What to Avoid When Someone is Having a Stroke?

Stroke is often known as a silent killer because it can happen without any warning and remains as one of the leading causes of death and disability around the world. When someone experiences a stroke, there is an immediate stop of the blood supply to the brain. The blood flow stops because a blood vessel ruptures or there is a blockage in a blood vessel. It is a deadly instance because people can have a stroke and not know about it, leading to a permanent damage in the brain. Stroke is a severe medical condition that requires immediate medical intervention. We at Max Healthcare have a dedicated centre of neurosciences and the best neurologist in Delhi for stroke treatment.

Stroke can be life-threatening and can even lead to permanent disability. There are certain essential things that a person suffering from stroke or the ones near them must follow in case of such an instance.

Here are things to avoid when someone is having a stroke:

Do not Let the patient Go to Sleep

It is important not to let the person who’s experiencing a stroke to go to sleep. People who have a stroke usually feel sleepy, and all that happens suddenly without any warning signs. Stroke treatment is time sensitive and letting a person sleep can be life-threatening. Even if the person is refusing to visit a hospital, it is important to call an ambulance and take them before any considerable damage.

Do not Drive them to the hospital

It is never advisable to drive a stroke patient to the hospital and never let the person drive themselves as stroke can impair the ability to drive safely. Always call an ambulance whenever someone is a having a stroke. Ambulances are equipped with necessary life-saving equipment, drugs and healthcare professionals who can immediately save the life of the patient. Emergency responders can start life-saving treatment as soon as they reach the patient which can help minimise damage.

Refrain from giving the patient anything to Eat or Drink

It is better to avoid eating or drinking when the person is experiencing a stroke. Since a stroke can cause muscle weakness throughout the body and can even lead to paralysis, a person suffering from a stroke can choke on food, water and have difficulty in swallowing.

Do not Give Them Any Medication

Do not self-medicate the person having a stroke. Usually, people believe that giving aspirin will help, but it does not because it is not always a blood clot that causes a stroke. It can be caused by a ruptured blood vessel and giving aspirin in such a situation will make the bleeding worse. To maximise chances of survival, it is essential to call an ambulance right away.

The points mentioned above are critical and must be followed without fail. A stroke can be deadly and life-threatening, so it is crucial never to delay in seeking medical attention. Most people will wait and observe if the symptoms will improve; however, it is one of worst things to do as it increases the chances of death or disability significantly. Remember, every second count when someone is experiencing a stroke. So, act wisely and fast!

Dr. Manoj Khanal is one of the Best Stroke Specialist in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.

Everything You Need to Know About Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis, also known as ALS, is a nervous system disease in which the neurons in the brain, as well as spinal cord, are attacked. The function of the neurons is to transfer messages from the brain and spinal cord to the voluntary muscles. The voluntary muscles are the ones which can be controlled, like in the arms and legs. ALS being a progressive disease can get worse as time passes. As it affects the nerves in the brain and spinal cord that control the muscles, the muscles get weaker and, this creates difficulty in walking, talking, eating, and even breathing. One should visit a brain hospital as soon as these symptoms start to appear.

Symptoms of Amyotrophic Lateral Sclerosis (ALS)

Some of the earliest signs of ALS include:

  • Constant tripping and falling
  • Difficulty in walking or doing the normal daily activities
  • Weakness in hand or clumsiness
  • Difficulty holding the head up or maintaining a good posture
  • Weakness in leg, feet or ankles
  • Muscle cramps and twitching in arms, tongue, and shoulders
  • Trouble swallowing or slurred speech

Types of ALS

There exist two main types of ALS:

  • Sporadic ALS: This being the most common form of ALS, affects up to 9 percent of individuals diagnosed with the disease. Sporadic means it sometimes happens without an apparent cause.
  • Familial ALS (FALS): This type of ALS runs in families. However, only 5 to 10 percent of individuals with ALS have this type. A faulty gene passes to the children through their parents. If one parent has the ALS gene, each of their children will have a 50 percent chance of inheriting the gene and being diagnosed with the disease.

Causes of ALS

ALS is inherited in 5 to 10 percent of cases, while the remaining cases have no known cause. As per the researchers, these could be the several possible causes of ALS:

  • Chemical Imbalance: Individuals with ALS usually have higher than normal levels of glutamate, which can be toxic to some nerve cells. Glutamate is a chemical messenger present in the brain, near the nerve cells in their spinal fluid.
  • Gene Mutation: Many genetic mutations can lead to inherited ALS, which has almost similar symptoms as the non-inherited form.
  • Protein Mishandling: Mishandled proteins present inside the nerve cells may accumulate which can eventually destroy the nerve cells.
  • Disorganized Immune Response: At times an individual’s immune system starts attacking some their normal cells, which may kill the nerve cells.

Risk Factors for ALS

Some of the established risk factors for ALS are:

  • Heredity: 5 to 10 percent of the individuals with ALS inherited it, which is known as familial ALS.
  • Age: The risk of ALS increases with age and people between the ages of 40 and 60 are more prone to be diagnosed with this disease.
  • Sex: Slightly more males than females develop ALS before the age of 65. This sex difference tends to disappear after age 70.
  • Genetics: There exist certain similarities in the genetic variations of individuals with familial ALS and some individuals with non-inherited ALS. These genetic variations might make individuals more vulnerable to ALS.

Treatment of ALS

Damage done by amyotrophic lateral sclerosis cannot be cured by treatments, however; medicines can slow the progression of symptoms, prevent complications and make an individual more independent as well as comfortable. One may require an integrated team of doctors skilled in multiple areas and other healthcare professionals to offer the right care. Doing this may prolong a patient’s survival and improve their quality of life.

Dr. Manoj Khanal is one of the Best ALS Doctor in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.

What Do You Need to Know About Locked-In Syndrome?

There are over 600 neurological disorders. Each one has its own shocking complications and symptoms that prove the fact that human mind is way more complex than what we conceive. Even a simple defect in the smallest of the nerves can result in challenging complications.

While you may have heard of common neurological conditions like brain tumor disease or may even know about brain stroke symptoms or brain tumor treatment, there are various other neurological conditions you might have never heard. One such rare neurological disorder is “Locked-In Syndrome”.

Also known as pseudocoma, Locked-In Syndrome (LIS) is a condition in which the patient loses the ability to move all voluntary muscles except for some like blinking of the eyes. To put it in simple words, the patients suffer from a complete paralysis where though they are aware of their surroundings, it is impossible for them to make any movement or use verbal communication. Another condition known as total locked-in syndrome causes paralyses even to the eyes; thus, barring communication.

Here is what you need to know about locked-in syndrome:

Signs and Symptoms

The syndrome is mainly characterized by the complete loss of movement in the voluntary muscles. However, there are some other signs and symptoms as well which may vary from one patient to another.

Patients suffering from locked-in syndrome are not able to speak or make any facial movement. The only way they can communicate is through blinking or eye movements. They can understand everything that happens around them and recognize people as their cognitive function remains unaffected during locked-in syndrome.


Locked-in syndrome is often caused by damage to a specific part of the brain known as pons which contains the important neuronal pathways between the cerebellum, spinal cord and cerebrum. A damage to this part interrupts the movement of motor fibers running from grey matter in the brain causing paralysis. Here are some of the causes and conditions that may lead to locked-in syndrome:

  • Amyotrophic Lateral Sclerosis (ALS)
  • Brainstem stroke
  • Traumatic brain injury
  • A stroke or brain hemorrhage
  • Lesion of the brain stem
  • Infection in the certain part of the brain
  • Poisoning from krait bite or other neurotoxic venoms


There are various other disorders like Akinetic mutism and a Guillain–Barré syndrome that exhibit symptoms similar to that of locked-in syndrome. This makes it difficult to recognize the occurrence of locked-in syndrome and hence the delay in treatment. Therefore, it is vital that one should seek medical consultation from hospitals that have an excellent neurological department.

We at Max Healthcare have highly experienced neurologists who have specializations in all type of neurological disorders and neurosurgery like brain tumor surgery. Some of the diagnostic tests that are performed for locked-in syndrome include Magnetic Resonance Imaging, Magnetic Resonance Angiography and Electromyography.


Though there is no specific treatment for locked-in syndrome, there are some therapies and supportive care methods that can increase the chances of recovery. In most of the cases, the doctors try to treat the underlying cause of the syndrome. They may also recommend tracheotomy to aid the patient in breathing.

Furthermore, to ensure that the patient gets enough nutrition, gastrostomy (where a feeding tube is inserted in the stomach) is performed as feeding and drinking via mouth is not possible. A special therapy called functional neuromuscular stimulation can also be used to stimulate muscle reflexes which can activate paralyzed muscles.

Another essential and effective treatment option is care, support and hope of the family members who can help the patient fight this unfortunate condition.

Dr. Manoj Khanal is one of the Best Neurologist in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.

Can You Have A Healthy Pregnancy If You Are Suffering From MS?

Also known as MS, Multiple Sclerosis is an autoimmune disorder that affects the brain and spinal cord. Unfortunately, in cases of many women, the diagnosis comes at a stage when they are about to plan a pregnancy. Several studies have shown that pregnancy, delivery, and rate of congenital disabilities are no different in women with MS when equated to those without MS. The good part is that there are no substantial evidence of MS causing infertility.

In the past, women with MS were advised not to start a family as the condition may keep them away from giving proper care to their newborn baby. In addition, it was also presumed that pregnancy might worsen the symptoms.

So, if someone is fighting hard with MS and wishes to plan a pregnancy, the advice is to seek consultation from the best neurologist in Gurgaon to better understand the chances of having a healthy pregnancy.

Living with MS While Pregnant

Luckily, the picture today is somewhat different. Multiple studies have shown that pregnancy reduces the chances of relapse and this mainly happens in the third trimester. However, if someone has unrecognized MS, they are more likely to start having symptoms during pregnancy. The incapacitating effects of MS may make it substantially hard to carry a pregnancy without any complications. Coordination problems and muscle weakness may surge the likelihood for falls. Furthermore, fatigue may worsen. With fatigue, wheelchair dependence may increase and so the risk of encountering UTIs.

Keeping the above things in mind, during pregnancy, women need regular and close monitoring to keep track of the condition and overall health of the baby. They may also require recurrent prenatal visits. Though, no standard treatment modifies the course of MS; there are medicines such as steroids and anti-inflammatory drugs that may help.

During pregnancy, rehabilitation and supportive treatment become especially important. Rehabilitation differs depending on the symptoms, but may help in:

  • Performing everyday activities
  • Getting the family involved
  • Being independent
  • Using canes, walkers and other assistive devices
  • Enhancing motor skills
  • Refining communication skills in those having trouble speaking caused by weakness or lack of coordination between face and tongue muscles
  • Dealing with bowel or bladder incontinence

Will There Be Any Complications in Breastfeeding?

Multiple Sclerosis does not carry any obstacle in breastfeeding. However, because it is still not clear whether disease-modifying drugs are passed in breast milk, most neurologists advise not to resume therapy until the time someone is breastfeeding. However, there is always an option to resume therapy and formula-feed the baby. Neither of them is right or wrong, as in the end only the mother can decide what is best for them and the baby.

The Role of Neurologist While Pregnant

The neurologist plays a significant role when someone is trying to conceive and that during pregnancy. They also have an opinion about therapy options that will work well in having a smooth pregnancy and prevent relapse after the delivery. Thus, the need of seeking consultation from the best neurologist in Gurgaon. Furthermore, some neurologists also prescribe intravenous immunoglobulin (IVIG) immediately after childbirth to significantly reduce the risk of postpartum relapse. On the other hand, some neurologists may recommend one or several doses of intravenous corticosteroids for the same purpose.

Is There Any Treatment Available for Parkinson’s Disease?

Parkinson is the 2nd most common neurodegenerative disorder that causes a progressive deterioration of motor function due to a loss in dopamine-producing brain cells. Moreover, this condition can significantly cause a reduction in the movements.

In Adults, the onset of Parkinson’s disease is the most common, an early onset can occur between 21-40 years of age, while the juvenile onset is less than 21 years. Dr. Manoj Khanal, Senior Consultant, Neurology, Max Super Speciality Hospital, Shalimar Bagh, says most cases are idiopathic; 5 genes are implicated (SNCA; PARK2; PARK7; LRRK2; PINK1).

What are the risk factors and its symptoms?

The risk factors include:

  • AGE (largest risk factor) more than 60 years
  • SEX (male:female)
  • Head trauma
  • Illness
  • Environmental toxins like pesticides
  • Herbicides

Main symptoms are:


Is there any diagnosis available?

For diagnosis:

1. At least two of the three major symptoms should be present (Tremor; muscle rigidity; slowness)

 2. Onset of symptoms started on one side of body

3. No secondary cause like medications; infection; stroke; metabolic cause;

4. Significant improvement with levodopa.

What is the treatment?

There is no treatment to cure the disease. The experts say that the treatment provided will only reduce the symptoms and progression of the disease. However, the most effective therapy is LEVODOPA+ CARBIDOPA, which is meant to increase the amount of dopamine in the brain. The treatment should be provided as early as possible to delay the progression of the disease.

Surgery and Deep Brain Stimulation (DBS) are meant in refractory cases. Parkinson is not a fatal disease. Those on proper medications can lead a normal life for several years. Secondary complications like pneumonia, fall-related injuries and choking can lead to death.

To manage the disease effectively, you need to:

  • Make lifestyle changes
  • Exercise Regularly
  • Physiotherapy
  • Occupational therapy
  • Speech therapy

You need to meet an expert neurologist to seek correct medical intervention.

Dr. Manoj Khanal is one of the Best Parkinsons Specialist in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.

Explained – The Common Types of Tremors

A tremor is different from a muscle twitch or any muscle spasms. It is actually an unintended and overpowering movement of one limb or one part of the body- typically the legs, hands, face, voice, abdomen or arms. They might not be serious but in some cases, they can be an indication of a serious health disorder. This neurological disorder can affect both women and men.

Common Causes of Tremors

  • Alcohol abuse
  • Stress
  • Too much caffeine intake
  • Muscle fatigue
  • Stroke
  • Brain injury
  • Multiple sclerosis
  • Hyperthyroidism
  • Parkinson’s Disease
  • Low blood sugar levels
  • Essential Tremor (Unknown )

What are its Symptoms?

  • Difficulty drawing or writing
  • Shaking of hands, torso, legs, head or arms
  • Shaky voice and nodding head
  • Problem carrying out tasks like holding a spoon or controlling the action of the limbs

If any of these symptoms appear repeatedly, it’s advisable to consult a specialist

Types of Tremors

Tremors are divided into two main categories –

  1. Resting Tremor – usually affecting the fingers or the hands, resting tremors occur when a person is resting and goes away once they begin to move around.
  2. Action Tremor – tremors that occur with any voluntary movement of a muscle. Furthermore, action tremors have several sub-classifications, many of which overlap.
    • Kinetic tremor– Caused by any voluntary movement like blinking of eyes and movement of the wrists
    • Postural tremor– Occurs when maintaining a position against gravity
    • Isometric tremor– Occurs during a voluntary muscle contraction such as holding a dumbbell or a heavy book
    • Task-specific tremor– This type occurs only when performing specific tasks like speaking or writing
    • Intention tremor– Occurs when the limb is guided to move towards a specific body part and becomes worse when it gets closer to the target

Categories of Tremor

  • Essential Tremor– Also known as familial tremor, Essential tremor is a common movement disorder which is usually mild and may not progress. The tremor usually starts from one side of the body and slowly progresses to the other. Recent studies have connected Essential tremor with mild degeneration in the cerebellum.
  • Dystonic Tremor– Occurring irregularly, Dystonic tremor can be relieved by resting. This tremor usually occurs in people suffering from dystonia. This tremor can occur at any age.
  • Parkinsonian Tremor– Often stated as the first sign of Parkinson’s disease, Parkinsonian Tremor is a resting tremor and is common in people above the age of 60. It occurs when parts of the brain that control the movements are damaged.
  • Psychogenic Tremor– Also known as functional tremor, psychogenic tremor has no particular characteristic and can appear in any form of tremor. Psychogenic tremor usually starts abruptly and may affect all parts of the body in the long run.
  • Physiologic Tremor– A physiologic tremor is caused by a reaction to alcohol withdrawal, certain drugs, or medical conditions, such as an overactive thyroid gland or hypoglycaemia. It usually goes away after the cause of the tremor is eliminated.
  • Cerebellar Tremor– Controlling movement and balance of the body, the cerebellum is part of the hindbrain. A cerebellar tremor is usually caused when a tumour or any disease like multiple sclerosis damages the cerebellum. Furthermore, Cerebellar tremor can also be caused by alcoholism or overuse of any medication.
  • Orthostatic Tremor– An orthostatic tremor usually occurs in the legs. This is a swift, recurring muscle contraction that arises instantly after someone stands. There are no medical signs or symptoms of Orthostatic Tremor. The unsteadiness stops when the person sits, legs are lifted, or when they start taking steps.

Are there any treatment Options available?

  • Medication
  • Botox Injections
  • Brain Stimulation Surgery
  • Physical Therapy

We at Max Healthcare are proud to be labelled as the best neuro hospital in Delhi. We have an excellent panel of doctors with years of expertise in the neurology department. If you experience any of the signs and symptoms indicating any kind of tremors, immediately consult a specialist at any of our closest centres for immediate diagnosis and treatment of the condition. Remember, tremor is not life-threatening. However, it can over the time making it difficult to carry out daily tasks.

A Health Guide to Multiple Sclerosis!

In multiple sclerosis, the communication within the brain, and brain and body is disrupted. Multiple Sclerosis is a chronic, unpredictable and often a disabling disease which affects the central nervous system, spinal cord, and optic nerves. It is categorized as an autoimmune disease caused by the immune system attacking and damaging the nervous system.

Cause and Risk Factors

The cause of Multiple Sclerosis is still not known. However, there is an interaction of several factors that may be involved in Multiple Sclerosis. An extensive ongoing research is being carried out in the areas such as genetics, immunology (the science of body’s immune system), and epidemiology (the study of patterns of disease in the population). Keeping the research in mind, Multiple Sclerosis causes can be classified into four categories.

Immunologic Factors

Multiple Sclerosis occurs when the immune system attacks the nervous system. In recent years, researchers have identified the immune cells that initiate the attack and factors that cause the immune cells to attack.

Environmental Factors

Epidemiologists have found that Multiple Sclerosis is more prevalent in areas that are farther from the equator. There is enough evidence that shows that Vitamin D plays a significant role in strengthening the immune system and people who are exposed to more sunlight throughout the year have lesser chances of Multiple Sclerosis.

Genetic Factors

Multiple Sclerosis is not genetic. However, having a first-degree relative such as a parent or sibling with Multiple Sclerosis increases the chance of developing the disease. Researchers are studying common genetic factors in families where Multiple Sclerosis is present in more than one person.

Infectious Factors

Any initial exposure to certain viruses, bacteria, and other microbes during childhood can be a cause of Multiple Sclerosis in the future. Since viruses are well-recognized as being the triggers of demyelination – the removal of the myelin sheath from a nerve fibre can lead to Multiple Sclerosis.


Multiple Sclerosis can threaten the life of patient depending on the symptoms and severity of the condition. The symptoms vary from person to person, and there is no ‘standard’ set of indicators.

Multiple Sclerosis symptoms are broadly categorized into 3 types –

Motor Symptoms (Changes in Muscle Function)

  • Weakness
  • Tremor
  • Difficulty walking
  • Stiffness
  • Poor Coordination
  • Bowel/Bladder problems

Sensory Symptoms (Changes in Sensation)

  • Tingling
  • Numbness
  • Dizziness or Vertigo
  • Visual disturbances
  • Abnormal sensations

Other Symptoms

  • Fatigue
  • Heat sensitivity
  • Sexual symptoms
  • Cognitive changes
  • Emotional changes

Multiple Sclerosis differs from person to person, and each patient has their own set of symptoms. There are also individuals who have mild Multiple Sclerosis and may never know that they have it, while for others it can be severe. Basis the signs, symptoms and severity, Multiple Sclerosis is classified in the following ways –

Relapsing-remitting (RRMS)

Patients have occurrences of symptoms, with or without recovery, but between attacks, there is no interval worsening.

Secondary Progressive (SPMS)

This stage comes few years after relapsing-remitting and the pattern change from a relapsing one to a progressive one in between the attacks.

Primary Progressive (PPMS)

Gradual onset from the beginning with no attacks

Progressive-Relapsing (PRMS)

One of the rare forms of Multiple Sclerosis, it begins with a progressive course which later transforms into developing attacks.


A rare yet extremely severe and rapidly progressive Multiple Sclerosis

Diagnosis and Testing

Multiple Sclerosis is often difficult to diagnose because there is no single diagnosis or test for finding out if the person suffers from it or not. Since the symptoms vary from person to person, neurologists have to take the history of neurological symptoms into account.

A neurological examination may suggest problems with the spinal cord or brain. Imaging studies help to confirm a diagnosis of multiple sclerosis. MRI is the most common test done to help diagnose the disease since it can be used to image the brain and spinal cord.

Furthermore, a spinal tap or lumbar puncture is done to collect a small amount of cerebrospinal fluid which is used to confirm the presence of proteins, inflammatory markers or other substances. A spinal tap is generally not necessary if MRI scans are not abnormal.

When neurologists suspect multiple sclerosis in a patient, other tests are also conducted to check for diseases such as Lyme disease, lupus, vasculitis, HIV and process which can lead to multiple strokes.


Several considerations are taken into account for Multiple sclerosis treatments. Once MS is confirmed in a patient, modifying therapy is recommended which controls the occurrence of symptoms.

At Max Institute of Neurosciences, our goal is to control symptoms and help the patient maintain a healthy life by providing dedicated care and monitoring. The treatment includes drugs for controlling symptoms to prevent attacks in the future. At Max, we have an exclusive Multiple Sclerosis Clinic that offers consultation, comprehensive diagnosis and therapies for the condition.

Dr. Manoj Khanal is one of the Best Neurologist in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.

Looking for a Neurologist? Here are 5 Tips to Choose One

To receive the best medical care, you should always first consult your primary care doctor. Your primary care doctor will be able to recommend you a neurologist basis your condition. However, in cases of emergencies, it makes sense to consult a specialist.

Neurology is a broad and complex field of medicine that deals with the disorders of the nervous system. It specifically deals with the diagnosis and treatment of all diseases involving the central, peripheral and autonomic nervous systems. A neurologist is an expert who treats diseases in the brain and spinal cord, peripheral nerves, and muscles. Neurological diseases can include epilepsy, headaches, stroke, and movement disorders like a tremor or Parkinson’s disease.

If you or a family member have been diagnosed with any of these diseases, then consulting a neurologist should be the first thing must do. Remember, it is a personal decision, albeit an important one.

If you are looking for a neurologist, here are five tips to choose one –

Get Referrals

Start by reviewing the references provided by your primary care doctor. If you don’t have a family doctor, ask friends, family and other healthcare providers for recommendations. Take time and research the credentials and experience of every doctor in the list. As you are narrowing down the list, ask for a consult appointment with the neurologist and see if you want to continue with them.

Consider the Neurologist’s Experience

The experience of the doctor matters when you or a family member is facing a severe neurological illness. The more experience a neurologist has with treating a particular condition, the better your chances of getting better. Ask the consulting neurologist about their experience, and how many patients they have successfully treated. For instance, if you are a patient of multiple sclerosis, then ask the neurologist about their experience in treating this condition.

Hospital Quality

Remember, your doctor’s hospital is your hospital. Consider the quality of care given by the hospital and what are the facilities available for patients. Hospital quality is a highly critical factor because the patients at top-rated hospitals suffer from fewer complications and have better survival rates. You can also bring the location of the hospital in the account and see if the proximity of location is a necessity for you. Closer the hospital, the better are your chances of reaching there in a case of a mishap. For instance, if you are based out in Delhi or the NCR region, Max Healthcare has the best neurologist in Delhi.

Communication Style and Approachability

A doctor must be easily approachable, one with whom you feel comfortable talking and who shows absolute transparency in your treatment. Since neurological diseases are complex and require an extensive study of patient’s history, you must be able to communicate freely with the neurologist. Treating neurological diseases hinge more on discussions than sophisticated scans. Look how welcoming the neurologist is, and if they answer all your questions. Ensure that there is a suitable amount of two-way communication.

Neurologist’s Credentials

Accreditation is one of the key factors to consider when choosing a neurologist. Credentials, education, and training will tell you about the qualification of your neurologist. It will showcase doctor’s training, experience, and skills.

The points mentioned above are crucial when choosing a neurologist. It is imperative to visit the neurologist in person and put together every piece of information for a successful diagnosis and treatment. The final choice of choosing the neurologist is yours. However, it’s for the neurologist to explain how best they can help you.

*There is a difference between a neurologist and a neurosurgeon. The training is totally different. Common people do not know the difference and land up with a neurosurgeon for neurological problems. If there is any neurological problem first consult a neurologist (DM neurologist in particular trained from good and reputed institute) and then let him decide whether the patient requires neuro surgeon opinion or not.

Feeling Numbness? It Could be A Stroke- Beware!

A transient ischaemic attack (TIA) has symptoms similar to that of a stroke. TIA occurs when an artery in the brain gets clogged and reopens on its own without causing any permanent damage to the brain. Some people may also call it a mini-stroke.  Do not be ignored if there is:

  • Weakness or numbness of the hand, tongue, cheek, face, arm, or leg
  • Trouble speaking normally
  • Blurred vision i.e. difficulty in seeing clearly with one or both eyes

These symptoms may completely vanish within 24 hours (whilst with the stroke where the symptoms are usually more permanent).

Note: Immediate intervention can reduce your chances of having brain attack. There is enough evidence to support that less than 10% of stroke patients are given medicines within three hours before the symptoms begin. You may be at an increased risk of developing recurrent stroke, hence it is important to initiate the treatment quickly. After TIA, at least 42% are likely to have a stroke within 48 hours of the occurrence and 4-10% within 48 hours.

An Easy Way to Remember Signs of Stroke

Just remember the word “FAST”. Each letter stands for the sign you should watch out for:

Face – Does the person’s face look uneven or drooping on one side?
Arm – Does the person have weakness or numbness in one or both arms? Or is one arm drifting down if the person is trying to hold both arms out?
Speech – Is the person having trouble speaking? Does his or her speech is unclear?
Time – If you notice any of these stroke signs, even if they go away. You need to act FAST. The sooner treatment begins, the better the chances of recovery.

Next Step After Stroke?

A basic initial evaluation may include blood tests, scanning of the brain and its blood vessels as well as evaluation of the heart. The doctor might exclude other neurological diseases that may mimic stroke. The patient is also subjected to imaging of brain-like CT, MRI, MRA (magnetic resonance angiography, CTA (computed tomography angiography), CDUS (carotid duplex ultrasonography), and TCD (transcranial Doppler ultrasonography) to look for the presence of major blockage in the affected territory. However, patients having symptoms like irregular heart rhythm, poor cardiac function, or those without clear etiology are subjected to echocardiography and prolonged hotel (heart rhythm) monitoring.

How serious can be TIA?

TIA does not cause any permanent damage to the brain. However, it indicates that you may be at a higher risk of forming blood clots in the blood vessels or heart. In that case, there is a higher probability that a large blood clot may cause a stroke or heart attack in the future.

1 out of 10 people who have had a TIA can also have a stroke, which is significantly higher than the average risk of someone who has had a stroke. The risky period is the first month, so it is advisable to have a treatment plan devised by the doctor. Also, it is observed that within a year of having a TIA, about 3 in 100 people have a heart attack (myocardial infarction) due to the formation of a blood clot. A research study published in 2007 concludes that “Early initiation of existing treatments after TIA or minor stroke was associated with 80% reduction in the risk of early recurrent stroke”.

Any Specific Diet to Follow?

The treatment plan includes optimum treatment of hypertension diabetes cholesterol, and smoking cessation. It is important to:

  • Consume a diet “Rich” in fruits, vegetables, and low-fat dairy products and “Low” in salts, meats, sweets, refined grains (such as white rice or white bread).
  • Do at least 30 minutes of exercise on most days of the week and try to lose weight (if overweight).
  • Undergo surgery to reopen clogged arteries in the neck.  

Proactively, taking a step ahead and managing your lifestyle can prevent you from the risk of having a stroke.

Dr. Manoj Khanal is one of the Best Stroke Specialist in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.