sometimes psychiatric problems. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). Between attacks, symptoms may go away completely; however, permanent neurological problems often occur, especially as the disease advances.  MS affects the brain and spinal cord. Early MS symptoms include weakness, tingling, numbness, and blurred vision. Other signs are muscle stiffness, thinking problems, urinary problems, clumsiness or lack of coordination, loss of balance, and weakness in an arm or leg. Patients may have their first symptoms between the ages of 20 and 40 years. Usually, the symptoms get better, but then they come back. Some may come and go, while others linger. Further symptoms may differ from patient to patient. Patients may have just a single symptom for months and years before other symptoms take place. However, symptoms in other patients may become worse within weeks or months.  MS can be of either of the four types:  

  • Clinically isolated syndrome (CIS)
  • Relapsing-remitting MS (RRMS)
  • Secondary progressive MS (SPMS)
  • Primary progressive MS (PPMS)

The symptoms of MS depend on the severity of the attacks as well as the location and size of the plaques. Early MS symptoms often include – Vision problems, such as double vision or optic neuritis (inflammation of the optic nerve), which causes pain with eye movement and vision loss, Muscle weakness, often in the arms and legs, and muscle stiffness with painful muscle spasms, Tingling, numbness, or pain in the arms, legs, trunk, or face, Clumsiness, especially difficulty staying balanced when walking, Bladder control problems, Intermittent or constant dizziness. MS may be associated with  other symptoms also , such as – Mental or physical fatigue, Mood changes such as depression or difficulty with emotional expression or control, Cognitive changes, including problems concentrating, multitasking, thinking, or learning, or difficulties with memory or judgment, Muscle weakness, stiffness, and spasms may be severe enough to affect walking or standing. In some cases, MS leads to partial or complete paralysis. Many people with MS find that their symptoms are worse when they have a fever or are exposed to heat or following common infections.

Diagnostic Tests : Sclerosis is a medical term for the distinctive areas of scar-like tissue (also called plaques or lesions) that result from the attack on myelin by the immune system. These areas are visible on an MRI .  A special dye or contrast agent may be injected into a vein to enhance the brain images. In addition, following tests may also be done : –

Lumbar puncture – This is done to obtain a sample of cerebrospinal fluid and examine it for proteins and inflammatory cells associated with the disease. This test can also indicate for diseases that may look like MS.

  • Evoked potential tests – This  is another test in which  electrodes are placed on the skin and painless electric signals are given to   measure how quickly and accurately the nervous system responds to stimulation.
  • Optic Coherence Tomography (OCT) may also be done to detect optic nerve lesions, ,

In most cases, doctors can diagnose MS by assessing symptoms and identifying characteristic MS signs on an MRI.  The patches of scar-like tissue can be as small as the head of a pin or as large as a golf ball.

Research indicates that people who spend more time in the sun, and those with relatively higher levels of vitamin D, are less likely to develop MS than those who do not. Additionally, people with MS who spend significant time in the sun and/or have higher vitamin D levels have a less severe course of disease and fewer relapses. Bright sunlight helps human skin produce vitamin D. Researchers believe that vitamin D may help regulate the immune system in ways that reduce the risk of MS and autoimmune disorders in general. Studies have also found that people who smoke are more likely to develop MS and have a more aggressive disease course. They also tend to have more brain lesions and brain shrinkage than non-smokers. 

STROKE : Stroke is the rapid loss of brain function due to disturbance in the blood supply to the brain. This can be due to lack of blood flow caused by blockage (thrombosis, arterial embolism) or a hemorrhage.   As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech or an inability to see one side of the visual field.

A stroke is a medical emergency and can cause permanent neurological damage and death.  High blood pressure is the most important modifiable risk factor of stroke. It is the second leading cause of death worldwide.  Other risk factors for stroke include old age, previous stroke, diabetes, high cholesterol, tobacco smoking and arterial fibrillation .

Treatment of stroke is  effective when given soon after a stroke begins. Symptoms of stroke include – Trouble speaking and understanding what others are saying. Numbness, weakness or paralysis in the face, arm or leg. This often affects just one side of the body. The person can try to raise both arms over the head. If one arm begins to fall, it may be a sign of a stroke. Also, one side of the mouth may droop when trying to smile. Problems seeing in one or both eyes  Or the person may see double.  Headache. A sudden, severe headache may be a symptom of a stroke. Vomiting, dizziness and a change in consciousness may occur with the headache. Trouble walking. Someone having a stroke may stumble or lose balance or coordination.

Risk factors include – Being overweight or obese, Physical inactivity. , Alcoholic drinking, Use of certain drugs such as cocaine and methamphetamine, High blood pressure, Smoking or second-hand smoke , High cholesterol, Diabetes, Obstructive sleep apnea, Cardiovascular disease, including heart failure, heart defects, heart infection or irregular heart rhythm, such as atrial fibrillation, Personal or family history of stroke, heart attack, COVID-19 infection, Age — People age 55 or older have a higher risk of stroke , Sex — Men have a higher risk of stroke than do women, Hormones — Taking birth control pills or hormone therapies that include estrogen can increase risk.

A stroke can sometimes cause temporary or permanent disabilities. Complications depend on how long the brain lacks blood flow and which part is affected. Complications may include –  paralysis  on one side of the body. Or  losing  control of certain muscles, such as those on one side of the face or one arm, Trouble talking or swallowing,  trouble with language, including speaking or understanding speech, reading or writing, Memory loss or trouble thinking,  reasoning, making judgments and understanding concepts, difficult control over emotions, depression, Pain,  tingling sensation in the effected  arm, leg or face, Changes in behaviour and self-care. 

PARALYSIS :  Paralysis can be termed as the loss of function of muscle in a part of the body. It happens when something goes wrong with the way messages pass between brain and muscles. Paralysis can be complete or partial. It can occur on one or both sides of our body. It can also occur in just one area, or it can be widespread. Paralysis of the lower half of our body, including both legs, is called paraplegia. Paralysis of the arms and legs is Quadriplegia. Paralysis on the same area of both sides of the body is  Diplegia. Paralysis of one side of the body (an arm and a leg of the same side) is  Hemiplegia. Paralysis of one limb ( arm or leg) is Monoplegia.  If the paralysis affects the muscles that cause breathing, it is quickly life threatening.

Loss of muscle function may be caused by:

  • A disease of the muscle itself (myopathy) that may include Alcohol- associated myopathy, congenital Drug- induced myopathy (statins, steroids), muscular dystrophy etc.
  • A disease of the nervous system: nerve damage (neuropathy), spinal cord or nerve injury, or brain damage (stroke or other brain injury including conditions like cerebral palsy), paralytic shellfish poisoning etc.
  • Autoimmune diseases , including multiple sclerosis(MS)
  • Bell’s palsy which affects muscles of the face.
  • Botulism
  • Polio

Bell’s Palsy is the most common cause of facial paralysis. It usually affects just one side of the face. Symptoms appear suddenly and are at their worst about 48 hours after they start. They can range from mild to severe and may include twitching, weakness, paralysis, drooping eyelid or corner of mouth, drooling, dry eye or mouth, Excessive tearing in the eye, impaired ability to taste.

The most common cause is a viral infection that causes inflammation of the facial nerve. Pregnant women, those are diabetic or sick with a cold or flu are more prone to get this infection.

Diagnostic Tests for Paralysis :

  • X-rays show broken bonesthat could cause nerve injury.
  • Imaging tests,such as a CT scan or MRI, check for signs of stroke or brain injury or spinal cord injury. A whole-body imaging scan shows bones, muscles and tissues.
  • Myelogramchecks for spinal cord and nerve injuries.
  • Electromyogram(EMG) tests the electrical activity of nerves and muscles.
  • Spinal tap(lumbar puncture) tests spinal fluid for infection, inflammation and disorders like multiple sclerosis (MS).

CEREBRAL PALSY : Cerebral palsy affect movement and posture. It is caused by damage that occurs to the developing brain, most often before birth. Symptoms appear during infancy  and vary from very mild to serious. Children with cerebral palsy may have exaggerated reflexes. The arms, legs and trunk may appear floppy or  may have stiff muscles, known as spasticity,  irregular posture, movements that can’t be controlled, a walk that is not steady, difficult swallowing,  eye muscle imbalance,  or some combination of these. The cause of cerebral palsy and its effect on function vary from person to person. Some people with cerebral palsy can walk while others need assistance. Some people have intellectual disabilities, but others do not. Epilepsy, blindness or deafness also might affect some people with cerebral palsy. Cerebral Palsy can be either of the following types :-

  • Spastic cerebral palsy – The most common type leading to stiff muscles and exaggerated reflexes.

  • Dyskinetic cerebral palsy – effecting  to control voluntary muscles.

  • Ataxic cerebral palsy – leading to trouble with balance and coordination.  

Cerebral palsy is caused by irregular brain development or damage to the developing brain. This usually happens before a child is born, but it can occur at birth or in early infancy also. Many factors  can lead to changes in brain development. Some include – Gene changes, Maternal infections – that affect an unborn baby, Stroke, -which interrupts blood supply to the developing brain, Bleeding into the brain in the womb or as a newborn, Infant infections –  that cause swelling in or around the brain, Traumatic head injury,  Lack of oxygen supply to  the brain due to any reason.

MENINGITIS : Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. There are several types of meningitis. The most common is viral meningitis, and is caused when a virus enters the body through the nose or mouth and travels to the brain. Some bacteria, fungi and parasites can also cause meningitis. Most infections can be transmitted from person to person. Injuries, cancers and drugs cause a small number of cases. Bacterial meningitis is the most common dangerous type of meningitis and can be fatal within 24 hours.  Meningitis can affect people of any age.

There are four main causes of acute bacterial meningitis:

  • Neisseria meningitidis(meningococcus)
  • Streptococcus pneumoniae(pneumococcus)
  • Haemophilus influenzae
  • Streptococcus agalactiae (group B streptococcus)

These bacteria are responsible for more than half of the deaths from meningitis globally and they cause other severe diseases like sepsis and pneumonia. Other bacteria e.g., Mycobacterium tuberculosis, Salmonella, Listeria, Streptococcus and Staphylococcus, viruses such as enteroviruses and mumps, fungi, especially Cryptococcus, and parasites like Amoeba are also important causes of meningitis.

Anyone can get meningitis, but it is more common in people whose bodies have trouble fighting infections. Meningitis can progress rapidly. Symptoms include a sudden fever, a severe headache, a stiff neck etc.  Early treatment can help prevent serious problems, including death.

Diagnostic test for meningitis may include – Blood cultures – to see under a microscope whether bacteria are present, Imaging. Computerized tomography (CT) or MRI  of the head may show swelling or inflammation. X-rays or CT scans of the chest or sinuses may show an infection that may be associated with meningitis, Spinal tap. A definitive test that is done by collecting cerebrospinal fluid and testing it to see a low sugar level along with an increased white blood cell count and increased protein.  Analysis of the  fluid may also help identify which bacteria  caused the meningitis. If viral meningitis is suspected, a DNA-based test known as a polymerase chain reaction amplification , or a test to check for antibodies against certain viruses to determine the specific cause.

MIGRAINES : Migraines are recurring attacks of moderate to severe headache. The pain is throbbing or pulsing, and is often on one side of the head.  During migraines, people are very sensitive to light and sound. They may also become nauseated and vomit. Migraine is three times more common in women than in men. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision. Many things can trigger a migraine. These include Anxiety, Stress, Lack of properly nourished food or sleep, Exposure to light, Hormonal changes (in women).

This disease has been described in Some Acute Diseases.

Parkinson’s disease (PD) is a type of, movement disorder. It happens when nerve cells in the brain don’t produce enough of a brain chemical called dopamine. Sometimes it is genetic, but most cases may be due to exposure to chemicals in the environment.   Symptoms begin gradually, often on one side of the body. Later they affect both sides. The symptoms include trembling of hands, arms, legs, jaw and face, stiffness of the arms, legs and trunk, slowness of movement, Poor balance and coordination. As symptoms get worse, patient may have trouble in walking, talking, or doing simple tasks. They may have additional problems such as depression, sleep problems, or trouble in chewing, swallowing, or speaking.

There is no lab test for PD, so it can be difficult to diagnose. Doctors use a medical history and a neurological examination to diagnose it. PD usually begins around age 60, but it can start earlier. It is more common in men than in women.

This has been described in Diseases of the Old age.

Pituitary Disorders are related to pituitary gland, which is a pea-sized endocrine gland at the base of the brain. The pituitary is the “master control gland” that controls functions of other endocrine glands. It makes hormones that affect growth and the functions of other glands in the body.  With pituitary disorders, one may have too much or too little of one of the hormones. Injuries can cause pituitary disorders, but the most common cause is a pituitary tumor.

Pituitary Tumors grow slowly, do not spread and are usually not cancerous. The most common type of pituitary tumor produces hormones and disrupts the balance of hormones in the body. This can cause endocrine diseases such as Cushing’s syndrome and hyperthyroidism. Symptoms of pituitary tumors include Headaches, Vision problems, Nausea and vomiting.

This has been described in diseases of the endocrine system.

Sleep Disorder is a condition having  difficult to fall asleep or staying in asleep through the night.  Wake up feeling tired or feel very sleepy during the day, even after having enough sleep in the night etc may amount to sleep disorders.  The most common kinds of such disorders are

    • Insomnia –a hard time falling or staying asleep – having  trouble falling asleep, staying asleep, or getting good quality sleep. This happens even if you have the time and the right environment to sleep well. 
    • Sleep apnea– breathing interruptions during sleep – has been described in diseases of the respiratory system.
    • Restless legs syndrome–  a tingling or prickly sensation in the legs leading to a very strong urge to move the legs. It typically happens in the evening or at night when sitting, lying down or sleeping. Moving eases the discomfort for a short time. It  disrupt sleep and may cause leg pain for several hours. It interferes with daily activities. RLS also is known as Willis-Ekbom disease.
    • Narcolepsy– daytime “sleep attacks” – It is s a chronic neurological disorder that affects the brain’s ability to control sleep-wake cycles. People with narcolepsy may feel rested after waking, but then feel very sleepy throughout much of the day.
    • Parasomnias– Nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding their teeth are kinds of sleep problems called parasomnias.

SPINAL CORD DISEASES : Spinal Cord Diseases are related to the damage and deterioration to spinal cord, which is a tube like structure consist of a bundle of nerves that runs  from the base of the brain down the back.   It carries signals back and forth between body and the brain. It remains well protected by vertebrae that make the spine.  The spinal cord is divided into four areas –  Cervical (neck),  Lumbar (upper back region), Thoracic (lower back region), and Sacral (pelvis).  Spinal nerves connect to specific areas of the body through spaces in the vertebrae. Spinal nerves have two nerve roots:

    • Motor Root: Carries signals from the spinal cord to the muscles that stimulate movement.
    • Sensory Root: Carries sensory information that relays sensations such as touch, pain, hot and cold etc from the body to the spinal cord.
    • Symptoms of spinal cord disorders can vary but may include pain, numbness, loss of sensation, Weakness or paralysis of limbs, Changes in reflexes, Loss of urinary or bowel control, Uncontrolled muscle spasms and muscle weakness. These symptoms can occur around the spinal cord, and also in other areas such as arms and legs. Disorders and conditions are conditions that cause damage and deterioration to the spinal cord. These conditions may include – Tumours , Spinal stenosis, Herniated discs, Abscess, Hematoma, Vertebral fractures, and Degenerative disc disease.

Causes of Spinal Cord Disorder : Spinal cord disorders can originate from either outside or inside the spinal cord. Damage from the outside of the cord is caused by compression of the spinal cord or injury. The spinal cord may be compressed due to a bone fracture, spinal degeneration, or abnormalities, such as a hematoma, tumour or herniated disk.  Damage from inside the spinal cord can be caused by a number of disorders, such as – Fluid-filled cavities. Blockage of blood supply, Vitamin deficiency  Autoimmune diseases, Multiple sclerosis, Syphilis¸

Diagnostic tests of Spinal Cord Disorder may include – ¸X-rays to check for fractures or tumours¸ Spine MRI or  CT scan –  to know areas of pressure on the spinal canal, Myelography –  to determine location and presence of abnormalities of the spinal cord, Electromyogram to determine the exact nerve root that is involved.  However, to treat such problems with our therapies to know exact nerve root is not necessary.

Spinal cord problems may be due to accidental injury to the vertebrae or other parts of the spine, tumors, infections such as meningitis, and polio, inflammatory diseases, autoimmune diseases, degenerative diseases such as amyotrophic lateral sclerosis and spinal muscular atrophy.

TREMORS : Tremors can be described as trembling or shaking movements in one or more parts of the body. Most tremors occur in the hands. It may also occur in arm, head, face, vocal cord, trunk, and leg. The cause of tremors is a problem in the parts of the brain that control muscles in the body or in specific parts of the body, such as the hands.  The tremor may be constant, or only happen sometimes. Tremor can occur on its own or as a result of another disorder.  Common symptoms may include – Rhythmic shaking of the hands, arms, head, legs, or trunk, Shaky voice, Difficulty with writing, Problems holding and controlling utensils, tools, or other items.

Some tremor can be triggered by stress or strong emotion, being physically tired, or being in certain postures or making specific movements.

Types of Tremor : tremor can be either Rest tremor type that take place when people are at rest (People with Parkinson’s disease often experience rest tremor). Or,  Action tremor type that take place  when a muscle is moved voluntarily. There are several sub-classifications of action tremor, many of which overlap.

    • Postural tremoroccurs when holding a position against gravity, such as holding the arms outstretched.
    • Kinetic tremoris associated with any voluntary movement, such as moving the wrists up and down or closing and opening eyes.
    • Intention tremorstarts when the person makes an intended movement toward a target, such as lifting a finger to touch their nose. 
    • Task-specific tremoronly appears when performing goal-oriented tasks such as handwriting or speaking.
    • Isometric tremoroccurs during a voluntary muscle contraction that is not accompanied by any movement, such as when holding a heavy book in the same position.

Tremor is usually caused by a problem in the parts of the brain that control movements. Most types have no known genetic cause, although there are some forms that appear to be inherited and run in families. 

Tremor can occur on its own or be a symptom of other neurological disorders such as Parkinson’s disease, multiple sclerosis, or stroke. Tremor sometimes can be caused by other medical conditions, including but not limited to:

    • Several drugs can cause tremors, including certain asthma medications, corticosteroids, chemotherapy, and drugs used for certain psychiatric and neurological disorders.
    • Heavy metals and other neurotoxins. Exposure to heavy metals (such as mercury, manganese, lead, arsenic, etc.),
    • Exposure to certain chemicals such as  pesticides.
    • Excessive caffeine may cause temporary tremor or make an existing tremor worse.
    • Thyroid disorder – overactive thyroid..
    • Liver or kidney failure – Liver and kidney failure may cause damage in certain brain areas resulting in tremors or jerky movements.
    • High or low blood sugar .
    • Traumatic brain injury
    • Alcohol abuse and withdrawal
    • Stress, anxiety, or fatigue may be associated with tremors.

MUSCULAR DYSTROPHY: Muscular Dystrophy (MD)is of various types.  These are a group of genetic diseases characterized by progressive weakness and degeneration of the skeletal or voluntary muscles which control movement. The muscles of the heart and some other involuntary muscles are also affected in some forms of muscular dystrophy, and a few forms involve other organs as well.

The symptoms of muscular dystrophy appear as a result of a deterioration of the body’s muscles. This deterioration is due to the death of the muscle cells and muscle tissues. This leads to ongoing muscle wasting and muscle weakness. Muscular dystrophy progresses slowly and gets worse over time eventually. This results in disability, difficult walking, need for leg and hand braces, and ultimately the use of a wheelchair.

The muscle weakness of muscular dystrophy generally begins in the legs. This makes it difficult for a child to walk normally, and he or she may walk with their feet wide apart. The child may use his or her hands and arms to get up from the floor and assist with standing. There may be frequent falls, a waddling gait, limited range of motion and pain in the calves. By 12 years of age, a child is often completely unable to walk and use of a wheel chair becomes a must.

Over a period of time, muscle weakness gets worse in severity and also progresses to include muscles in other parts of the body. These include muscles in the neck and arms. The muscle in the chest may also be affected. This can result in such complications as deformities in development of the bones of the chest and spine and scoliosis. This can lead to serious complications, including difficulty breathing and pneumonia. Some children may also have mental impairment, cardiac arrhythmias or cardiomyopathy.

The progression and severity of the symptoms of muscular dystrophy varies greatly between individuals and the type of muscular dystrophy. Some people may not develop symptoms until adulthood, and while many people experience severe disabilities and eventually die from the disease, others may have mild symptoms, no significant disability, and a normal life expectancy.

Types of Muscular Dystrophy :  Muscular Dystrophy can be of many types such as – Duchenne type –  the most common form in boys. Becker Type, Myotonic –  inability to relax muscles following contractions. Facioscapulohumeral (FSHD) – Muscle weakness typically begins in the face, hip and shoulders. The shoulder blades might stick out like wings when arms are raised. Congenital – affects both boys and girls and is apparent at birth or before  2 years of age. Limb-girdle – Hip and shoulder muscles are usually affected first leading to difficult lifting the front part of the foot and so might trip frequently. Onset usually begins in childhood or the teenage years.

Diagnostic test of Muscular Dystrophy may include – Enzyme tests –  Damaged muscles release enzymes, such as creatine kinase (CK), into  blood. Genetic testing – Blood samples can be examined for mutations in some of the genes. Muscle biopsy.  Analysis of the tissue sample can distinguish muscular dystrophy from other muscle diseases. Heart-monitoring tests (electrocardiography and echocardiogram) – These tests are used to check heart function. Lung-monitoring tests. Electromyography – An electrode needle is inserted into the muscle to measure electrical activity when relaxed  and when muscles are  gently tightened.  Changes in the pattern of electrical activity can confirm a muscle disease.

MYOPATHY : Myopathy refers to diseases that affect skeletal muscles (muscles that connect to  bones). These diseases attack muscle fibers,  making  muscles weak  resulting in  dysfunction or non-function of muscle fiber  . It could be due to one or more reasons having primary defect within the muscle, as opposed to the nerves or elsewhere e.g., the brain etc.  Muscle cramps, stiffness and spasm can also be associated with myopathy.

Types of Myopathy : Myopathies are separated into two categories: inherited and acquired.

Inherited myopathies: Inherited myopathies are an abnormal gene mutation from a parent. Conditions that are inherited myopathies include: 

    • Congenital myopathies – are somewhat unique compared with other inherited myopathies, as weakness typically affects all muscles (not just proximal [closest to the canter of the  body) and is often not progressive.
    • Mitochondrial myopathies –  is caused by a defect in the mitochondria, which are the energy-producing part of cells. Mitochondrial disorders typically affect other organ systems like  heart, brain and gastrointestinal tract. It can be caused by gene mutations with or without a family history.
    • Metabolic myopathies – This is caused by defects in genes that code for enzymes that are needed for normal muscle function and movement. They may have exercise intolerance, exertional muscle painsin shoulders and thighs, or non-traumatic rhabdomyolysis (muscle fiber condition). These can also happen with episodes of weakness that come and go with other times of normal strength.
    • Muscular dystrophies –  refer to  progressive degeneration of muscle tissue due to abnormal or insufficient presence of structural support proteins. They  involve  arms and/or legs to varying degrees, and some involve the muscles of  eyes or face.

Acquired myopathies – They can be due to some  medical disorders, infections, exposure to certain medications or electrolyte imbalances, among other possibilities. They may  include:

    • Autoimmune/inflammatory myopathy-   diseases in which  body mistakenly attacks itself, causing problems with muscle function.
    • Toxic myopathy –  happens due to toxin or medication interference with muscle structure or function.  Certain medicines such as Checkpoint inhibitor immunotherapy (pembrolizumab, nivolumab), corticosteroids (prednisone), cholesterol-lowering drugs (statins), amiodarone, colchicine, chloroquine, antivirals and protease inhibitors used in the treatment of HIV infection, omeprazole etc may cause this.
    • Endocrine myopathies –  happen due to malfunction of Thyroid, Parathyroid, and Adrenal glands when hormone released by these interfere with muscles.
    • Infectious myopathies – This may be the result of some infections that affect muscle function such as – Viral infections like HIV, influenza, Epstein-Barr, Bacterial pyomyositis, Lyme disease, Parasitic infections like trichinosis, toxoplasmosis, cysticercosis, Fungal infections like Candida, Coccidiomycosis etc.
    • Electrolyte imbalance : High or low levels of  Potassium and high level of Magnesium may cause this.
    • Critical illness myopathy – This is a disease of  limbs and the muscles that help respiratory muscles. It develops when you take treatment in an ICU of a  hospital  and may be caused prolonged immobility, or by some  medications such as muscle relaxants, corticosteroids or sedatives.

There are some common symptoms in many myopathies which include – Muscle weakness, most commonly of upper arms, shoulders and thighs (more common and more severe), Muscle cramps, stiffness and spasms, Fatigue with exertion, Lack of energy. Other symptoms may vary depending on the type of myopathy,  Muscle weakness can be either non-progressive, or very slowly progressive, In some disorders, muscle weakness is intermittent with other normal periods of strength, Slow development of skills requiring the use of muscles in children (such as walking, hopping, climbing stairs or grasping a spoon or pencil), Children who can’t keep up with their peers during sports or games like tag, Trouble with the muscles that control swallowing and speech, which can lead to choking and slurring of words.

Diagnostic test of Myopathy :  may include Tests your healthcare provider may order include:

    • Blood tests – to know level of certain muscle enzymes such as creatine kinase (CK) or aldolase which may be increased in certain myopathies as a result of the breakdown of muscle fibers, Electrolyte levels such as sodium, magnesium, potassium, calcium and phosphorus, Autoimmune disease testing such as antinuclear antibodies (ANA), rheumatoid factor, sedimentation rate and c-reactive protein, harmone testing such as thyroid hormone.  Electromyography(EMG and nerve conduction studies), including testing the electrical conduction of nerves and needle examination of  muscles to assess the type and degree of muscle damage, MRI of  muscles, Genetic tests , and Muscle biopsy.

POLIOMYELITIS :  Poliomyelitis commonly known as polio is a  highly infectious viral disease of infants under 5 years of age. It is caused by a viral infection and thereby inflammation of the grey matter of the spinal cord takes place .  The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, sometimes by contaminated water or food and multiplies in the intestine, from where it enters the blood stream and enters the central nervous system, infecting and destroying motor neurons which results in muscle weakness, and flaccid paralysis.  A severe infection can extend into the brainstem and even higher structures, resulting in polio-encephalitis Polio can be either of the following types :

    • Abortive poliomyelitiscauses flu-like and intestinal symptoms. It  lasts a few days only. Symptoms of abortive poliomyelitis include – Fatigue, Fever, Headache, Vomiting, Diarrhoea or constipation, Sore throat.
    • Non-paralytic poliomyelitisNon-paralytic poliomyelitis starts with the same symptoms as abortive poliomyelitis It causes more symptoms than abortive poliomyelitis and  within a few days  additional symptoms appear .  These may  include: Neck stiffness. Pain or pins-and-needles feeling in  arms and legs. Severe headache, Sensitivity to light (photophobia).
    • Paralytic poliomyelitishappens when poliovirus attacks  brain and spinal cord. It can paralyze the muscles that needed to breathe, speak, swallow and move  limbs. Depending on what parts of your body are affected, it’s called spinal polio or bulbar polio. Spinal and bulbar polio can appear together (bulbospinal polio). Less than 1% of people with polio get paralytic poliomyelitis. This may  result in aseptic meningitis, a swelling of the area around brain. Additional symptoms can develop days or weeks later, such as Sensitivity to touch, Muscle spasms, paralysis. Spinal poliomyelitis results in immovability of  arms or legs or both, Bulbar poliomyelitis results in difficult breathing, , swallowing  and speaking. Bulbospinal poliomyelitis has symptoms of both spinal and bulbar polio.
    • Polioencephalitis is a rare type of polio that results in  brain swelling. Symptoms of polioencephalitis can be on their own or along with flu-like symptoms. Other  Symptoms include – Extreme tiredness (fatigue). Anxiety. Trouble focusing, and Seizures

Post-polio syndrome : This is  the appearance of new signs or symptoms or the progression of problems. This usually happens decades after having polio. Common signs and symptoms may include – Progressive muscle or joint weakness and pain, Fatigue, Muscle wasting, Breathing or swallowing problems, Sleep-related breathing disorders, such as sleep apnea, Lowered tolerance of cold temperatures.

In order to diagnose polio, test of body fluids such as Spit (saliva) , Stool,  Blood, and Cerebrospinal fluid is required to be done. Besides, some other tests my also be required to rule out other common conditions.

TREATMENT :  All the diseases of the brain and spinal cord are of very complex nature and patient are advised to contact for specific consultancy as early as possible.  However, in case of an acute attack of Paralysis, some Acupressure points are given below which should be followed immediately even pending  consultation . Moreover, as a first-aid measure Homoeopathic medicine Causticum 30 and  Kali Phos 3 X  must be started immediately at an interval of two hours maintaining a gap of 15 minutes in between the two.  Proper homoeopathic medical consultancy must be sought as early as possible. Patient desirous of seeking medical consultancy from us, as an exception, need not fill our patient history form. Just a mail followed by a small WhatsApp message of having sent a mail is enough.  We shall call you as early as possible and take all the  detailed information we need to send a prescription on your mail/WhatsApp.  

Besides,  in all these diseases quit smoking, tobacco , and  Alcohol.  Also keep diabetes, HBP and Cholesterol under control.

ACUPRESSURE FOR PARALYSIS :