Condition - Amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in the brain and spinal cord that control voluntary muscle movement. ALS is also known as Lou Gehrig's disease.

Signs and Symptoms

The symptoms of ALS do not appear until after age 50, but they can be seen in younger people. Major symptoms include:

  • Difficulty in breathing
  • Difficulty in swallowing
  • Muscle cramps
  • Muscle contractions
  • Paralysis
  • Voice changes, hoarseness
  • Weight loss
  • Speech problems

Causes

In about 10% of cases, the disease is caused by a genetic defect. However, the cause is unknown in the remaining cases.

Treatment

There is no known cure for ALS. Treatments to control other symptoms include:

  • Baclofen or diazepam for spasticity that interferes with daily activities
  • Trihexyphenidyl or amitriptyline for people with problems swallowing on their own
Condition - Apraxia

Apraxia is a disorder of the brain and nervous system in which a person is unable to carry out tasks or movements when asked, even though:

  • The request or command is understood
  • They are willing to perform the task
  • The muscles needed to perform the task work properly
  • The task may have already been learned

Signs and Symptoms

Symptoms of apraxia of speech include:

  • Speech sounds and words may be distorted, repeated, or left out
  • Failure in pronouncing the right word
  • Problem in saying everyday phrases

Causes

Apraxia is caused by damage to the brain. The most common causes are:

  • Brain tumor
  • Dementia
  • Stroke
  • Traumatic brain injury

Treatment

Speech and language treatment may include:

  • Repeating sounds over and over in order to teach mouth movements
  • Learning to slow down how the person talks
  • Different techniques to help with communication
Condition - Brain Tumor

A brain tumor is defined as an abnormal growth of cells within the brain or the skull vault. Brain tumors include all tumors inside the cranium. They are created by an abnormal and uncontrolled cell division, usually in the brain itself, but also sometimes in lymphatic tissue, in blood vessels, in the cranial nerves, in the brain envelopes (meninges), skull, pituitary gland, or pineal gland and from congenital vest cells.

Brain tumors are classified depending on:

  • The location of the tumor
  • The type of tissue involved
  • Whether they are noncancerous (benign) or cancerous (malignant)
  • Other factors

Signs & Symptoms

The symptoms of brain tumor depend on tumor’s size, location, its spread, and whether there is swelling. The most common symptoms are:

  • Changes in person’s mental function
  • Headaches
  • Weakness in one part of the body
  • Seizures (especially in older adults)
  • Vision problems
  • Difficulty swallowing
  • Lack of control over the bladder or bowels
  • Difficulty writing or reading
  • Clumsiness
  • Personality, mood, behavior, or emotional changes

Causes

The cause of primary brain tumors is still unknown. There are many possible risk factors including:

  • Radiation therapy to the brain, used to treat brain cancers, increases the risk for brain tumors up to 20 or 30 years afterwards
  • Some inherited conditions increase the risk of brain tumors, including ineurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome
  • Lymphomas that begin in the brain in people with a weakened immune system are sometimes linked to the Epstein-Barr virus

Treatment

When a brain tumor is diagnosed, a team is formed to assess the treatment options which is presented to the patient and his/her family. Given the location, stage, and type of the growth, these are the various types of treatment options that are either used in isolation or as a combination procedure.

Neurosurgery

Complete or partial resection of the tumor/growth/clot. Besides removing the tumour, surgery is also done for the following neurological disorders:

  • Aneurysms
  • Hydrocephalus
  • Spinal tumours
  • Vascular malformations
  • Spine injuries
  • Vascular occlusions
  • Infections of the spine
  • Brachial plexus
  • Diseases of the peripheral nerve
  • Pain syndromes (chronic ischemia of brain pain or intractable pain)
  • Degenerative diseases of spine and disc problems
  • Parkinson's Disease

In times when disease and conditions spread and overlap beyond specific disciplines, our endeavor is to provide you with comprehensive and complete care under one roof. Therefore, one can get access to the following surgical techniques at Max Institute of Neurosciences.

Brain Surgery

Our Brain Surgery Program offers you comprehensive evaluation, neurodiagnostic and treatment services. Our care includes:

  • Brain Tumor surgery
  • Neurovascular surgery
  • Neuroendoscopy
  • Stereotactic and functional neurosurgery - Deep Brain Stimulation (DBS) for Parkinson's disease, Dystonias, and Tremors
  • Radio surgery
  • SRT

Spine Surgery

Our Spine Surgery Care Program includes:

  • Endoscopic Discectomy
  • MIS (Minimally Invasive Surgery)
  • Disc replacement surgery
  • Trauma
  • Interventional MR surgery
  • Surgeries for relief of pain
  • Spinal cord stimulation (for failed back surgery, complex pain, CPRS Type II, Peripheral Vascular Disease, Phantom Limb Pain)
  • Programmable Drug Infusion Pumps
  • Baclofen for Spasticity
  • Opioid for pain
  • Medication for Cranio Spinal Malignancy

Paediatric neurosurgery

Our Paediatric Neurosurgery Care Program includes:

  • Epilepsy Surgery
  • Shunt Surgery
  • Brachial Plexus Surgery
  • Congenital malformation of spine

Endovascular Neurosurgery

Endovascular Neurosurgery is performed for the following conditions:

  • Intracranial Aneurysms - Aneurysms are focal swelling of blood vessels, which can burst and cause bleeding in the brain. Endovascular coiling can treat these aneurysms, thus avoiding open surgery.
  • Angioplasty or Stent Placement - This procedure is done to treat stenosis in arteries of brain (including carotid, vertebral, intracranial arteries). Many cases of stroke occur due to stenosis (narrowing) in arteries leading to the brain. They can be treated non-invasively by endovascular route with an angioplasty or stenting procedure.
  • Stroke or Brain Attack, including intra-arterial thrombolysis - Acute stroke or brain attack usually occurs due to blockage of arteries of the brain. Appropriate patients can be treated by placing a micro catheter at the site of blockage followed by administration of thrombolytic drugs, which dissolve the blocking material.
  • Arteriovenous Malformation - Arteriovenous malformations (AVMs) of the brain are malformed blood vessels, which can cause intracranial bleeding (bleeding in brain), seizures and headache. AVMs can be treated by injecting "glue" through a microcatheter placed precisely into these abnormal blood vessels.
  • Tumour Embolisation - One of the major problems in surgical removal of intracranial tumour is bleeding during the surgery. Interventional neuroradiologist can help the surgeon by pre-operative endovascular occlusion of the blood vessels supplying the tumour. This will reduce the bleeding and facilitate the surgery.
  • Cerebral or Spinal Angiography - DSA (digital subtraction angiography) is considered as the 'gold standard' investigation to diagnose diseases of blood vessels.
  • Vertebroplasty (Minimally invasive spine procedure )- With age bones become weak and collapse of bones in the spine (vertebrae) is one of the major causes of severe back pain in the elderly. Vertebroplasty is a revolutionary treatment in which "bone cement" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain.
  • Percutaneous Sclerotherapy - Many superficial vascular malformations such as haemangioma (malformation of blood vessels) or lymphangiomas (malformation of lymphs) can be treated by puncturing through a needle, followed by injection of "sclerosant material" which causes obliteration of the malformation.

Radiotherapy

The most commonly used treatment for brain tumors where the tumor is irradiated with beta, x rays or gamma rays.

Condition - Cerebral Palsy

It is typically a group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking. There are different types of cerebral palsy such as spastic, dyskinetic, ataxic, hypotonic, and mixed.

Signs and symptoms

A complete neurological exam is critical. In older people, test for cognitive function is very crucial. Its symptoms include:

  • Delayed milestones such as controlling head, rolling over, reaching with one hand, sitting without support, crawling, or walking
  • Developing handedness before age of 18 months
  • Persistence of "infantile" or "primitive reflexes," which normally disappear 3 to 6 months after birth
  • Abnormal muscle tone
  • Abnormal movements
  • Skeletal deformities
  • Vision problems
  • Hearing loss
  • Speech problems
  • Seizures
  • Mental retardation
  • Dental problems
  • Bladder control problems

Causes

Cerebral palsy is caused by injuries or abnormalities of the brain. Premature infants have a slightly higher risk of developing cerebral palsy. Its major causes are:

  • Bleeding in the brain
  • Brain infections (encephalitis, meningitis, herpes simplex infections)
  • Head injury
  • Infections in the mother during pregnancy (rubella)
  • Severe jaundice

Treatment

There is no permanent cure for cerebral palsy. The objective of treatment is to help the person be as independent as possible.

  • Our physiotherapy experts at Max Healthcare recommend occupational therapy for children suffering from cerebral palsy. An occupational therapist helps kids with severe developmental delays learn some basic tasks such as bathing, getting dressed, brushing their teeth, and feeding themselves.
  • He also helps kids with behavioural disorders learn anger-management techniques (i.e., instead of hitting others or acting out, the children would learn positive ways to deal with anger, such as writing about feelings or participating in a physical activity).
Condition - Epilepsy

Epilepsy is a common and diverse set of chronic neurological disorders characterized by recurrent and unprovoked seizures due to alterations in structure / brain function.

Signs & Symptoms

The symptoms of epilepsy vary from person to person. The most common signs are:

  • Staring spells
  • Loss of alertness
  • Strange sensation

Causes

The most common causes of epilepsy include:

  • Traumatic brain injury
  • Infections, including brain abscess, meningitis, encephalitis, and AIDS
  • Abnormal blood vessels in the brain
  • Brain tumor
  • Metabolism disorders present at birth

Treatment

Epilepsy is usually controlled, or cured, with medication. At Max Institute of Neurosciences, we use the following programs to monitor and control Epilepsy.

Max Epilepsy Programme
  • Max Institute of Neurosciences provides comprehensive and compassionate care to adults and children with seizure disorders. Our team of highly experienced doctors and surgeons strives to ensure best results that eventually bring good quality life to people.
  • The Epilepsy Program at Max Institute of Neurosciences is led by an epileptologist.
  • Get comprehensive evaluation, neurodiagnostic and treatment services including Counseling, Education, Customized treatment plans, Medication, Physical evaluations, and Psychological report.
Condition - Fibromyalgia Syndrome

This is a kind of disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure. With fibromyalgia syndrome, the following symptoms commonly occur together:

  • Anxiety or depression
  • Decreased pain threshold or tender points
  • Incapacitating fatigue
  • Widespread pain

Signs and Symptoms

The symptoms of fibromyalgia syndrome are:

  • Swelling
  • Disturbances in deep-level or restful sleep
  • Mood disturbances
  • Abdominal pain
  • Anxiety and depression
  • Chronic headaches
  • Fatigue upon arising
  • Incontinence
  • Stiffness, numbness

Causes

The cause of fibromyalgia is currently unknown. Some causes may be:

  • Stress
  • Genetic predisposition
  • Dopamine dysfunction
  • Abnormal serotonin metabolism
  • Deficient growth and hormone secretion
  • Psychological factors

Treatment

The Department of Physiotherapy & Rehabilitation offers a unique experience by combining clinical expertise with an integrated approach to treat fibromyalgia from medications to ease pain, fatigue, and sleep problems to physical therapy, relaxation modalities, and regular exercises.

Condition - Headache

Headache is defined as pain in any part of the head including face & neck. There could be numerous reasons of headache - as the cause. There are different types of headaches including tension headaches, migraine headaches, and cluster headaches.

Headaches should be managed professionally as they can be a sign of something serious to your health. Overuse of medication can lead to other issues that can be harmful for your body.

Causes of Headaches

The most common causes of headaches are:

  • Stress
  • Depression
  • Anxiety
  • Bad posture
  • Staying in one position for a long time
  • Working in an awkward position for a long time
  • Clenching one’s jaw

Treatment

Recent advances in technology and medications have greatly helped countless headache patients.

A dedicated clinic, The Max Headache Clinic (kindly hyperlink to the clinic page/pdf), will be set up to provide excellent diagnosis and treatment of headaches.

  • Facilities for Inj Botulinum toxin available by experienced neurologists
  • The clinic is dedicated to quality diagnosis and comprehensive, individualized management of headaches and works in close cooperation with the patient's personal physician.
  • Close communication with referring physicians will be a strong goal of this Headache Clinic, as we understand that headache is a chronic disease requiring on-going treatment.
Condition - Multiple Sclerosis

Multiple sclerosis is an autoimmune disease (where the immune system attacks healthy body cells) that affects the brain and spinal cord (central nervous system) causing:

  • Loss of balance
  • Muscle spasms
  • Numbness or abnormal sensation in any area
  • Problems moving arms or legs
  • Problems walking
  • Problems with coordination and making small movements
  • Tremor in one or more arms or legs
  • Weakness in one or more arms or legs

Causes

Multiple sclerosis affects women more than men. The problem is mostly found between ages 20 and 40, but can occur at any age. Multiple sclerosis is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. Family history is another reason behind the onset of MS.

Treatment

At Max Institute of Neurosciences, the goal of treatment is to control symptoms and help you maintain a normal quality of life through dedicated care and monitoring.

The treatment includes drugs for symptom control as well as preventive future attacks.

We have an exclusive Multiple Sclerosis Clinic that offers consultations, comprehensive diagnosis and therapies for the condition.

Condition - Neck Pain (Cervical Pain)

Neck pain is a very common medical condition found in people these days. Neck pain can arise from a number of disorders and diseases of any tissues in the neck. Common neck pain conditions are whiplash, a herniated disc, or a pinched nerve.

Signs and Symptoms

Its symptoms are:

  • Pain around neck
  • Numbness
  • Weakness
  • Color changes
  • Deformity
  • Difficulty in swallowing
  • Dizziness

Causes

Major causes of neck pain include:

  • Head and neck cancer
  • Spinal disc herniation
  • Spondylosis
  • Spinal stenosis
  • Carotid artery dissection
  • Stress
  • Pinched nerve
  • Prolonged postures

Treatment

On your first visit to the physiotherapist, he or she will first determine exactly how serious the problem is. Once the most likely cause of your problem has been determined (your diagnosis has been made), you and your healthcare professional can decide on a treatment plan. One of the keys to managing back pain or neck pain is to actively engage in rehabilitation and exercise. Physical therapy helps place patients on the right track by exercising weak points and regaining strength that may have been lost.

An exercise programme should be tailored to the individual's condition and pain level, and include a combination of stretching, strengthening and aerobic conditioning. Knowing the right exercises and how to find the right trainers can be the difference between recovery and chronic pain.

The physiotherapist works to remove the cause of the damage to the spine and prevent further occurrence. Physiotherapy therefore aims to identify:

  • Faulty movement patterns, for example, excessive mobility in the lumbar spine and insufficient participation in the hips and thoracic spine results in segmental overstrain and pain.
  • Associated imbalance between muscles that have become too overactive and those that have become too weak, as a result of faulty movement patterns.
  • Joint stiffness, soft tissue tightness and tension in the nerve structures, contributing to and resulting in faulty movement patterns.

Physiotherapy then aims to correct these problems by:

  • Developing the tonic function of the deep stabiliser muscles (i.e. deep abdominals, and the gluteal/buttock muscles) to stabilise the spine initially, then
  • Re-educating the body to perform new and corrected movement patterns to redistribute the forces of movement more economically, and away from the overused vulnerable segments, and
  • Elongating shortened structures and mobilising neural tissues and facet joints in order to restore full and correct range of movement
Condition - Parkinson’s Disease

It is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination. Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging.

Symptoms may affect one or both sides of the body, and can include:

  • Slow blinking (tremors involving half of the body)
  • Constipation
  • Difficulty swallowing
  • Drooling
  • Problems with balance and walking
  • No expression in the face (like you are wearing a mask)

Causes

This disease most often occurs after age 50 and is one of the most common nervous system disorders of the elderly. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. In the absence of dopamine, the nerve cells cannot function properly which leads to the loss of muscle function. The damage gets worse with time. Exactly why these brain cells waste away is unknown.

Treatment

At Max Institute of Neurosciences, the goal of treatment is to control symptoms & make the patients able to carry out the daily living independently with us of various medicates & delaying progression.

  • Our doctors and therapists work closely with the patient to find a treatment program that works best
  • Inj Botulinum toxin by experienced neurologists
  • Deep Brain Stimulation (DBS) is a surgical technique which helps ease symptoms of Parkinson’s in some cases. It involves placing electrical stimulators in specific areas of the brain that control movement.
Condition - Parkinson’s disease

Parkinson’s disease is a kind of disorder in which the affected person feels tremors or shaking. It is a degenerative disorder of the central nervous system.

Signs and symptoms

Symptoms may affect one or both sides of the body, and can include:

  • Slow blinking
  • Constipation
  • Difficulty swallowing
  • Drooling
  • Problems with balance and walking
  • No expression in the face
  • Muscle aches and lower back pain
  • Rigid or stuff muscles
  • Stooped position
  • Memory loss

Causes

This disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly and affects both men and women. Its major causes are:

  • Family history
  • Lack of dopamine
  • Stress

Treatment

There is no known cure for Parkinson’s disease. The objective of treatment is to control symptoms.

Medications are used to control symptoms by increasing the levels of dopamine in the brain. The department of physiotherapy and rehabilitation focuses on the restoration of function in people with a wide range of disabling injuries and illnesses. The therapist deals not only with the physical aspects of injury or disease but also on the person's social, emotional and vocational well-being.

Condition - Stroke

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage, i.e, rupture of blood vessel. As a result, within minutes the affected area of the brain cannot function, which might result in the inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field, deviators of face, difficulty swallowing /chewing.

There are two major types of stroke: ischemic stroke and hemorrhagic stroke. Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open, causing blood to leak into the brain.

Signs & Symptoms

The symptoms of stroke depend on what part of the brain is damaged. The most common symptoms include:

  • Headaches
  • Changes in hearing ability
  • Confusion or loss of memory
  • Difficulty swallowing
  • Trouble walking
  • Muscle weakness in the face, arm, or leg (generally on one side)

Causes

High BP is the most primary reason for strokes. The other risk factors include:

  • Diabetes
  • Family history of stroke
  • High cholesterol
  • Aging, especially after age 55
  • Alcohol consumption
  • Smoking

Treatment

Max Institute of Neurosciences provides complete management of stroke including primary stroke prevention, emergency management of stroke and after stroke management.

Primary Stroke Prevention

Identification of potential & reversible stroke risk factors

Emergency Management of Stroke
  • Thrombolytic Therapy of stroke using rt-Pa (the institute has the expertise of emergency Stroke imaging and experienced Stroke Neurologist) (Intra-arterial)
  • Neurointerventional therapy of selected cases of stroke with the help of Interventional Neuroadiologist.
  • Comprehensive treatment for hemorrhagic stroke available

After Stroke Management
  • This is performed in a dedicated 8-bedded sophisticated Stroke unit with the help of experienced Neurocritical care team.
  • Use of Inj Botulinum toxin for post stroke spasticity

Stroke Rehabilitation
  • Comprehensive neurorehabilitation and long-term, risk-factor modification programs are available through the Cerebrovascular Center in conjunction with the Department of Physical Medicine and Rehabilitation. Under the direction of Neurologist, patients learn to maximize their function and resume normal activities to the fullest extent possible.
  • Acute stroke therapies must be initiated within 4.5 hours after the onset of symptoms in order to be effective. The sooner acute Thrombolytic therapy is initiated, the greater the probability of limiting or reversing brain damage. Rapid access to these therapies is absolutely essential.