Clinical Management of Amyotrophic Lateral Sclerosis (ALS)
By admin - April 24, 2010
There is no proper cure for Amyotrophic Lateral Sclerosis (ALS) till date. So, the emphasis is more on clinically managing the disease rather than curing the disease as such.
The following exercises and therapies are advised to the patient suffering from ALS for better quality of life:
Lite Aerobic Exercises: Exercises such as walking, swimming, and stationary bicycling are advised for strengthening the unaffected muscles. These exercises also considerably improve the cardiac condition of the patients apart from addressing the symptoms of fatigue and depression.
Motion and Stretching Exercises: Motion and stretching exercises are suggested for preventing and curing spasticity and irregular, unusual muscle contraction. But muscles should not be allowed to overwork while doing the above exercises. So they have to be carried out under the supervision of a qualified physical therapist.
Occupational Therapy: Occupational therapists generally suggest devices such as ramps, braces, walkers and wheelchairs for improving the patient’s mobility. These also help in conserving the energy of the patient.
Speech Therapy: Speech therapist services must also be utilized to help the patients, especially when they no longer can speak and depend on signs of communication.
Care Givers and Nutritionists : These people help the patient by designing the diet plan in such a way that the patient consumes little amounts of food more times. The food must also be fibrous and mostly contain fluids. In advanced stages where swallowing becomes difficult, a feeding tube must be used.
If the thoracic (chest region) muscles also get affected, use of Intermittent Positive Pressure Ventilation (IPPV) or Bilevel Positive Airway Pressure (BIPAP) is highly recommended for assisting the process of breathing during sleep.
Those patients who are in the final days of their life need to be supported by a ventilator.
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What is Eye Migraine or Ophthalmic Migraine ?
By admin - April 23, 2010
Ophthalmic migraine or eye migraine is a very common disorder. People sometimes experience a kind of zig-zag lines in their central or peripheral vision. Typical flash light sensations are noticed. The vision gets disturbed. Unlike the usual migraine where broadly similar symptoms across the population are witnessed, symptomatic variation is noticed in eye migraine.
Ophthalmic migraine only causes minor discomfort. It is not as troublesome as common migraine. Usually the symptoms are resolved without any medical intervention. It may take anywhere from a few minutes to a few hours for the symptoms to cease.
Usually eye migraine is not associated with headaches. In most of the cases, a spasm in the blood vessels behind the eye leads to eye migraine. This is quite similar to the spasm that one experiences in the lower limbs. The sensations are quite similar to Charlie-Horse, the North American colloquial term for painful muscle spasm.
There is no specific treatment as the symptoms cease and fade out without any major medical intervention. Eye migraine is mostly a one time occurrence and recurrence of symptoms is not noticed. But some people may experience recurrence. Eye examination must be carried out in such people because, usually recurrence is not associated with eye migraine as such but with an underlying systemic disorder.
However, rarely eye migraines do occur in people time and again without any under current disorder. It does not result in severe symptoms. But it does affect the quality of life to an extent. Some pills are available. The pills have to be taken under strict supervision of a general physician and a neurologist. Migraine medications usually have side effects.
No Comments - Posted in Neurology, Psychiatry
Apnea – Apnea Test for Determination of Clinical Brain Death
By admin - April 22, 2010
1.Preparation for Apnea Test
The following prerequisites are ensured before carrying out the apnea test.
Prerequisites of Body Condition
Body Temperature: 36.5°C or 97°F
Systolic Blood Pressure: 90 mm Hg
Corrected diabetes insipidus (Positive fluid balance)
Maintaining normal PCO2 (Arterial PCO2 of 35-45 mm HG)
Preoxygenate (supplying pure oxygen before a medical procedure) with 100% O2 for 30 minutes.
Connect to the pulse oxymeter (device that measures the oxygen content of the blood indirectly) and disconnect the ventilator.
Place a nasal cannula (device supplementing the oxygen of airflow) at the level of the carina and deliver 100% O2, 8 L per minute.
Monitor the respiratory movements closely (abdominal or chest excursions that produce adequate tidal volumes).
After 10 minutes measure PO2, PCO2, pH if there is any reconnect the ventilator.
7.Positive Apnea Test: If the respiratory movements are not found and arterial PCO2 is less than 60 mm Hg or 20 mm Hg more, over normal baseline PCO2, the apnea test result is determined as positive. This is enough for confirmation of brain death and no further test is needed.
8.Negative Apnea Test: If some traces of respiratory movements are found and arterial PCO2 is more than 60 mm Hg or 20 mm Hg less than the normal baseline PCO2, the apnea test result is determined as negative. This is not enough for confirmation of brain death and further tests are carried out for proper confirmation.
No Comments - Posted in Neurology