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Highlights

  • Brain Tumour Surgery 
  • Epileptic Surgery
  • Surgery of Brain Aneurysm
  • AVM Surgery
  • Awake Brain Surgery

Best Neurologist in Kolkata

The center of Neurosciences, at AMRI Hospitals has a demonstrated track record in providing highest levels of professional expertise in the varied field of Neuro diagnostics, Neurology, Neuro surgery, Neuro Anaesthesia and Interventional Neurology. We are backed by a team of the country's best neurologists & surgeons who have immense knowledge and experience in diagnosis, treatment and patient-care management. The Neurosciences Centre is committed to follow multidisciplinary approach & advanced techniques for treating life threatening & challenging neurological disorders. At AMRI Hospitals we are fully equipped to provide 24*7 comprehensive evaluation and therapeutic care to a wide range of neurological conditions including stroke, seizures, brain & spine disorders, and congenital diseases.

Facilities

Brain tumour surgery with Neuronavigation:

  • Micro surgery for spinal tumour
  • Minimally invasive disc surgery
  • Head & spinal injury services
  • Neuro endoscopy & pituitary surgery
  • Microvascular surgery for AVM & Brain Aneurysm

24x7 1.5 Tesla Ambient MRI :

  • 70cm bore for comfort
  • Premium digital imaging
  • Reduced noise
  • In gantry entertainment 24x7 128 Slice CT Scan :
  • Gem stone imaging
  • Single pass cerebral DSA
  • 60% less radiation
  • 230-micron resolution

Neurophysiology :

  • Electroencephalogram (EEG)
  • electro myelogram (EMG)
  • Nerve conduction velocity test (NCV)
  • Evoked Potentials (EP)
  • Video EEG
  • Transcranial Doppler (TCD) 

 

 

 

Technology

 Pneumatic & Electrical Drill Systems Operating Microscope of Carl Zeiss CUSA - Cavitron Ultrasonic Surgical Aspirator Image Intensifier • Stereotactic Frame IGRT with SRS & SRT

Diseases & Procedures
Diseases | Procedures
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Reset
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Transient global amnesia

Transient Global Amnesia is a condition which refers to sudden memory loss for a temporary period of time. In this disease patients cannot remember anything related to recent events and cannot recall where he or she is or how he or she got into the place. Transient Global Amnesia has no relation with stroke, head injury or epilepsy. 
Symptoms 
Symptoms of Transient Global Amnesia include:

  • Inability to form new memories 
  • Losing recent memories for a temporary span
  • Retention of personal identity during memory loss phase
  • Normal cognition like identifying known names, objects, and other facts. 
  • Do not show any sign of brain damage like paralysis, impaired word recognition or involuntary limb movements. 

Cause
Cause of Transient Global Amnesia is not known. It is believed this disease might have some relation with history of migraine. People above 50 years have higher chance of getting this disease. Strenuous physical work, sudden fall in hot or cold water, mental shock can be the other causes that may trigger this condition. It may also occur as an after effect of angiography or endoscopy.      
Diagnosis 
To diagnose Transient Global Amnesia doctors consider medical history and also focus on physical check-up that reveals patient’s neurological conditions. Usually, reflex, muscle tone, muscle strength, coordination, gait, sensory function are examined. To confirm Transient Global Amnesia and rule out other possibilities, the following tests are ordered:

  • MRI 
  • EEG
  • CT scan

Treatment
No treatment is required in Transient Global Amnesia. This is a condition that automatically and normally gets resolved in due course of time and has no sustaining impact. 
 

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Tension Headache

Tension Headache

A tension headache is the most common type of headache. It can cause mild, moderate, or intense pain behind the eyes and in the head and neck. It often headache feels like a tight band around their forehead.

There can be  number reasons behind a tension headache, including stress, inadequate sleep and poor posture. The main symptom is pain on both sides of the head. Treatments include pain relievers and other medication, stress reduction, ice or heat on sore muscles.

 

Types

Tension-type headaches are divided into two main categories — episodic and chronic.

Episodic tension headaches

Episodic tension-type headaches can last from 30 minutes to a week. Frequent episodic tension-type headaches occur less than 15 days a month for at least three months. Frequent episodic tension-type headaches may become chronic.

Chronic tension-type headaches

This type of tension-type headache lasts hours and may be continuous. If the headaches occur 15 or more days a month for at least three months, they're considered chronic.

Causes

Tension headaches are caused by muscle contractions in the head and neck regions. These types of contractions can occur due to -

  • foods
  • activities
  • stressors

Some people develop tension headaches after staring at a computer screen for a long time or after driving for long periods. Cold temperatures may also trigger a tension headache.

Other trigger factors include:

Symptoms

  • Dull pain
  • Pressure around the forehead
  • Tenderness around the forehead and scalp

The pain is usually mild or moderate, but it can also be intense. In this case, one might confuse tension headache with a migraine. But tension headaches don’t have all the symptoms of migraines, such as nausea and vomiting.

Treatment

Basic remedies are -

Using medications in conjunction with stress management techniques is effective.

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Temporal lobe seizure

Temporal lobe seizure 

Syringomyelia is the development of a fluid-filled cyst within the spinal cord. Over time, the cyst can grow in size, damaging the spinal cord and causing pain, weakness and stiffness, among other symptoms. If Syringomyelia doesn't cause problems, monitoring the condition might be adequate. But if symptoms aggravate a surgery may be required.
Causes
The cause is not very clear that how it develops. Several conditions and diseases can lead to Syringomyelia, including:

  • Chiari malformation, a condition in which brain tissue protrudes into the spinal canal
  • Meningitis
  • Spinal cord tumor, which can obstruct  the normal circulation of cerebrospinal fluid
  • Conditions present at birth
  • Spinal cord injury, which can cause symptoms months or years later

Symptoms
Syringomyelia symptoms usually develop slowly over time. In some cases, coughing or straining can trigger symptoms.  Signs and symptoms can include:

  • Muscle weakness and wasting (atrophy)
  • Loss of reflexes
  • Loss of sensitivity to pain and temperature
  • Headaches
  • Stiffness in the back, shoulders, arms and legs
  • Pain in your neck, arms and back
  • Spinal curvature (scoliosis)

Diagnosis
CT Scan or MRI
Treatment
Treatment depends on the severity or progression of the symptoms. Periodic monitoring and  neurological examinations are required. In some cases surgery is the answer. 

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Tay Sachs disease

Tay Sachs disease is an uncommon genetic disorder that passes down from the parentsto the children. In this disease absence of a particular enzyme create trouble in breaking fatty substances. As a result the fatty substances becomes toxic and get accumulates in the brain and the spinal cord which causes death of nerve cells and neurological problems.  

Symptoms 
Usually symptoms starts showing up when the baby becomes 3 months old. The symptoms increase and usually flair up within age 4. The symptoms include:  
Low muscle tone and muscle weakness 

  • Sudden falling asleep 
  • Less responsiveness 
  • Lack of attentiveness 
  • Lack of eye movement and inability to make eye contact 
  • Falling behind in meeting motor milestone
  • Slowly losing ability to do tasks the baby used to do before 
  • Cherry red spot in the eye
  • Losing vision  

Cause 
Tay Sachs disease is a hereditary disease. A baby gets affected by it if both the parents are carrier of this disease.    

Diagnosis 
To diagnose Tay Sachs disease, doctors prescribe blood tests that measures level of ‘hexosaminidase A’ protein in the blood. Often, the affected child will have no count or much reduced count of this protein. Also, cherry red eye spot, a typical sign is checked to diagnose this disease. 

Treatment 
Tay Sachs disease is a fatal disease. So far no treatment is there and has no cure. Only symptomatic medicines are provided to minimize the conditions.  
 

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Syringomyelia

Syringomyelia 

Syringomyelia is the development of a fluid-filled cyst within the spinal cord. Over time, the cyst can grow in size, damaging the spinal cord and causing pain, weakness and stiffness, among other symptoms. If Syringomyelia doesn't cause problems, monitoring the condition might be adequate. But if symptoms aggravate a surgery may be required.
Causes
The cause is not very clear that how it develops. Several conditions and diseases can lead to Syringomyelia, including:

  • Chiari malformation, a condition in which brain tissue protrudes into the spinal canal
  • Meningitis
  • Spinal cord tumor, which can obstruct  the normal circulation of cerebrospinal fluid
  • Conditions present at birth
  • Spinal cord injury, which can cause symptoms months or years later

Symptoms
Syringomyelia symptoms usually develop slowly over time. In some cases, coughing or straining can trigger symptoms.  Signs and symptoms can include:

  • Muscle weakness and wasting (atrophy)
  • Loss of reflexes
  • Loss of sensitivity to pain and temperature
  • Headaches
  • Stiffness in the back, shoulders, arms and legs
  • Pain in your neck, arms and back
  • Spinal curvature (scoliosis)

Diagnosis
CT Scan or MRI
Treatment
Treatment depends on the severity or progression of the symptoms. Periodic monitoring and  neurological examinations are required. In some cases surgery is the answer. 

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Spinal stenosis

Spinal stenosis is a narrowing of the spaces within the spine, which can put pressure on the nerves that passes through the spine. Spinal stenosis develops usually in the lower back and the neck. The condition develops due to age-related wear and tear. Symptoms include pain, numbness, muscle weakness and impaired bladder or bowel control. Some people with may not have symptom. Treatment includes medication, physiotherapy and possibly surgery.
Causes
Spinal stenosis has many causes. Age related wear and tear and injuries are risk factors. The causes of Spinal stenosis include – 

  • Bone overgrowth or Arthritic spur
  • Bulging disk or herniated disk
  • Thockened ligaments
  • Spinal fractures or injuries
  • Spinal cord cyst / tumor
  • Congenital Spinal stenosis

Symptoms 
Symptoms of lower back (lumbar) spinal stenosis include:

  • Pain in the lower back. Pain can come and go.
  • Sciatica. This is pain that begins in the buttocks and extends down the leg and may continue up to foot.
  • A heavy feeling in the legs, which may lead to cramping in one or both legs.
  • Numbness or tingling in the buttocks, leg or foot.
  • Weakness in the leg or foot (as the stenosis worsens).
  • Pain that worsens when standing for long periods of time or walking 
  • Pain that lessens when leaning, bending slightly forward, walking uphill or sitting.
  • Loss of bladder or bowel control (in severe cases).

Symptoms of neck (cervical) spinal stenosis include:

  • Pain in the Neck 
  • Numbness or tingling in the arm, hand, leg or foot. 
  • Weakness or clumsiness in the arm, hand, leg or foot.
  • Loss of balance.
  • Loss of functional efficiency in hands, like writing or buttoning shirts.
  • Loss of bladder or bowel control (in severe cases).

Diagnosis
Apart from checking medical history and physical examination the doctor may advise -Imaging tests like X ray, MRI, CT Scan or CT Myelogram.


Treatment 
Treatment for Spinal stenosis include medication, physical therapy, steroid injections, decompression procedure and surgery.


 

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Spinal cord tumor

Spinal cord tumor 

A spinal tumor is a growth that develops inside  the  spinal canal or within the bones of the spine. A spinal cord tumor which  begins within the spinal cord or in the covering of the spinal cord (dura) is also called  Intradural tumor. A tumor that affects the bones of the spine (vertebrae) is called a vertebral tumor.
Spinal tumors can lead to pain, neurological problems and sometimes paralysis. A spinal tumor can be life-threatening and may cause permanent disability.
Treatment for a spinal tumor may include surgery, radiation therapy, chemotherapy or other medications.
Symptoms
Spinal cord tumors can cause different signs and symptoms. The symptoms may include:

  • Pain at the site of the tumor 
  • Back pain is a common early symptom of spinal tumor and it radiates to other parts of the body
  • Feeling less sensitive to pain, heat, and cold
  • Loss of bowel or bladder function
  • Difficulty walking
  • Back pain that worsens at night
  • Loss of sensation or muscle weakness, especially in the arms or legs

Causes
It's not clear why most spinal tumors develop. Experts suspect that defective genes may play a role.
Diagnosis

  • MRI of the Spinal cord
  • CT Scan
  • Biopsy

Treatment
The treatment options include surgery, radiation and Chemotherapy.
 

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Shaken baby syndrome

Shaken Baby Syndrome is an extremely serious brain injury that develops from forcefully shaking an infant by parents or caregivers out of frustration or anger.  It may cause permanent brain damage or death also.

Symptoms

Shaken Baby Syndrome includes the following symptoms:

  • Irritability
  • Drowsiness
  • Seizures
  • Poor eating
  • Vomiting
  • Breathing difficulty  
  • Developing paralysis
  • Coma

Cause

Tiny babies have weak neck muscles which cannot support their head unless they grow up a little. At this stage shaking them hard makes their brain move back and forth inside their head that results into a very serious permanent brain injury. It often becomes fatal or develops blindness, hearing loss, seizures, cerebral palsy and learning disability.

Diagnosis

Often it becomes difficult to diagnosis if somebody shook the baby or not as the babies cannot speak.

Once the doctors suspects a Shaken Baby Syndrome, they might order imaging tests like X-ray, CT scan or MRI are the usual tests or eye tests to check evidences for retinal bleeding. 

Treatment

Shaken Baby Syndrome needs immediate attention before it becomes too late. The adults’ confession and cooperation is extremely important to start the treatment. The process of treatment depends on the severity of the conditions. If necessary immediate breathing support and a surgery might be ordered to stop bleeding in the brain.    

 

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Serotonin syndrome

Serotonin syndrome 

Serotonin Syndrome is a drug reaction that appears due to taking some medications that increases serotonin level in the body.  It is a serious health condition. 
Symptoms  
Serotonin Syndrome usually has the following symptoms:

  • Restlessness              
  • Rapid heartbeat         
  • Headache 
  • Muscle stiffness        
  • Shivering 
  • Confusion                    
  • Dilated pupils
  • Heavy sweating        
  • High blood pressure
  • Confusion                
  • Insomnia
  • Nausea  
  • Diarrhea                   
  • Vomiting

In severe Serotonin Syndrome, symptoms may also include: 

High fever, unconsciousness, seizure, tremor, kidney failure and irregular heartbeat.  

Cause 
Usually a combination of medications that increases Serotonin level cause Serotonin Syndrome. But sometimes a few people may get it by taking a single drug that may raise the serotonin level.  
Antidepressant pills, migraine medications, some antibiotics, pain killers, cough and cold medicines and medicines used for nausea and vomiting may cause this condition. Herbal supplements, HIV medications and Illegal drugs and dietary supplements are also responsible in building up Serotonin in human system.  
Diagnosis 
Doctors diagnose Serotonin Syndrome through physical exam and checking up of medical history that reveals use of medicines and supplements. To confirm this disease medical professionals my order other lab tests that rule out the possibility of tetanus, encephalitis, sepsis and heatstroke.      
Treatment 
To treat Serotonin Syndrome, stopping the medicines that is increasing Serotonin is critical. The patient needs to be hospitalized to keep a close watch to attend the symptoms. Sometimes patients may need to get extra fluid through IV to flush the system. In severe condition medicines that stops natural production of serotonin in the human body are used for quick recovery.    
 

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Sacroiliitis

Sacroiliitis

Sacroilitis causes inflammation in one or both the Sacroiliac joints that connects lower portion of spine and pelvis. The pain occurs in the lower back region, buttocks and spread towards the legs. Standing for a long time or climbing stairs can aggravate the pain.

Symptoms

Low back pain is the primary symptom of this disease.

Causes

The common causes that develop Sacroilitis include:

  • Traumatic Injury
  • Arthritis
  • Pregnancy

Diagnosis

Initially a doctor physically checks a patient suffering from pain in the lower back and buttocks. If Sacroiliitis is suspected, the doctor may prescribe the following tests:

  • X-ray
  • CT scan
  • MRI
  • Ultrasound
  • Anesthetic Injection

Treatment

Treatment procedure of Sacroiliitis largely depends on the cause of developing this disease and its condition. Managing pain and treatment may include: 

  • Medication
  • Physical therapy
  • Surgery and other procedures

 

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Pseudotumor cerebri

Pseudotumor cerebri 

Pseudotumor cerebri is a condition that increases the pressure inside the patient’s skull without any reason. This disorder is also known as Idiopathic Intracranial Hypertension or IIH which has symptoms that appear to be a Brain Tumour.  Usually, overweight women at child bearing age get affected by this disease.  
Symptoms 
Pseudotumor cerebri causes the following symptoms: 

  • Headache
  • Blurred Vision or double vision
  • Nausea and Vomiting 
  • Dizziness
  • Swelling of optic nerves 
  • Ringing sound in the ears
  • Sudden flashes of light 

Cause 
Pseudotumor cerebri is caused by over accumulation of cerebrospinal fluid around the brain and the spinal cord. Human body continuously produces this fluid to protect the brain and the spinal cord from injuries. The cerebrospinal fluid is also naturally gets absorbed by the system that maintains a perfect balance. But if more fluid is generated than it is required or less fluid is reabsorbed in the body, the quantity of cerebrospinal fluid becomes high and increases the pressure on brain. 
Diagnosis  
To diagnose Pseudotumor cerebri a medical professional initially ask the patient about the medical history and check the optic nerves with ophthalmoscope. The other tests may include: 

  • Spinal Tap or Lumber Puncture
  • CT or Computed Tomography 
  • MRI 

Treatment 
Getting treatment without delay is important in Pseudotumor cerebri. This helps save the vision. Taking quick measure in losing body weight and controlling salt intake improves the condition. Steroids and medicines used to treat glaucoma, migraine and fluid controlling are used to treat this disease. If the condition is severe surgery is also prescribed to reduce the pressure around the brain.       
 

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Primary progressive aphasia

Primary progressive aphasia 

Primary Progressive Aphasia is a rare nervous system syndrome that affects one’s ability to communicate. People affected by this condition can have trouble expressing their thoughts and understanding or finding words.
Symptoms begin gradually, often before the age 65 and it worsens over time. People with primary progressive aphasia can lose the ability to speak and write. This condition progresses slowly.
Primary progressive aphasia is a type of dementia, a cluster of related disorders that results from the degeneration of the frontal or temporal lobes of the brain, which include brain tissue involved in speech and language.
Symptoms
Primary progressive aphasia symptoms vary, depending on which portion of the brain's language areas are involved. The condition has three types, which cause different symptoms. But basically it affects the language ability initially the following:

  • Difficulty comprehending spoken or written language
  • Frequently pausing in speech 
  • Difficulty repeating phrases or sentences
  • Poor grammar in written and spoken form
  • It may be accompanied by speaking problems 

Causes
Primary progressive aphasia is caused by shrinking of certain sections (lobes) of the brain responsible for speech and language. In this case, the frontal, temporal or parietal lobes, primarily on the left side of the brain, are affected.
Complications
People with primary progressive aphasia eventually lose the ability to speak and write, and to understand written and spoken language. As the disease progresses, other mental skills, such as memory, can become impaired. Some people develop other neurological symptoms such as problems with movement. With these complications, the affected person eventually will need help with day-to-day care.
Diagnosis 
Worsening communication difficulty without significant changes in thinking and behavior for a year or two is a hallmark of primary progressive aphasia. The diagnostic tests include:
Neurological tests
Doctors might conduct a neurological examination, a speech-language evaluation and a neuropsychological evaluation. 
Blood tests
Blood tests to check  infections or other medical conditions. Genetic tests can be  advised to determine genetic mutations associated with this disease.

Brain Scan
Like MRI Scan, SPECT Scan or PET Scan
Treatment
Primary progressive aphasia can't be cured, and there are no medications to treat it. However, some therapies might help improve or maintain the patient’s ability to communicate and manage the condition. Options like Speech & Language Therapy can help control the symptoms and may slow the progression of the disease. 
 

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Naegleria infection

Naegleria is a rare type of brain infection. This is a fatal disease which caused by a type of brain eating amoeba.

Symptoms 
Symptoms of Naegleria include headache, nausea and vomiting and fever in the initial stage of the disease. In more advance stage, symptoms like stiff neck, confusion, losing balance and attention towards surroundings, hallucinations and seizures occurs. 

Cause
Naegleria occurs if Naegleria fowleri, a special type of free-living amoeba enters a human body usually through nose and travel to the brain. This amoeba is found in warm freshwater riversor lakes or springs. Most of the times swimmers or divers get it while practicing water sports.  

Diagnosis 
Naegleria infection is diagnosed through a clinical test of Cerebrospinal fluid. In addition to this doctors may also order imaging tests like CT scan or MRI.

Treatment 
A few people survive Naegleria as they are timely diagnosed. But most of the times it becomes fatal.   Several antibiotics and anti-fungal drugs are used to control this disease.  
 

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Multiple sclerosis

Multiple sclerosis 

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In this disease one’s immune system destroys the protective covering of nerves. This damage disrupts communication between the brain and the body.
Multiple sclerosis causes many different symptoms, including vision loss, pain, fatigue and impaired coordination. The symptoms, severity and duration can vary from person to person. Physiotherapy and medication can help slow disease progression.

There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.
Symptoms
Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently, while others may experience long periods of remission without any new symptoms. Some symptoms include :

  • Numbness or weakness in one or more limbs 
  • Electric-shock sensations that occur with certain neck movements
  • Tremor, lack of coordination or unsteady gait
  • Slurred speech
  • Fatigue
  • Dizziness
  • Tingling or pain in different body parts
  • Problems with sexual, bowel and bladder function
  • Vision problems like double vision, blurry vision or total loss of vision

Complications

  • Muscle stiffness or spasms
  • Paralysis, typically in the legs
  • Mental changes, such as forgetfulness or mood swings
  • Depression
  • Epilepsy

Course of the Disease
Most of the MS patients have relapsing and remitting phases. They pass through periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by periods of  remission that can continue for months or even years.
At least 50% of those with relapsing-remitting MS eventually develop a steady progression of symptoms, with or without periods of remission, within 10 to 20 years from disease onset. This is known as secondary-progressive MS.
Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses. It is known as primary-progressive MS.
Causes
The reason for developing MS is not yet clear. A combination of genetics and environmental factors may be responsible.
Risk Factors

  • Age
  • Sex
  • Family history
  • Certain infections
  • Vitamin D deficiency
  • Certain autoimmune diseases

Diagnosis

  • Blood tests
  • MRI
  • Spinal Tap (Lumbre Puncture)

Treatment
Multiple sclerosis cannot be cured. Treatment basically focuses on rapid recovery from attacks, slowing the progression of the disease and controlling MS symptoms. In some cases treatment includes Cortico steroids and Plasma exchange (Plasma Pheresis). Physical therapy,  stress relief, rest and relaxation, healthy diet help in living a better quality of life for an MS patient. 
 

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Moyamoya disease

Moyamoya disease 

Moyamoya Disease is a rare blood vessel disease that blocks or narrows the carotid artery in the skull and decrease blood flow to the brain. As a result, tiny blood vessels develops at the base of the brain in a natural attempt to supply blood to the brain. This disease may appear to anyone irrespective of age but usually symptoms start showing up within 5 to 10 years among children and 30 to 50 among adults.  
Symptoms 
Symptoms of Moyamoya Disease vary from children to adults. Children usually get stroke or recurrent transient ischemic attack (TIA). The symptoms faced by adults usually include: 

  • Headache
  • Seizures
  • Numbness or partial paralysis on the face, arm, or leg on a particular side
  • Involuntary movements of limbs
  • Visual disturbances
  • Difficulty in speaking and understanding
  • Cognitive or developmental delay

Cause 
The cause of Moyamoya Disease is not yet identified. But it is seen in Asian countries like China, Korea and Japan. It may have some common genetic factor that help developing this condition.  Moyamoya Disease also have relation with other diseases like Down syndrome, sickle cell anemia, hyperthyroidism and type 1 neurofibromatosis. 
Diagnosis 
Doctors diagnose Moyamoya Disease by physically checking the patient and asking questions about family and medical history. But to confirm this condition usually they take help of the following tests: 

  • Magnetic Resonance Imaging (MRI)
  • Computerized Tomography (CT) scan
  • Cerebral Angiogram
  • Positron Emission Tomography (PET) scan
  • Single-Photon Emission Computerized Tomography (SPECT)
  • Electroencephalogram (EEG)
  • Transcranial Doppler Ultrasound

Treatment
Treatment of Moyamoya Disease include:

  • Medications consisting blood-thinners, anti-seizure medicines and calcium blockers. 
  • Surgery that may include either ‘Direct Revascularization Procedures’ or ‘Indirect Revascularization

Procedures
Therapy mostly psychiatric with additional support of physical and occupational therapies. 
 

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Meralgia paresthetica

Meralgia paresthetica is a health condition that occurs due to compression of the particular nerve responsible for providing sensation to the upper portion of leg in human body. It develops burning pain, tingling feeling and numbness in the outer part of thigh.

Symptoms
Here are the common symptoms of Meralgia paresthetica:

  • Tingling feeling
  • Burning pain
  • Numbness and decreased sensation   
  • Intensified pain to even a light touch
  • Aggravated pain with standing or walking
  • Occurs in one side of the body

Cause 
The lateral femoral cutaneous nerve passes through abdomen to the groin and to the upper leg and supplies feeling of sensation to the upper leg. If it gets pinched or trapped under inguinal ligament this disease develops. Most of the times Meralgia paresthetica occurs as a result of the following conditions:

  • Wearing tight clothing that create pressure on the groin 
  • Pregnancy 
  • Obesity 
  • Wearing heavy tool belt 
  • Increased abdominal pressure due to abdominal fluid accumulation
  • Injury or surgery that develop scar tissue near inguinal ligament
  • Diabetes

Diagnosis 
Usually, doctors diagnose Meralgia parestheticawith the help of physical examination medical history. The confirmatory tests of this disease include: 

  • Imaging studies    
  • Nerve conduction study
  • Electromyography    
  • Nerve Blockade  

Treatment
To treat Meralgia paresthetica, three types of processes are followed: 
Conservative measure: It recommends losing weight, wearing loose fitting clothing and taking common pain relievers. 
Medication: If conservative measure doesn’t improve the condition, injection, anti-depressant medicines and anti-seizure medicines are prescribed. 
Surgery: In rare situations surgery is suggested to decompress the pinched nerve.  
 

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Brain Aneurysm

Brain Aneurysm

 

An aneurysm is a ballooning at a weak spot in an artery wall.  Aneurysms often occur in the aorta, brain, back of the knee, intestine or spleen. A ruptured aneurysm can result in internal bleeding and stroke. It can sometimes be fatal.

Aneurysms often have no symptoms until they rupture.

Treatment varies from watchful waiting to emergency surgery. The choice depends on the location, size and condition of the aneurysm.

 

Symptoms

Ruptured aneurysm

The tmain symptom of a ruptured aneurysm is sudden, severe headache. Common signs and symptoms of a ruptured aneurysm also include:

  • Nausea and vomiting
  • Stiff neck
  • Blurred or double vision
  • Sensitivity to light
  • Seizure
  • A drooping eyelid
  • Loss of consciousness
  • Confusion

Leaking aneurysm

In some cases, an aneurysm may leak a slight amount of blood. This leaking (sentinel bleed) may cause  a sudden, extremely severe headache.

Unruptured aneurysm

An unruptured brain aneurysm may occur without any symptom, particularly if it's small. However, a larger unruptured aneurysm may press on brain tissues and nerves, causing the following symptoms:

  • Pain above and behind one eye
  • A dilated pupil
  • Change in vision or double vision
  • Numbness of one side of the face

Causes

The causes of brain aneurysm are unknown, but a spectrum of factors may increase the risk.

Risk factors

A number of factors can contribute to weakness in an artery wall and increase the risk of a brain aneurysm or aneurysm rupture. Brain aneurysms are more common in adults than in children and more common in women than in men.

Risk factors that develop over time

  • Cigarette smoking
  • High blood pressure (hypertension)
  • Drug abuse, particularly the use of cocaine
  • Heavy alcohol consumption

Some types of aneurysms may occur after a head injury or from certain blood infections (mycotic aneurysm).

Risk factors present at birth

Certain conditions that date to birth can be associated with an increased risk of developing a brain aneurysm. These include:

  • Inherited connective tissue disorders
  • Polycystic kidney disease, an inherited disorder
  • Abnormally narrow aorta 
  • Cerebral arterio-venous malformation 
  • Family history of brain aneurysm

Complications

When a brain aneurysm ruptures, the bleeding usually lasts only a few seconds. The blood can cause direct damage to surrounding cells, and the bleeding can damage or kill other cells. If the pressure becomes too elevated, the blood and oxygen supply to the brain may be disrupted to the point that loss of consciousness or even death may occur.

Complications that can develop after the rupture of an aneurysm include:

  • Re-bleeding
  • Vasospasm -   blood vessels in the brain may narrow erratically (vasospasm).
  • Hydrocephalus - blood can block circulation of the fluid surrounding the brain and spinal cord (cerebrospinal fluid).
  • Hyponatremia - Subarachnoid hemorrhage from a ruptured brain aneurysm can disrupt the balance of sodium in the blood. This may occur from damage to the hypothalamus, an area near the base of the brain.

A drop in blood-sodium levels (hyponatremia) can lead to swelling of brain cells and permanent damage.

Diagnosis

The tests for detection include the following:

  • CT Scan
  • MRI
  • Cerebrospinal fluid test
  • Cerebral Angiogram

Treatment

There are two common treatment options for a ruptured brain aneurysm.

  • Surgical clipping
  • Endovascular coiling 

A newer treatment option available for brain aneurysm is Flow diverters. Flow diverters may be particularly useful in larger aneurysms that can't be safely treated with other options.

Other Treatment options aimed at relieving symptoms and managing complications include the following:

  • Pain Relievers
  • Calcium Channel Blockers
  • Anti seizure medication
  • Intervention to prevent stroke from insufficient blood flow
  • Lumber draining catheters and shunt surgery

Prevention

In order to lower the risk of its rupture the following steps can be taken:

  • Discarding smoking and use  of recreational drugs. 
  •  Healthy  fat free diet and exercise. 

 

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G
Guillain-Barre syndrome

Guillain-Barre syndrome is a rare disease in which one’s body's immune system attacks its own nerves. Usually the first symptoms are extreme weakness and tingling sensation. These symptoms can quickly spread and paralyze the whole body. Guillain-Barre syndrome, In its most severe form, is a medical emergency. Most people with the condition needs hospitalization.
 

Symptoms

  • Prickling  sensations in fingers, toes, ankles or wrists
  • Weakness in legs that spreads upwards
  • Inability to walk or climb stairs and unstable walking
  • Difficulty with facial movements, including speaking, chewing or swallowing
  • Double vision or inability to move eyes
  • Severe pain and cramp like feeling that becomes worse at night
  • Problem of bladder control or bowel function
  • Rapid heart rate
  • Low or high blood pressure
  • Breathing difficulty
     

Types
 Guillain-Barre syndrome is now known to occur in several forms. The main types are:

  • Acute inflammatory demyelinating polyradiculoneuropathy (AIDP). The most common sign is muscle weakness in the lower part of the body and spreads upward.
  • Miller Fisher syndrome (MFS). Paralysis starts in the eyes.
  • Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN).
     

Causes
The exact cause of Guillain-Barre syndrome isn't known. The disorder usually appears days or weeks after a respiratory or digestive tract infection. A surgery or vaccination can trigger Guillain-Barre syndrome. Recently, there have been cases reported following infection with the Zika virus and COVID-19 virus. 
 

Diagnosis
Guillain-Barre syndrome is difficult to detect in its early stages. Its symptoms are similar to those of other neurological disorders and may vary from person to person. The following tests may be ordered by the doctor -

  • Spinal tap (lumbar puncture
  • Electromyography
  • Nerve conduction studies  
     

Treatment
Guillain-Barre syndrome has no total cure. Apart from medications, two types of treatments can expedite recovery and reduce the severity of the illness:

  • Plasma exchange (plasmapheresis) -  Plasmapheresis may work by removing the plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves.
  • Immunoglobulin therapy - High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.

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E
Epilepsy

Epilepsy 

A disorder in which nerve cell activity in the brain is disturbed, causing seizures.
Epilepsy may occur as a result of a genetic disorder or an acquired brain injury, such as a trauma or stroke.
During a seizure, a person experiences abnormal behaviour, symptoms, and sensations, sometimes including loss of consciousness. There are few symptoms between seizures.
Epilepsy is usually treated by medication and in some cases by surgery, devices or dietary changes.
Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages.
Symptoms
Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include:

  • Temporary confusion
  • A staring spell
  • Stiff muscles
  • Uncontrollable jerking movements of the arms and legs
  • Loss of consciousness or awareness
  • Psychological symptoms such as fear or anxiety 

Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar every time. 
Types of seizures
Seizures are classified as either focal or generalized, based on how and where the abnormal brain activity begins.
Focal Seizure
Focal seizures appear to result from abnormal activity in just one area of the brain, These seizures fall into two categories:

  • Focal seizures without loss of consciousness
  • Focal seizures with loss of awareness

Generalized Seizure
Seizures that involve all areas of the brain are called generalized seizures. Six types of generalized seizures are there - 

  • Absence seizures - It  usually occur in children. They're characterized by staring into space with or without subtle body movements and a brief loss of awareness.
  • Tonic seizures -Tonic seizures cause stiff muscles and may affect consciousness. 
  • Atonic seizure – It cause  loss of muscle control.
  • Clonic seizures - Clonic seizures are associated with repeated or jerking muscle movements.
  • Myoclonic seizures - It  usually appear as sudden brief jerks or twitches and usually affect the upper body/
  • Tonic-clonic seizures -  It can cause an abrupt loss of consciousness and body stiffening, twitching and shaking. This can cause loss of bladder control or biting one’s tongue.

Causes
Epilepsy has no identifiable cause in most of the people. The  condition may be due to various factors, including:

  • Genetic influence
  • Head trauma 
  • Brain abnormalities
  • Infections like Meningitis, HIV, viral encephalitis 
  • Prenatal injury
  • Developmental disorders

Diagnosis

  • Neurological examination
  • Blood tests
  • EEG
  • CT Scan
  • MRI / Functional MRI
  • PET Scan

Treatment
The treatment of  epilepsy generally starts with medication. If medications cannot control the condition, doctors may propose surgery or other methods.
 

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Words of Appreciation

Mr. Jayanta Dutta underwent Cerebral brain surgery under the supervision of Dr. Rajan Kumar, Consultant Neurosurgeon at AMRI Mukundapaur. He talks about his experience at the hospital highlighting the entire process of treatment.

Mr. Jayanta Dutta
kolkata
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