Neurology

A seizure is a burst of uncontrolled electrical activity between brain cells (also called neurons or nerve cells) that causes temporary abnormalities in muscle tone or movements (stiffness, twitching or limpness), behaviors, sensations or states of awareness.

Seizures are not all alike. A seizure can be a single event due to an acute cause, such as medication. When a person has recurring seizures, this is known as epilepsy.

Symptoms

• Seizures symptoms vary and can include a sudden change in awareness or full loss of consciousness, unusual sensations or thoughts, involuntary twitching or stiffness in the body or severe stiffening and limb shaking with loss of consciousness (a convulsion.)
• There are two major classes or groups of seizures: focal onset and generalized onset.
• Focal onset seizures start in one area and can spread across the brain and cause mild or severe symptoms, depending on how the electrical discharges spread.
• Generalized seizures can start as focal seizures that spread to both sides of the brain. They also can occur as “generalized onset” seizures in which seizure activity starts simultaneously over both sides of the brain. Generalized onset seizures usually start during childhood and are similar to a thermostat surge or a light flash — abnormal regulation between parts of the brain causes the seizures.
• Seizures of all kinds are most commonly treated with medication, and, if they are difficult to control, with diet therapy, nerve stimulation or surgery.

Migraine: In this type of headache, symptoms other than pain occur as part of the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual symptoms typically occur with migraines. Migraines also have distinct phases. Not all people have each phase, however. The phases of a migraine headache may include:

• Premonition or prodromal phase. A change in mood or behavior may occur hours or days before the headache.
• Aura phase. A group of visual, sensory, or motor symptoms can precede the headache. Examples include vision changes, hallucinations, numbness, changes in speech, and muscle weakness.
• Headache phase. Period during the actual headache with throbbing pain on one or both sides of the head. Sensitivity to light and motion are common, as are depression, fatigue, and anxiety.
• Resolution phase. Pain lessens during this phase, but may be replaced with fatigue, irritability, and trouble concentrating. Some people feel refreshed after an attack, others do not.

Symptoms

• Individual migraines are moderate to severe in intensity
• Characterized by a throbbing or pounding feeling
• Frequently one-sided, but may occur anywhere on the head, neck and face
• Typically associated with sensitivity to light, noise and/or smells
• Nausea is common and it worsens with activity

A stroke, or brain attack, happens when blood flow to your brain is stopped. It is an emergency situation. The brain needs a constant supply of oxygen and nutrients in order to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen. When brain cells die, brain function is lost. You may not be able to do things that are controlled by that part of the brain. For example, a stroke may affect your ability to:

• Move
• Speak
• Eat
• Think and remember
• Control your bowel and bladder
• Control your emotions
• Control other vital body functions

A stroke can happen to anyone at any time.

Symptoms

Stroke symptoms may happen suddenly. Each person’s symptoms may vary. Symptoms may include:

• Weakness or numbness of the face, arm, or leg, usually on one side of the body
• Having trouble speaking or understanding
• Problems with vision, such as dimness or loss of vision in one or both eyes
• Dizziness or problems with balance or coordination
• Problems with movement or walking
• Fainting (loss of consciousness) or seizure
• Severe headaches with no known cause, especially if they happen suddenly

Other less common symptoms of stroke may include:

• Sudden nausea or vomiting not caused by a viral illness
• Brief loss or change of consciousness, such as fainting, confusion, seizures, or coma
• TIA, called a mini-stroke

A TIA can cause many of the same symptoms as a stroke. But TIA symptoms are passing. They can last for a few minutes or up to 24 hours. Call for medical help right away if you think someone is having a TIA. It may be a warning sign that a stroke is about to occur. But not all TIAs are followed by a stroke.

Dementia is a general term for a syndrome that involves impairment in multiple aspects of mental ability, and is sufficiently severe that an individual cannot function independently.

Causes of dementia

There are many diseases that cause dementia, including:

• Alzheimer’s disease
• Corticobasal Degeneration
• Creutzfeldt-Jakob disease
• Dementia with Lewy Bodies
• Frontotemporal Dementia
• HIV Dementia
• Huntington’s disease
• Normal Pressure Hydrocephalus
• Vascular Dementia

There are other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, brain tumors, anoxia or hypoxia, and heart and lung problems. A comprehensive work-up is therefore indicated for all patients who develop symptoms of dementia.

Symptoms

• Mood and personality changes
• Difficulty with words and language
• Poor judgment
• Confusion regarding familiar places and time, date and season
• Inability to concentrate or think clearly
• Difficulties with gait or balance
• Increased daytime sleepiness
• Apathy

Visual hallucinations

Dizziness and vertigo are symptoms of a vestibular balance disorder. Balance disorders can strike at any age, but are most common as you get older.

Your ear is a complex system of bone and cartilage. Within it is a network of canals. These are called semicircular canals. The canals are filled with fluid. The position of the fluid changes with movement. A sensor in the ear then sends the information to your brain to contribute to your sense of balance. These and other delicate pieces make up the vestibular system.

Symptoms

Certain things can affect the signals from any of the parts of the vestibular system causing symptoms.

• Dizziness or vertigo (a spinning sensation).
• Falling or feeling as if you are going to fall.
• Staggering when you try to walk.
• Lightheadedness, faintness, or a floating sensation.
• Blurred vision.
• Confusion or disorientation.

Other symptoms might include nausea and vomiting; diarrhea; changes in heart rate and blood pressure; and fear, anxiety, or panic. Symptoms may come and go over short time periods or last for a long time, and can lead to fatigue and depression.

Sleep disorder covers a wide range of conditions and symptoms, but sleep disorders can be broken down into various types.

• Primary sleep disorders aren't caused by another medical or psychological condition.
• Secondary sleep disorders are the result of another medical problem, such as depression, thyroid problems, stroke, arthritis, or asthma.

Types of primary sleep disorders

Primary disorders can be divided into parasomnias and dyssomnias.

• Parasomnia sleep disorders cause abnormal activities during sleep, such as sleep terrors or sleep walking.
• Dyssomnia sleep disorders cause trouble falling asleep or staying asleep. Perhaps the most well known dyssomnia is obstructive sleep apnea.

Symptoms

• Being sleepy during the daytime and having trouble falling asleep at night
• Falling asleep at inappropriate times
• Unusual breathing patterns when trying to sleep
• Unusual or bothersome movements or experiences during sleep
• Irregular sleep and wake cycles

Multiple sclerosis (MS) is a long-lasting (chronic) disease of the central nervous system. It is thought to be an autoimmune disorder, a condition in which the body attacks itself by mistake. MS is an unpredictable disease that affects people differently. Some people with MS may have only mild symptoms. Others may lose their ability to see clearly, write, speak, or walk when communication between the brain and other parts of the body becomes disrupted.

Symptoms

Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination. Parkinson’s disease most commonly begins with a tremor in one hand but can also cause limb stiffness or slowness of movement without tremor. Or, perhaps, someone else may notice that you’re not swinging your arm normally as you walk. 

Symptoms

• Tremor in hands, arms, legs, jaw, or head
• Muscle stiffness, where muscle remains contracted for a long time
• Slowness of movement
• Impaired balance and coordination, sometimes leading to falls

Other symptoms may include:

• Depression and other emotional changes
• Difficulty swallowing, chewing, and speaking
• Urinary problems or constipation
• Skin problems

Neuromuscular diseases affect the function of muscles due to problems with the nerves and muscles in your body. The most common sign of these diseases is muscle weakness.

Neuromuscular disorders affect the nerves that control voluntary muscles and the nerves that communicate sensory information back to the brain. Nerve cells (neurons) send and receive electrical messages to and from the body to help control voluntary muscles. When the neurons become unhealthy or die, communication between the nervous system and muscles breaks down. As a result, muscles weaken and waste away (atrophy).

Symptoms

These disorders result in muscle weakness and fatigue that progress over time. Some neuromuscular disorders have symptoms that begin in infancy, while others may appear in childhood or even adulthood. Symptoms will depend on the type of neuromuscular disorder and the areas of the body that are affected.

Some symptoms common to neuromuscular disorders include:

• Muscle weakness that can lead to twitching, cramps, aches and pains
• Muscle loss
• Movement issues
• Balance problems
• Numbness, tingling or painful sensations
• Droopy eyelids
• Double vision
• Trouble swallowing
• Trouble breathing

Types of neuromuscular disorders include:

• Amyotrophic lateral sclerosis (ALS)
• Charcot-Marie-Tooth disease
• Multiple sclerosis
• Muscular dystrophy
• Myasthenia gravis
• Myopathy
• Myositis, including polymyositis and dermatomyositis
• Peripheral neuropathy
• Spinal muscular atrophy