SERVICES

BRAIN STROKE

Stroke is the third leading cause of death worldwide after coronary heart disease and cancer of all types. Stroke occurs when the flow of blood to the brain is interrupted or a blood vessel gets ruptured inside the brain. When this happens, the brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function.

Also called as 'Brain Attack', the stroke can affect either any part or the entire body from the head. The W.H.O estimated that over 50 million healthy life, across the globe will be lost by year 2015 as a result of stroke, and 90% of this burden will be borne in low income and middle income countries. India is silently witnessing a stroke epidemic.Stroke mortality rate in India is 22 times that of malaria and 1.4 times of tuberculosis and Stroke represented 1.2% of total deaths in India.

Thanks to progress in medical technology, Brain stroke can be treated if detected in time and this can greatly reduce the damage caused by a stroke. When that happens, every minute counts when someone is having a stroke.The longer blood flow is cut off to the brain, the greater the damage and as such immediate treatment is the need of the hour. If this is done, it can save the patient's life and enhance chances for successful recovery.

Basically, there are two types of stroke, Ischemic Stroke- blockage of blood vessel and Hemorrhagic Stroke (bleeding in brain)- rupture of the blood vessel. Either way, the symptoms of a stroke needs to be recognized in time and the patient taken to the hospital quickly.

At Bhaskar Neuro Care, a regular neurophysician is available for prompt and thorough evaluationof stroke for the advanced treatment of stroke and other brain disorders. A comprehensive stroke care program is available for managing the problems of both acute and chronic stroke patients.

For acute stroke patients, Bhaskar Neuro Care offers accurate and immediate diagnosis and advice regarding thrombolytic therapy in eligible patients. Bhaskar Neuro Care is strategically located with advantage of immediate availability of CT and or MRI scan of the brain in the very immediate vicinity with ambulance facility also if needed. And when necessary patients can be admitted and can be taken care appropriately where ICU care, round the clock anesthetic and neurosurgery facilities are also available in the referral hospitals.

EPILEPSY / SEIZURES

A common chronic neurological disorder, Epilepsy affects 1 in every 200 people in the society and in India, its estimated that there are over five million people with epilepsy and one million with medically refractory epilepsy. There are nearly five hundred thousand people with focal epilepsies, and in a majority of them, surgery cures or controls epilepsy.

Epilepsy is a disorder wherein the person has repeated spontaneous seizures (fits/convulsions) that are episodes of disturbed brain electrical activity.When there is a disturbed brain electrical activity, attention or behavior or involuntary movements called in other words, Fits or Seizures which occur because of brief excessive currents in the brain. The symptoms of the same vary depending on the part of the brain that has abnormal current.

There are different types of fits or seizures.

• Grand Mal Seizure: Under this seizure, the current invades the entire brain. The person having this seizure falls to the ground, becomes stiff and then shakes all over. There may be frothing at the mouth, with loss of urine control and also biting of tongue. These are commonly called 'convulsions'.
• Partial Seizures: Abnormal current occurs in only some portion of the brain with the symptoms varying with the location of the current.
• Simple Partial Seizure: Under this seizure, the person remains fully aware, but has an unusual sensation or jerking of limbs.
• Complex Partial Seizure: Under this seizure, the person isnot fully in his/her senses and has some irrelevant automatic behavior. The person cannot recollect this event later.

Bhaskar Neuro Care offers evaluation and management of Epileptic seizures with the most advanced techniques handled by skilled doctors in a calm setting. A comprehensive treatment and care program is available that addresses the needs of children as well as adults with epilepsy.

With state-of-the-art diagnostic facilities under one umbrella, Bhaskar Neuro Care is well-placed to handle all kinds of epilepsy and seizure cases.

HEADACHE

A headache is a pain that occurs anywhere in the region of the head or neck and can be a symptom of a number of different conditions of the head and neck. The disturbance of the pain-sensitive structures around the brain causes headache. Nine areas of the head and neck possess these pain-sensitive structures and they include Cranium (Periosteum of the skull, Muscles, Nerves, Arteries and Veins, Subcutaneous Tissues, Eyes, Ears, Sinuses and Mucous Membranes). The treatment of a headache depends on the underlying cause.

A migraine is a severe, debilitating headache that's often followed by symptoms other than headache, including lightheadedness, sensitivity to light,sound,smell, nausea and vomiting, and visual disturbances. It is estimated that Migraine accounts for 87 percent of all headaches and affects approximately 12% of the population across the world. According to the W.H.O, around 15 percent of women and 10 percent of men suffer from migraine headaches in India.

The Migraine can be moderate to severe if left untreated, and can last between four to 72 hours. It can be one sided, throbbing and aggravated by routine physical activity and can be associated with light, sound,smell even journey sensitivity. In some patient's cases, there can be visual or sensory changes before, during or after the headache, known as auras. Any kind of activity like walking up the stairs usually makes the pain worse and also makes the person feel sick or vomit.

The common triggers for Migraine include stress or anxiety, change in sleep patterns and fatigue /tiredness, depression, poor posture or tension in your neck and shoulders, certain food or drink like chocolate, cheese, alcohol, caffeine, loud noises, bright or flickering lights, strong smells, strenuous exercise if you're not used to it and skipping meals and not drinking enough fluid. Migraines occur about three times more frequently in women than in men. Each migraine can last from four hours to three days. Occasionally, it will last longer.

Bhaskar Neuro Care specializes in the diagnosis and treatment of recurring headaches and migraines. Specialist Neurologist undertakes a thorough review of current symptoms as well as complete neurological exam. Every patient gets an individually tailored treatment plan with a multi-disciplinary approach and incorporates both medication and non-medication treatments into care. The treatment and care also includes effective pain management for all kinds of headaches, that range from mild and nagging to severe and debilitating.

Even primary headaches such as migraines that have no obvious cause, as well as those that are caused by serious underlying medical conditions that may require prompt diagnosis and treatment, are treated at Bhaskar Neuro Care. The neurologist will work with the patient to consider all available alternatives and develop a personalized plan.

PERIPHERAL NEUROPATHY

Peripheral nerves carry information to and from the brain as well as signals to and from the spinal cord to the rest of the body. When the nerves don't work properly, it is called Peripheral Neuropathy. End result is damage to a single nerve or to a nerve group, affecting at times the nerves in the whole body.

Peripheral Neuropathy is very common and there are many types and causes. Some prominent health conditions that may cause neuropathy are:

• Autoimmune disorders such as rheumatoid arthritis or lupus ,Chronic kidney disease, HIV, Liver infections, Low levels of vitamin B12, Metabolic disease, Poisoning due to heavy metals, such as lead, Poor blood flow to the legs, Underactive thyroid gland, Broken bone that affects a nerve, Long-term, heavy alcohol use, Glue, lead, mercury, and solvent poisoning, Drugs that treat infections, cancer, seizures, and high blood pressure, Pressure on a nerve, such as carpal tunnel syndrome

The symptoms include Pain, tingling, pricking, burning and numbness, muscle aches, bladder problems, and sexual problems where in men may have problems with erections. Early diagnosis and treatment offers the best chance for controlling symptoms and preventing further damage to the peripheral nerves.

Bhaskar Neuro Care has a multidisciplinary approach of specialistto identify the cause of peripheral neuropathy and minimize the progression of the neuropathy.

DEMENTIA

With aging population, there will be more and more elderly suffering from dementia. Dementia affects the brain and the brain cells are damaged resulting in loss of mental functions.

In a dementia patient, some of these brain cells get damaged and die as a result of which the brain doesn't work as well as it used to. Even simple messages do not get through and the person becomes forgetful, not remembering even yesterday's events. They even get confused by surroundings or how to get dressed. Also, they may not recognize their husband / wife / family members or friends. Sometimes finding the right word might be difficult.

There are several types of dementia of which the most common is Alzheimer's disease. Early signs of dementia are becoming forgetful and confused like forgetting people's names or how to get home. Later, such people are likely to find everyday tasks such as shopping or cooking - difficult and may also find social situations hard to manage. Overtime, the symptoms grow worse.

There is no cure but there are treatments that help slow dementia down or help people cope with certain symptoms. Bhaskar Neuro Care offers services including -

• Counselling and education to caretakers of patients diagnosed with dementia. They include equipping them with basic knowledge about dementia, coping strategies, on non-pharmacological management of behavioral problems, and informing them of relevant community resources.
• Early diagnosis, excellent clinical treatment and care, ensuring diagnosing dementia and delirium at the right time, in the right place and providing the right support afterwards.
• Providing environment of care, creating a truly friendly atmosphere with secure, safe, homely and comfortable social and therapeutic environments that facilitate all types of functioning.

CERVICAL SPONDYLOSIS

Cervical spondylosis is the degeneration of the cartilage and bones of the neck (cervical vertebrae), the discs (cushions) between the vertebrae and the joints between the bones of the cervical spine. Sometimes, abnormal growths (bone spurs) may also appear on the bones of the spine.

It's estimated that more than 85% of people over the age of 60 years suffer from cervical spondylosis. The bones in the neck (or "cervical spine") of such people are affected resulting in the inevitable deterioration of arthritis in the joints. However, unlike spinal osteoarthritis, cervical spondylosis rarely causes disabilities or symptoms resulting in crippling condition.

The problem is also common among adolescent athletes participating in sports and activities that place stress on or continually overstretch/hyperextend the spine. Further, cervical spondylosis may also occur in some people at birth, specifically in the case of those born with thin vertebrae.

• Pain over the shoulder blade
• Pain spreading to the upper arm, forearm or, rarely, fingers.
• Worsening of pain after prolonged standing or sitting or when sneezing /coughing or when bending neck backwards or walking a few yards distance.
• Muscle weakness.
• Hardness after lifting arm.
• Numbness or abnormal sensations in shoulders, arms or, rarely, legs.
• Headaches, primarily in the back of the head.

Symptoms usually develop slowly over time or may start suddenly or worsen suddenly.

LOW BACK ACHE

It results from conditions affecting the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.

SCIATICA

It's a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg. Sciatica usually affects only one side of the lower body and often, the pain extends from the lower back all the way through the back of the thigh and down through the leg.

Bhaskar Neuro Care has a multidisciplinary team of orthopedic experts with strong expertise in treating cervical spondylosis as well as a broad range of spine conditions that occur at any stage of a person's life.

Treatment options at Bhaskar Neuro Care focus on nonsurgical approaches such as pain medications, injections, physical therapy, a home exercise program, cold packs and heat therapy. In addition, sometimes surgical treatments including minimal invasive surgery or micro discectomy and spinal fusion surgery are undertaken.

DEMYELINATING DISEASES : MULTIPLE SCLEROSIS

One of the most common diseases of the central nervous system (brain and spinal cord), Multiple Sclerosis is said to affect more than 2,000,000 people across the world. More women than men are said to suffer from Multiple Sclerosis, with a ratio of 2 men to 3 women affected. In addition, MS is the most common diseases of the central nervous system in young adults.

Popularly called MS, Multiple Sclerosis is an inflammatory demyelinating condition that is caused by damage to myelin, a fatty material that insulates nerves acting much like the covering of an electric wire. The loss of myelin (demyelination) is followed by a disruption in the nerves ability to conduct electrical impulses to and from the brain. This results in the production of various symptoms of MS. The body sites where myelin is lost (plaques or lesions) appear as hardened (scar) areas. In people with multiple sclerosis these scars appear at different times and in different areas of the brain and spinal cord.

There are four main types of Multiple Sclerosis - benign, relapsing remitting, secondary progressive and primary progressive.

• Blurred vision.
• Weak limbs.
• Tingling sensations.
• Unsteadiness and fatigue etc.

Some people with MS have periods of relapse and remission while for others it has a progressive pattern.

Bhaskar Neuro Care offers comprehensive diagnostic and therapeutic services for multiple sclerosis (MS) as well as related demyelinating disorders and inflammatory disorders of the brain and spinal cord. A state-of-the-art and latest ways of evaluation and treatments are advised to treat all kinds of MS problems.

Using advanced equipments, the neurologists conduct a complete medical history and neurological examination to understand the exact nature of the patient's problem. Though there is no known cure for MS, they treat the problem with medication and also recommend physical therapy, speech therapy, and occupational therapy.

MYASTHENIA GRAVIS

A rare autoimmune disease, Myasthenia gravis (MG) occurs when the immune system interferes with the transmission of nerve impulses to the muscles. People with myasthenia gravis develop severe, sometimes life-threatening, weakness. The muscles in body become weak and cause progressive paralysis due to formation of antibodies, which attack muscles and block neuromuscular transmission.

Most commonly affected are the muscles of eye along with muscles of face, which are responsible for chewing, speaking and esophageal muscles. In severe cases, muscles of limbs and respiratory muscles are also affected leading to respiratory difficulty and life threatening condition. The causes of myasthenia gravis are many from genetic causes to Thymomas which are tumors of thymus gland, (thymus gland is situated in neck and produce antibodies) thyroid diseases, rheumatoid arthritis, diabetes, systemic lupus erythematosus and other autoimmune disorders.

Myasthenia gravis symptoms include progressive weakness of muscles aggravated by exertion, and relieved by rest, drooping of eyelids, blurred speech, difficulty in speaking and swallowing, and respiratory difficulty. In addition, exposure to bright sunlight, surgery, immunization, emotional stress, menstruation, and physical factors might trigger or worsen exacerbations. Intercurrent illness (e.g. viral infection) or medication can exacerbate weakness, leading to a myasthenic crisis and rapid respiratory compromise called myasthenic crisis.

At Bhaskar Neuro Care, focus is on the diagnosis and treatment of myasthenia gravis. Diagnosis is done for detection of antibodies on serological tests, EMG studies, and electrophoresis; x ray chest, CT and MRI scan to detect thymomas and thyroid diseases. After diagnosis, the neurologist is well equipped with state-of-the art infrastructure using well-established techniques and advanced systems in the nearby hospitals are on hand to provide world class cutting-edge treatment and individualized care with compassion.

Patients benefit from the expertise and care of the experts who have extensive experience treating myasthenia gravis.

CFS (Fibromyalgia)

Also called Myalgic Encephalomyelitis (ME), CFS (Chronic Fatigue Syndrome) is a group of debilitating and complex illness characterized by profound fatigue and other symptoms of pain and immune system dysfunction for a minimum of six months in adults (and 3 months in children or adolescents).

The symptoms of CFS include malaise after exertion, improper sleep, acute muscle and joint pain/weakness, sore throat, headaches not previously experienced, cognitive difficulties, chronic and severe mental and physical exhaustion, increased sensitivity to light, sounds and smells, digestive disturbances, depression, painful and often slightly swollen lymph nodes, cardiac and respiratory problems. The symptoms vary in number, type, and severity from person to person.

It is estimated that there 7 to 3,000 cases of CFS for every 100,000 adults. CFS occurs more often in women than men, and is less prevalent among children and adolescents

Bhaskar Neuro Care offers quality services providing more intensive assessment for severely affected patients as well as outpatient treatment for a wide range of CFS problems, including addictions, depression, anxiety and stress, fatigue syndromes, personality disorders.

ALCOHOL NEUROPATHY

A disease associated with chronic alcohol abuse, Alcoholic neuropathy is characterized by damage to the nervous system. It can affect the brain as well as nerves situated anywhere in the body including the feet, hands, muscles, gastrointestinal system, and reproductive system.

Although Alcoholic neuropathy's exact cause is not known, it is thought to result from alcohol-related nerve damage, as well as poor diet and vitamin deficiency, which are associated with excessive alcohol drinking. The symptoms range from slight discomfort to major disability, sensations of numbness, tingling and pain, as well as muscle weakness that can be more frequently experienced in the legs and can also occur in the arms and other regions of the body. Whatever the symptoms, they can develop over a long period of time.

Alcoholic neuropathy can affect both movement and sensation. Although the condition is not life threatening, it can greatly affect the quality of life for the patients.

Bhaskar Neuro Care offers world class treatment and care including treating the disease causing the neuropathy and specific management of pain.

PARKINSON'S - BOTOX

A chronic, progressive neurological disorder, Parkinson's disease affects a small area of nerve cells deep within the brain. Worldwide, more than thousands are diagnosed with Parkinson's disease each year.

Some of the movement disorders resulting from Parkinson's disease include essential tremor (uncontrollable shaking or tremors in different parts of the body) and dystonia (forceful sustained muscle contractions cause twisting and repetitive movements or abnormal postures).Apart from conventional treatment with medications Botox also can be considered in special situations

Botox treatment is increasingly being used for Parkinson's treatment. By loosening tight spastic muscles, Botox treatment helps to relieve pain and tremors caused by Parkinson's disease. The neurotoxin in Botox by getting into the nerve terminals and making those nerve terminals fire less, helps release the grip of muscle or the limbs spasms, tremors and pain, enabling them to return to their original or more normal position.

At the Bhaskar Neuro Care, patients with Parkinson's and other muscular disorders get multiple targeted injections of botulism toxin. Specially trained in Botox and expertise in Parkinson disease, help inject Botox directly into the muscle and ensure that the process goes off smoothly. On average, the Botox treatment will last for three months and when the injections wear off, patients will have to go back for more to control the disease.