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Neurology

The entire spectrum of Neurological diseases are treated by Fortis Escorts institute of Neurosciences at Okhla, New Delhi. We have successfully treated patients with brain and spine injury, tumour in brain and spine, nerve injuries, brain haemorrhage, disc prolapse, spinal dislocation, stroke, epilepsy, multiple sclerosis, Parkinson's disease, congenital malformations, just to name a few.

The Department of Neurology is supported by well-equipped ICU facilities and bedside Electro Encephalogram (EEG) Monitoring for managing critically ill patients with Neurological illnesses. Our team of Neurologists is available round-the-clock for diagnosis, treatment and management of patients. We have state-of-the-art diagnostic imaging modalities like 3T MRI and CT Scan.

Services:

  • Management and treatment of Stroke and Intracranial Bleeds - Comprehensive stroke care under one roof including IV Thrombolysis, mechanical thrombectomy, neurosurgical and neuro critical care expertise and stroke rehabilitation services.
  • Diagnosis and management of various Seizure Disorders and RefractoryEpilepsies.
  • Neurophysiology unit offers EEG, EMG, VEP, BERA and RNST.
  • Management of Neuromuscular Disorders, Peripheral Neuropathies, Headaches and Chronic Pains Neuro Rehabilitation including Physiotherapy and Occupational Therapy for all kinds of Neuromuscular and Post-Stroke cases.
  • Management of Dementia, including Alzheimer's disease.
  • Treatment of all kinds of Movement Disorders such as Parkinson's disease, Parkinsonism, Tremors, Rigidity, Chorea and Tic Disorder.

Neurology

The common Neurology disorders treated are:

Common Neurological Conditions

1. Headache

Headaches are one of the most common neurological disorders—and there are a variety of different kinds of headaches, such as migraines, cluster headaches, and tension headaches. When headaches occur repeatedly, it’s a good sign that you should see a doctor, as it could be a symptom of an underlying condition.

The most common conditions that can cause recurring headaches include:

  • High blood pressure
  • Infections
  • Temporal arteritis, or when blood vessels in and around your scalp become inflamed
  • Tumors
  • We typically discuss your symptoms to help determine what’s causing your headache. If we find that you’re just experiencing a migraine, we can prescribe you medication to alleviate your symptoms. If your condition is something serious, such as temporal arteritis, we often prescribe a steroid to reduce inflammation. The medication will help you avoid complications such as vision loss.

2. Stroke

Strokes, which occur when you experience damage to the brain as a result of arteries leading to and within the brain becoming impaired. It’s usually difficult to anticipate a stroke, but signs that you may be having a stroke include sudden:

  • Blurred vision
  • Confusion, trouble speaking, or understanding
  • Dizziness or loss of balance
  • Numbness or weakness of the face, arm, or leg—especially on one side of the body
  • Severe headache

When we see people who have experienced a stroke, our priority is to help them prevent a second stroke. We often do this through medication, which can include blood thinners or drugs to treat any underlying heart problems, but it depends on your particular situation. You can lower your stroke risk by exercising 30 minutes a day, five days a week, and by following a healthy diet that prioritizes fruits and vegetables and limits processed food.

These lifestyle modifications can help you control key stroke risk factors, such as:

  • Diabetes
  • Heart disease
  • Heavy alcohol use
  • High blood pressure
  • High cholesterol
  • Obesity and lack of exercise
  • Smoking

3. Seizures

Seizures are changes in the brain’s electrical activity and affect about one in 100 people. Signs and symptoms of a seizure can vary depending on the severity of your seizure, but the most common include:

  • Cognitive or emotional symptoms, such as fear, anxiety, or deja vu
  • Loss of consciousness or awareness
  • Temporary confusion
  • Uncontrollable jerking movements of the arms and legs

After having a seizure, it's important to see your doctor. Early treatment and medication can control yourseizures, and you will avoid long-term complications such as memory loss and brain damage. A seizure often is the result of epilepsy, but can also happen due to:

  • Alcohol abuse or withdrawal
  • Head trauma that causes an area of bleeding in the brain
  • High fever
  • Lack of sleep
  • Low blood sodium
  • Medications, such as antidepressants or pain relievers

4. Parkinson’s Disease

Parkinson’s disease is a progressive nervous system disorder that affects your movement. Generally, it begins affecting people around age 60, and symptoms gradually get worse over time. Common symptoms include:

  • Constipation: This can occur at any time during Parkinson’s disease, sometimes even decades before you experience motor symptoms
  • Muscle stiffness: This can occur throughout your body; in some cases, it can be difficult to swing your arms while you walk
  • Reduced smell: Most people with Parkinson’s disease have some loss of their sense of smell
  • Stiff face: Especially in the early stages of Parkinson’s disease, your face may begin showing little or no expression
  • Speech changes: Your speech can become soft or slurred
  • Tremor: Usually starts in your hands or fingers

Your doctor will diagnose Parkinson’s disease during a visit in which you discuss your symptoms and undergo a physical examination. In many cases, you can alleviate symptoms and manage Parkinson’s disease effectively through medication.

5. Dementia

Dementia is an umbrella diagnosis that describes a group of diseases, including Alzheimer’s, that may cause your brain to fail. Dementia, which becomes increasingly more likely as you age, leads to continuous loss of brain tissue, which can affect:

  • Behavior
  • Emotions
  • Memory
  • Perceptions
  • Thinking

If you feel as though you may be experiencing symptoms of dementia, see your doctor. Some medications and therapies can help you manage symptoms. Moreover, your doctor can connect you with support groups to help you manage life with dementia.

Dr. Dhruv Zutshi

CONSULTANT

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Dr. Nitin Kumar Rai

ASSOCIATE CONSULTANT

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Headache Clinic

Headache is one of humanity most common afflictions. Estimate are that one person in three persons experience severe headache at some stage of life. The life time prevalence for any type headache as estimated from population-based studies is more than 90% for male and 95% for women. World health organization declared migraine to be among the most disabling medical condition experienced worldwide. Headache arises from activation of pain sensitive intracranial structure.

Primary headaches are when headache itself is a problem. It is not a symptom of underlying disease or condition.While the pain from primary headaches can be disabling, the headaches are not dangerous. Most common primary headache are migraine headache/tension type headache/trigeminal autonomic cephalalgia.

Migraine headache: They are recurrent headache disorder with attacks lasting 4-72 hours and typical characteristics of the headache are

  • Unilateral location.
  • Pulsating quality.
  • Moderate or severe intensity.
  • Aggravation by routine physical activity.
  • Association with nausea and/or photophobia and phonophobia.

Migraine headache with aura: Recurrent attacks, lasting 5 to 60 min of one side, fully reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and associated migraine symptoms.

Chronic migraine: Headache occurring on 15 or more days per month for more than 3 months, which has the features of migraine headache on at least 8 days per month.

Tension type headache: A mild or moderate intensity pain as a feeling like pressing or tight band around head with bilateral location and not aggravated by routine physical activity such as walking or climbing stairs. Not associated with any nausea, vomiting, photophobia or phonophobia.

The trigeminal autonomic cephalalgias (TACs): Type of primary headache with pain on one side of head and often have prominent autonomic features, which are ipsilateral to the headache side.

1. At least one of the following symptoms or signs are seen ipsilateral to the headache:

a) Conjunctival injection and/or lacrimation

b) Nasal congestion and/or rhinorrhoea.

c) Eyelid swelling

d) Forehead and facial sweating

e) Forehead and facial flushing

f) Sensation of fullness in the ear

g) Miosis and/or drooping of eyelid.

2. A sense of restlessness or agitation

Trigeminal autonomic cephalalgia(cluster headache/paroxysmal hemicrania/SUNCT/SUNA/hemicrania continua)can be differentiated by length and frequency of recurrence of the headache.

Secondary headache: Are headache that are due to underlying medical condition. These headaches are worrisome and require urgent neurologist consultation. Symptoms of secondary headache are:

  • The worst headache of your life.
  • The first headache you ever had.
  • Headache came on suddenly within seconds with no warning (thunder clap)
  • Headache below 5 and after 50 year of age.
  • Headache associated with double vision/blurring of vision
  • Headache with postural variation.
  • Headache causing faintness or seizure.
  • Headache associated with weakness one side of body.
  • Headache associated with fever and altered mental status.

Headache clinic: The main purpose of headache clinic is first to diagnose patient with type of headache and classify them into primary headache /secondary headache (due to underlying infectious and structural problem) and painful cranial neuropathies and other facial pain.

Treatment will be offered for primary headache which commonly include migraine headache/tension type headache/trigeminal autonomic cephalalgia and other different types of primary and secondary headache.

Once diagnosed with type of headache patient will be offered following treatment or procedure depending on the patient clinical profile.

  • Preventive oral medication for primary headache (migraine headache/tension type headache/trigeminal autonomic cephalalgia).
  • Medication for difficult to treat trigeminal autonomic cephalalgias (cluster headache/paroxysmal hemicrania/SUNCT/SUNA/hemicrania continua)
  • Botox injection for chronic migraine.
  • Greater occipital nerve blocks for difficult to treat chronic migraine and episodic migraine.
  • An external trigeminal nerve stimulation device for migraine.
  • Life style modification and physiotherapy.
  • Investigation and Management of secondary headache.

Our Doctor

Dr. Nitin Kumar  Rai

Dr. Nitin Kumar Rai

Associate Consultant

Neurology

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