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Nov22
schizophrenia
Schizophrenia is a mental disorder characterized by loss of contact with reality (psychosis), hallucinations (usually, hearing voices), firmly held false beliefs (delusions), abnormal thinking, a restricted range of emotions (flattened affect), diminished motivation, and disturbed work and social functioning.

Schizophrenia is probably caused by hereditary and environmental factors.

People may have a variety of symptoms, ranging from bizarre behavior and rambling, disorganized speech to loss of emotions and little or no speech to inability to concentrate and remember.

Doctors diagnose schizophrenia based on symptoms after they do tests to rule out other possible causes.

How well people do depends largely on whether they take the prescribed drugs as directed.

Treatment involves antipsychotic drugs, rehabilitation and community support activities, and psychotherapy.

Schizophrenia is a major health problem throughout the world. The disorder typically strikes young people at the very time they are establishing their independence and can result in lifelong disability and stigma. In terms of personal and economic costs, schizophrenia has been described as among the worst disorders afflicting humankind.

Schizophrenia is the 9th leading cause of disability worldwide. It affects about 1% of the population. Schizophrenia affects men and women equally. In the United States, schizophrenia accounts for about 1 of every 5 Social Security disability days and 2.5% of all health care expenditures. Schizophrenia is more common than Alzheimer's disease and multiple sclerosis.

Determining when schizophrenia begins (onset) is often difficult because unfamiliarity with symptoms may delay medical care for several years. The average age at onset is 18 for men and 25 for women. Onset during childhood or early adolescence is uncommon (see Mental Health Disorders in Children: Childhood Schizophrenia). Onset is also uncommon late in life.

Deterioration in social functioning can lead to substance abuse, poverty, and homelessness. People with untreated schizophrenia may lose contact with their families and friends and often find themselves living on the streets of large cities.


Did You Know...


Schizophrenia is more common than Alzheimer's disease and multiple sclerosis.

Various disorders, including thyroid disorders, brain tumors, seizure disorders, and other mental health disorders, can cause symptoms similar to those of schizophrenia.



Causes

What precisely causes schizophrenia is not known, but current research suggests a combination of hereditary and environmental factors. Fundamentally, however, it is a biologic problem (involving changes in the brain), not one caused by poor parenting or a mentally unhealthy environment. People who have a parent or sibling with schizophrenia have about a 10% risk of developing the disorder, compared with a 1% risk among the general population. An identical twin whose co-twin has schizophrenia has about a 50% risk of developing schizophrenia. These statistics suggest that heredity is involved.

Other causes may include problems that occurred before, during, or after birth, such as influenza in the mother during the 2nd trimester of pregnancy, oxygen deprivation at birth, a low birth weight, and incompatibility of the mother's and infant's blood type.

Symptoms

The onset of schizophrenia may be sudden, over a period of days or weeks, or slow and insidious, over a period of years. Although the severity and types of symptoms vary among different people with schizophrenia, the symptoms are usually sufficiently severe as to interfere with the ability to work, interact with people, and care for oneself. In some people with schizophrenia, mental function declines, leading to an impaired ability to pay attention, think in the abstract, and solve problems. The severity of mental impairment largely determines overall disability in people with schizophrenia.

Symptoms may be triggered or worsened by environmental stresses, such as stressful life events. Drug use, including use of marijuana, may trigger or worsen symptoms as well.

Categories: Overall, the symptoms of schizophrenia fall into four major categories:

Positive symptoms

Negative symptoms

Disorganization

Cognitive impairment

People may have symptoms from one, two, or all categories.

Positive symptoms involve an excess or a distortion of normal functions. They include the following:

Delusions are false beliefs that usually involve a misinterpretation of perceptions or experiences. For example, people with schizophrenia may have persecutory delusions, believing that they are being tormented, followed, tricked, or spied on. They may have delusions of reference, believing that passages from books, newspapers, or song lyrics are directed specifically at them. They may have delusions of thought withdrawal or thought insertion, believing that others can read their mind, that their thoughts are being transmitted to others, or that thoughts and impulses are being imposed on them by outside forces.

Hallucinations of sound, sight, smell, taste, or touch may occur, although hallucinations of sound (auditory hallucinations) are by far the most common. People may hear voices in their head commenting on their behavior, conversing with one another, or making critical and abusive comments.

Negative symptoms involve a decrease in or loss of normal functions. They include the following:

Blunted affect refers to a flattening of emotions. The face may appear immobile. People make little or no eye contact and lack emotional expressiveness. Events that would normally make them laugh or cry produce no response.

Poverty of speech refers to a decreased amount of speech. Answers to questions may be terse, perhaps one or two words, creating the impression of an inner emptiness.

Anhedonia refers to a diminished capacity to experience pleasure. People may take little interest in previous activities and spend more time in purposeless ones.

Asociality refers to a lack of interest in relationships with other people. These negative symptoms are often associated with a general loss of motivation, sense of purpose, and goals.

Disorganization involves thought disorders and bizarre behavior:

Thought disorder refers to disorganized thinking, which becomes apparent when speech is rambling or shifts from one topic to another. Speech may be mildly disorganized or completely incoherent and incomprehensible.

Bizarre behavior may take the form of childlike silliness, agitation, or inappropriate appearance, hygiene, or conduct. Catatonia is an extreme form of bizarre behavior in which people maintain a rigid posture and resist efforts to be moved or, in contrast, display purposeless and unstimulated motor activity.

Cognitive impairment refers to difficulty concentrating, remembering, organizing, planning, and problem solving. Some people are unable to concentrate sufficiently to read, follow the story line of a movie or television show, or follow directions. Others are unable to ignore distractions or remain focused on a task. Consequently, work that involves attention to detail, involvement in complicated procedures, and decision making may be impossible.










Disorders That Resemble Schizophrenia


General medical and neurologic conditions such as thyroid disorders, brain tumors, seizure disorders, kidney failure, toxic reactions to drugs, and vitamin deficiencies can sometimes cause symptoms similar to those of schizophrenia. In addition, a number of mental disorders share features of schizophrenia.

Brief psychotic disorder: Symptoms of this disorder resemble those of schizophrenia but last only for 1 day to 1 month. This time-limited disorder often occurs in people with a preexisting personality disorder or in people who have experienced a severe stress, such as loss of a loved one.

Schizophreniform disorder: The schizophrenia-like symptoms characteristic of this disorder last for 1 to 6 months. This disorder may resolve or may progress to manic-depressive illness or schizophrenia.

Schizoaffective disorder: This disorder is characterized by the presence of mood symptoms, such as depression or mania, plus more typical symptoms of schizophrenia.

Schizotypal personality disorder: This personality disorder (see Personality Disorders: Schizotypal personality disorder) may share symptoms of schizophrenia, but they are generally not severe enough to meet the criteria for psychosis. People with this disorder tend to be shy and to isolate themselves and may be mildly suspicious and have other disturbances in thinking. Genetic studies indicate that schizotypal personality disorder may be a mild form of schizophrenia.



Subtypes of Schizophrenia: Some researchers believe schizophrenia is a single disorder, but others believe it is a syndrome (a collection of symptoms) based on numerous underlying disorders. Subtypes of schizophrenia have been proposed in an effort to classify people into more distinct groups. However, the subtype in a particular person may change over time. Subtypes include the following:

Paranoid: People are preoccupied with delusions or auditory hallucinations. Disorganized speech and inappropriate emotions are less prominent.

Disorganized: Speech and behavior are disorganized, and people do not express emotions or have inappropriate emotions.

Catatonic: Symptoms are mainly physical. They include immobility, excessive motor activity, and assumption of bizarre postures.

Undifferentiated: People have a mixture of symptoms from the other subtypes: delusions and hallucinations, thought disorder and bizarre behavior, and negative symptoms.

Residual: People have had a clear history of prominent schizophrenia symptoms that are followed by a long period of mild negative symptoms.

Diagnosis

No definitive test exists to diagnose schizophrenia. A doctor makes the diagnosis based on a comprehensive assessment of a person's history and symptoms. Schizophrenia is diagnosed when symptoms persist for at least 6 months and cause significant deterioration in work, school, or social functioning. Information from family members, friends, or teachers is often important in establishing when the disorder began.

Laboratory tests are often done to rule out substance abuse or an underlying medical, neurologic, or hormonal disorder that can have features of psychosis. Examples of such disorders include brain tumors, temporal lobe epilepsy, thyroid disorders, autoimmune disorders, Huntington's disease, liver disorders, and side effects of drugs. Testing for drug abuse is sometimes done.

People with schizophrenia have brain abnormalities that may be seen on a computed tomography (CT) or magnetic resonance imaging (MRI) scan. However, the abnormalities are not specific enough to help in diagnosing schizophrenia.


Did You Know...


About 10% of people with schizophrenia commit suicide.



Prognosis

For people with schizophrenia, the prognosis depends largely on adherence to drug treatment. Without drug treatment, 70 to 80% of people have another episode within the first year after diagnosis. Drugs taken continuously can reduce this percentage to about 20 to 30% and can lessen the severity of symptoms significantly in most people. After discharge from a hospital, people who do not take prescribed drugs are very likely to be readmitted within the year. Taking drugs as directed dramatically reduces the likelihood of being readmitted.

Despite the proven benefit of drug therapy, half of people with schizophrenia do not take their prescribed drugs. Some do not recognize their illness and resist taking drugs. Others stop taking their drugs because of unpleasant side effects. Memory problems, disorganization, or simply a lack of money prevents others from taking their drugs.

Adherence is most likely to improve when specific barriers are addressed. If side effects of drugs are a major problem, a change to a different drug may help. A consistent, trusting relationship with a doctor or other therapist helps some people with schizophrenia to accept their illness more readily and recognize the need for adhering to prescribed treatment.

Over longer periods, the prognosis varies. In general, one third of people achieve significant and lasting improvement, one third achieve some improvement with intermittent relapses and residual disabilities, and one third experience severe and permanent incapacity. Factors associated with a better prognosis include the following:

Sudden onset of the disorder

Older age at onset

A good level of skills and accomplishments before becoming ill

Presence of positive rather than negative symptoms

Factors associated with a poor prognosis include the following:

Younger age at onset

Poor social and vocational functioning before becoming ill

A family history of schizophrenia

Presence of negative rather than positive symptoms

About 10% of people with schizophrenia commit suicide.










What Is Neuroleptic Malignant Syndrome?


Neuroleptic malignant syndrome is unresponsiveness caused by use of certain antipsychotic drugs. It develops in up to 3% of people who are treated with antipsychotic drugs, usually within the first few weeks of treatment. The syndrome is most common among men who, because they are agitated, are given rapidly increased doses of the drugs or high doses initially.

Symptoms include muscle rigidity, a dangerously high temperature, a fast heart rate, a fast breathing rate, high blood pressure, and coma. Damaged muscles release the protein myoglobin, which is excreted in the urine. Myoglobin turns the urine brown. This condition (myoglobinuria) can result in kidney damage or even kidney failure.

People with this syndrome are usually treated in an intensive care unit. The antipsychotic drug is stopped, fever is controlled (usually by wetting people and blowing air on them and by placing special cooling blankets on them). People are also given a muscle relaxant (such as bromocriptine

or dantrolene
). Giving sodium bicarbonate
intravenously helps prevent myoglobulinuria by making the urine alkaline.

Almost 30% of people with this syndrome die, but most of the rest recover completely. After recovery, up to 30% of people develop the syndrome again if they are given the same antipsychotic drug.



Treatment

Generally, treatment aims

To reduce the severity of psychotic symptoms

To prevent the recurrence of symptomatic episodes and the associated deterioration in functioning

To provide support and thus enable people to function at the highest level possible

Antipsychotic drugs, rehabilitation and community support activities, and psychotherapy are the major components of treatment.

Antipsychotic Drugs: Drugs can be effective in reducing or eliminating symptoms, such as delusions, hallucinations, and disorganized thinking. After the immediate symptoms have cleared, the continued use of antipsychotic drugs substantially reduces the probability of future episodes. However, antipsychotic drugs have significant side effects, which can include drowsiness, muscle stiffness, tremors, weight gain, and motor restlessness. Antipsychotic drugs may also cause tardive dyskinesia, an involuntary movement disorder most often characterized by puckering of the lips and tongue or writhing of the arms or legs. Tardive dyskinesia may not go away even after the drug is stopped. For tardive dyskinesia that persists, there is no effective treatment. A rare but potentially fatal side effect of antipsychotic drugs is neuroleptic malignant syndrome. It is characterized by muscle rigidity, fever, high blood pressure, and changes in mental function (such as confusion and lethargy).

Some newer antipsychotic drugs, termed second-generation antipsychotic drugs, have fewer side effects. However, these drugs seem to cause significant weight gain. They also increase the risk of the metabolic syndrome (see Obesity and the Metabolic Syndrome: Metabolic Syndrome). In this syndrome, fat accumulates in the abdomen, blood levels of triglycerides (a fat) are elevated, levels of high density cholesterol (HDL, the “good” cholesterol) are low, and blood pressure is high. Also, insulin is less effective (called insulin resistance), increasing the risk of diabetes. These drugs may relieve positive symptoms (such as hallucinations), negative symptoms (such as lack of emotion), and cognitive impairment (such as reduced mental functioning and attention span) to a greater extent than the older antipsychotic drugs, although some doctors question these differences.

Clozapine
, the first of the second-generation antipsychotic drugs, is effective in up to half of
people who do not respond to other antipsychotic drugs. However, clozapine
can have
serious side effects, such as seizures or potentially fatal suppression of bone marrow activity (which includes making blood cells). Thus, it is usually used only for people who have not responded to other antipsychotic drugs. People who take clozapine
must have their white
blood cell count measured weekly, at least for the first 6 months, so that clozapine
can be
stopped at the first indication that the number of white blood cells is decreasing.

Rehabilitation and Community Support Activities: Community support activities, such as on-the-job coaching, are directed at teaching the skills needed to survive in the community. These skills enable people with schizophrenia to work, shop, care for themselves, manage a household, and get along with others. Hospitalization may be needed during severe relapses, and involuntary hospitalization may be needed if people pose a danger to themselves or others. However, the general goal is to have people live in the community. To achieve this goal, some people need to live in a supervised apartment or group home where someone can ensure that drugs are taken as prescribed.

A few people with schizophrenia are unable to live independently, either because they have severe, persistent symptoms or because they lack the skills necessary to live in the community. They usually require full-time care in a safe and supportive setting.

Psychotherapy: Generally, psychotherapy aims to establish a collaborative relationship between people, their family members, and doctor. That way people may learn to understand and manage their disorder, to take antipsychotic drugs as prescribed, and to manage stresses that can aggravate the disorder. A good doctor-patient relationship is often a major determinant of whether treatment is successful. Psychotherapy reduces the severity of symptoms in some people and helps prevent relapse in others.


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Nov22
bipolar disorder
What is bipolar disorder?

Bipolar disorder is a brain disorder that causes extreme changes in mood, thinking, and behavior. There are usually two phases, a manic phase and a depressed phase. In the manic phase you feel highly energized and are very active. In the depressed phase you are very depressed. Most people with bipolar disorder have these severe mood swings many times during their lives. Some people have mostly manic phases. Others may have mostly depressed phases. Some people have a mix of manic and depressed symptoms. Bipolar disorder used to be called manic-depressive disorder.

Bipolar disorder may last a lifetime. Symptoms tend to get worse if not treated. Follow the treatment prescribed. Bipolar disorder can be managed even if it is not cured.
What is the cause?

About 1% of people develop bipolar disorder. It usually begins during the young adult years. About as many men as women get bipolar disorder.

The exact causes of the disorder are unclear. However, it does run in families. If you have relatives with bipolar disorder, you are more likely to have it.

Parts of the brain may not work normally during manic and depressive episodes. But exactly what triggers these switches is unclear.

If you are a woman, episodes may be more likely right before your monthly period or after the birth of a child.
What are the symptoms?

During a manic episode you may:
Have a very high sense of self-worth and a feeling of being "on top of the world."
Be very talkative and talk fast, maybe so fast that others have trouble following what you are saying.
Have racing thoughts and ideas to the point of being disorganized and muddled.
Have trouble concentrating and jump between different ideas.
Be very restless and hyperactive.
Have more feelings of anxiety and panic.
Go for days with little or no sleep and not feel tired.
Be very irritable and get into fights with others.
Have bursts of high interest in sex and sexual activity.
Be too active and act recklessly. For example, you might spend all your money, or take a sudden trip without planning.

If you have a very intense episode, you may also have symptoms like confusion, delusions (ideas that aren't true), or hallucinations (see or hear things that are not there).

A manic episode may be followed by a period of normal mood and behavior or a period of depression.

During a period of depression, you may:
Feel hopeless or just not care about anything.
Be irritable.
Have trouble falling asleep, wake up very early, or sleep too much.
Notice increases or decreases in your appetite and weight.
Notice a lower energy level, although you may sometimes feel overexcited.
Lose sexual desire and function.
Feel worthless and guilty.
Have trouble concentrating or remembering things.
Have unexplained physical symptoms.
Think often about death or suicide.

These symptoms may last for days or weeks. Rapid cycling patterns are defined by 4 or more mood disturbances (major depressive, mixed, manic, or hypomanic episodes) in a year.

You may also have what is called a mixed episode. A mixed episode is mania with depressed symptoms at the same time. In a mixed episode you may be overly active, withdraw from others, feel worthless, and cry often.
How is it diagnosed?

Your healthcare provider or mental health therapist will ask about your symptoms and any drug or alcohol use. You may have lab tests to rule out medical conditions such as thyroid gland problems.
How is it treated?

Medicines are the most effective treatment for bipolar disorder. If an episode is severe, you may need to spend some time in a hospital.

Medicines

Several types of mood stabilizing medicines can help treat bipolar disorder. Your healthcare provider will work with you to carefully select the best one for you.

Sometimes you may need other medicines. Your provider may prescribe an antidepressant, an antipsychotic, or an antianxiety medicine. However, it is possible that symptoms may become worse if you take antidepressants.

There are no nonprescription medicines for bipolar disorder.

Psychotherapy

Counseling and psychotherapy are usually very helpful. They help you learn how to maintain a positive lifestyle and attitude, which can reduce your episodes.

Natural Remedies and Alternative Treatments

Omega-3 fatty acids may help to reduce symptoms of depression. No herbal or natural remedies are effective in treating bipolar disorder.

Controlling stress, keeping to a regular sleep schedule, having friends or family to support you, and being more relaxed may help manage manic or depressive episodes.
How can I take care of myself?
Take your medicines every day , even if you are feeling well. Stopping your medicines when you feel well may bring about episodes.
Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, take walks. Try deep breathing exercises when you feel stressed.
Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
Check your medicines. Check with the healthcare provider treating you for bipolar disorder before you take other medicines to make sure there is no conflict with your bipolar medicines.
Get support. Talk with family and friends. Contact organizations such as the Depression and Bipolar Support Alliance (DBSA), the National Alliance for the Mentally Ill (NAMI), and the Mental Health America for information and support.
Watch yourself for the beginning signs of a manic or depressive episode. Ask others around you to also watch closely.
When should I seek help?

If you are showing the signs of either a manic or depressive episode, seek professional help quickly. Do not try to treat your illness by yourself. Professional treatment is necessary. If bipolar disorder is not treated, it tends to get worse. The mania and depression can be more severe and episodes happen more often. Most of the time, you will feel much better after a few weeks of treatment.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others. Also get emergency help if manic behavior becomes so wild that it endangers you or others.


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Nov22
EEG
What is an EEG?

An EEG (electroencephalogram) is a test that records the electrical activity of your child's brain. (The nerve cells in your child's brain work by carrying tiny electrical charges.)
When is it used?

An EEG can help your child's healthcare provider diagnose medical problems such as:
epilepsy
sleep apnea or other sleep problems
encephalitis (infection in the brain)
brain tumors

An EEG can help healthcare providers decide on the best medicine to treat epilepsy. This test is sometimes used during surgery to check the effect of anesthesia. It may be used to test for brain death in cases of severe injury or illness.
How do I prepare for an EEG?

Your child's head doesn't need to be shaved for an EEG. Some EEG labs ask that your child's hair be clean and free of hair products such as hairspray or mousse. On the day of the EEG, your child should not have any drinks that containe caffeine (such as sodas, sports drinks, or tea).

Ask your child's provider if there are any special instructions your child needs to follow. Also ask if there are any substances or medicines that your child should avoid before the test.

Sometimes a sedative is given just before the test to help your child relax during the EEG.
What happens during the test?

An EEG normally takes 45 to 60 minutes. During the test your child will relax in a bed. Small metal plates (electrodes) are pasted or taped to your child's head. The electrodes send information to a machine that records brain waves on paper. Young children do not like the feel of the electrodes, but it doesn't hurt except when the electrodes are removed.

EEGs may be done while your child is:
sleeping (Your child may be given a medicine to help your child sleep).
resting with eyes closed (for babies, this may be done by placing a hand over the baby's eyes and playing peek-a-boo)
resting with eyes open
breathing rapidly (and just after)
looking at a flashing light.

The EEG records how the brain responds to these changes. Your child may have a video EEG instead. This gives more time to study the brain waves. A video EEG may take 6 to 8 hours, or be done for 24 hours.
What happens after the test?

Your child can usually go home as soon as the test is done.
What are the benefits and risks of this test?

This test helps your child's healthcare provider diagnose certain medical conditions. There are no risks.
When should I call my child's healthcare provider?

Call your child's provider right away if your child has any change or worsening of symptoms after the test.


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Nov22
tension headaches
What is a muscle tension headache?

A tension headache is a headache caused by tense muscles in the scalp or neck. Muscle tension headaches are a common kind of headache. These headaches give a feeling of tightness around the head. The neck muscles also become sore and tight. Tension headaches can be caused by staying in one position for a long time, such as reading, playing video games or using a computer. Many children get tension headaches as a reaction to stresses (such as pressure for better grades or family conflicts).
How long does it last?

Muscle tension headaches usually last from a few hours to a day and tend to return.
How can I take care of my child?

If your child has been checked by your healthcare provider and has muscle tension headaches, try the following to help ease the pain:
When a headache occurs, your child should lie down and relax.
Give acetaminophen or ibuprofen as soon as the headache starts. The medicine is more effective if it is started early.
A cold pack applied to the skin often helps.
Stretch and massage any tight neck muscles.
If something is bothering your child, help him talk about it and get it off his mind.
How can I prevent muscle tension headaches?
Teach your child not to skip meals. Doing so can bring on headaches.
See that your child gets regular exercise, which can release natural painkillers (endorphins).
Teach your child to take breaks from activities that require sustained concentration. Encourage your child to do relaxation exercises during the breaks.
Teach your child the importance of getting enough sleep.
If overachievement causes headaches, help your child get out of the fast track.
When should I call my child's healthcare provider?

Call IMMEDIATELY if:
The headache is severe AND constant.
Your child has trouble seeing, thinking, talking, or walking.
The neck is stiff.
Your child is acting very sick.

Call during office hours if:
Headaches are a recurrent problem for your child.
You think blocked sinuses may be causing the headache.
The headache has lasted more than 24 hours even though your child has taken pain medicines.
You have other concerns or questions.
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Nov22
migraine headache
What is a migraine headache?

A migraine headache is a specific kind of headache that can last for hours to days. It can cause intense pain as well as other symptoms. For example, you may feel sick to your stomach or have changes in your vision just before or during the headache.
How does it occur?

The exact cause of migraines is not clear. Most experts think migraine attacks start with abnormal activity in the brain. They may be related to a problem with the blood flow in your brain, or they may happen with changes in brain chemicals. Migraine headaches often are triggered by specific things. Common migraine triggers include:
stress
tiredness
changes in the weather
certain foods, such as wine, cheese, or chocolate
MSG or food preservatives, such as nitrates
red wine
some medicines
bright lights.

Migraines tend to run in families. They affect women 3 times more often than men. They often happen right before or during a woman's menstrual period. Or they may happen when a woman is taking birth control pills or hormone replacement pills.
What are the symptoms?

Before a migraine starts, there is often a warning period when you don't feel well. Some people have vision changes before their head starts hurting. They lose part of their vision or see bright spots or zigzag patterns. These warning symptoms are called migraine aura. The vision changes of the aura usually go away as the headache begins.

Migraine symptoms may include:
throbbing or pounding headache
pain that gets worse with physical activity
extreme sensitivity to light, smells, and sounds
nausea
vomiting

The pain is usually more severe on one side of the head, but it can affect the whole head.

Sometimes a migraine can cause symptoms such as numbness or even weakness. However, these can also be symptoms of a stroke. If you have these other symptoms along with problems with your vision, do not assume a migraine is the cause. Call your healthcare provider right away.
How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. There are no lab tests or X-rays for diagnosing migraine headaches.

A careful history of your headaches is very helpful. Your healthcare provider may ask you to keep a headache diary in which you record the following:
date and time of each attack
how long the headache lasted
type of pain (for example, dull, sharp, throbbing, or a feeling of pressure)
location of pain
any symptoms before the headache began
foods and drinks you had before the headache began (This should include checking the ingredients in the product ingredient list of packaged foods you have eaten. Saving the labels of the foods or drinks might be a good way to record this information.)
use of cigarettes, caffeine, alcohol, or carbonated drinks before the headache began
time you went to bed and time you got up before the headache began
if you are a woman, the dates of your menstrual periods and use of birth control pills or other female hormones.

Depending on your headache symptoms and physical exam, your provider may recommend tests to check for other, more serious causes of your symptoms. For example, you may have a brain scan or magnetic resonance imaging (MRI).
How is it treated?

You may be able to stop mild migraine headaches by taking nonprescription pain-relief medicine when you start to have symptoms. Aspirin, acetaminophen, caffeine, ibuprofen, and naproxen have all been shown to be effective. You may find that any one of these medicines alone will treat your headache. Even just a caffeinated drink may help. However, some studies have shown combinations to be more effective and to work faster. Excedrin Migraine is an example of such a combination. It includes acetaminophen, aspirin, and caffeine. Other combination drugs, such as Midrin, are available for mild to moderate headaches with a prescription from your healthcare provider.

Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Aspirin, ibuprofen, and naproxen are nonsteroidal anti-inflammatory medicines (NSAIDs). NSAIDs may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take NSAIDs for more than 10 days for any reason.

Other medicines your healthcare provider may prescribe to help keep headaches from getting severe once they start are:
A group of drugs called triptans, which are available as tablets (including some that may be taken without water), a shot, and a nasal spray. Examples of triptans are naratriptan, rizatriptan, sumatriptan, and zolmitriptan.
Ergot medicines such as dihydroergotamine (DHE) or ergotamine. These medicines are available in various forms, including pills you swallow or put under your tongue, nasal spray, rectal suppositories and shots.

It's best to take these medicines as soon as possible after a headache begins. This means you need to recognize the warning symptoms.

If you have frequent migraines (3 or more a month), you may need to take other medicine every day to prevent severe and frequent headaches. Examples of drugs your provider may prescribe for this purpose are:
antiseizure medicines (divalproex sodium/valproate, gabapentin, or topiramate)
antidepressants (tricyclics, such as amitriptyline, nortriptyline, or doxepin)
some beta blockers (such as atenolol, metoprolol, nadolol, nebivolol, propranolol, or timolol)
some calcium channel blockers (such as verapamil).

Women who have migraines triggered by their menstrual cycle may take preventive medicines for a few days around their period. Medicines that may be recommended are NSAIDs, triptans, and ergots. If these medicines do not work, hormone (estrogen) therapy may be helpful. Hormone therapy may also be helpful for women who have migraines during or after menopause. However, there is an increased risk of stroke for women with migraines who use birth control products (contraceptives) that contain estrogen.

You may need to take preventive medicine for several weeks before you know if it is helpful for you.

If you are planning to get pregnant, be sure to talk to your healthcare provider about whether the medicines you have been prescribed are safe during pregnancy. If they are not known to be safe, you will need a different treatment plan while you are trying to get pregnant and during pregnancy and breast-feeding.
How long will the effects last?

The headache may last from a few hours to a few days. You may tend to get migraines for the rest of your life. However, many people find that they have migraines less often as they get older.
How can I take care of myself?

When you have a migraine:
As soon as possible after the symptoms start, take the medicine recommended or prescribed by your healthcare provider.
If you can, rest in a quiet room until the symptoms are gone. The pain may go away with sleep.
Put a cool, moist washcloth on the painful side of your head. You might also try a heating pad set on the lowest setting.
Don't drive a car while you have the headache.

You can make your migraines easier to take care of. Learn to become aware of your early warning signs of headache. You will need to pay close attention to your body to be aware of these signs. When the warning signs appear, try going to a quieter place and doing relaxation exercises. This early care can make a big difference in how easily you can get over the migraine.

If your symptoms don't get better when you take medicine, make another appointment with your healthcare provider. It may take several visits to find the best way to control your headaches. Also, if you are having headaches more often, make a follow-up appointment with your provider to see if something has changed or you need more testing or preventive medicine.

Call your healthcare provider right away if:
Changes in your vision do not go away.
You have symptoms that are not usually part of your migraines, such as:
trouble talking or slurred speech
arm or leg weakness
You have other symptoms such as:
fever
stiff neck
repeated vomiting for several hours
numbness or tingling in your face, arms, or legs
You are pregnant and your headache is particularly bad or it seems different from your usual migraines, particularly in the last half of pregnancy. This is especially important if you have problems with your vision such as flashing lights, difficulty focusing or blurriness, any nausea or vomiting, or weakness in any part of your body. These may be signs of a pregnancy problem that needs immediate attention.
How can I help prevent migraine headaches?

Prevention is an important part of treatment. To help prevent migraine headaches:
You may need to take medicine prescribed by your healthcare provider.
You may need to avoid certain foods or activities suggested by your headache diary as possible triggers of headaches. Common food triggers are:
citrus fruit
chocolate
cheese and other preserved or aged foods containing tyramine, including leftovers held for more than 1 or 2 days at refrigerator temperature
sodium nitrate (found, for example, in food coloring, preservatives, processed meats and fish, hot dogs, and luncheon meats)
monosodium glutamate "MSG" (found, for example, in Chinese food, pepperoni, and many processed foods)
red wine and beer
the artificial sweetener aspartame
Ask your provider about avoiding medicines that may trigger headaches.
If you are taking birth control pills or other female hormones, ask your provider if you should stop taking them.
If you smoke, stop. If someone else in your household smokes, ask them to smoke outside. Cigarette smoke can make your symptoms worse.
Eat healthy meals at about the same time each day. Don't skip meals, especially breakfast.
Get regular rest and exercise.
Try to reduce stress. Relaxation exercises and biofeedback may help you manage stress.
Limit alcohol to no more than 1 drink a day for women and two drinks a day for men.

For more information, call or write:

American Council for Headache Education (ACHE)
Phone: 800-255-ACHE (255-2243)
Web site: http://www.achenet.org

National Headache Foundation
Phone: 800-843-2256
Web site: http://www.headaches.org
(includes more information about diet)


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Nov22
epilepsy
August 1, 2012 · by deemagclinic · in Uncategorized · Edit

What is a seizure?

A seizure is a symptom, not a disease. It happens when nerve cells in the brain don’t work right and there is a sudden abnormal electrical signal in the brain. The seizure can cause strange sensations and behavior. Sometimes it causes muscle spasms and a change in or loss of consciousness.

The 2 most common types of seizures are:
focal or partial seizures, which begin in just a part of the brain but sometimes may spread to involve all of the brain
generalized seizures , which seem to involve all areas of the brain from the start of the seizure.

A common feature of partial seizures is the sensing of something that others are not aware of. For example, you may see flashing lights, have a particular taste in your mouth, or hear noises not seen or heard by others. Sometimes partial seizures also cause some numbness or jerking of the limbs. You may be awake and remember what happened, or you may lose consciousness for a short time.

There are 2 types of generalized seizures based on the pattern of the attack:
A grand mal seizure is a seizure that starts with a loss of consciousness and falling down, followed by a brief period of rigid muscles and a 1- to 2-minute period of violent, rhythmic jerking. The seizure ends with a few minutes of deep sleep before you are conscious again. You will probably not remember the seizure. You may be drowsy for hours after the seizure.
An absence or petit mal seizure is a short period of staring, fluttering eyelids, or twitching of muscles in your face. You do not lose consciousness. You are awake, but you are not able to understand what is going on around you. It’s not possible to pay attention at work or school when you are having petit mal seizures. You will probably not remember the seizure. Petit mal seizures usually begin when you are a child. Each seizure may last only 10 to 30 seconds, but hundreds may happen each day.

One seizure right after another or one very long seizure is called status epilepticus. The symptoms are usually those of a grand mal seizure. This can be life threatening because it can keep you from getting enough oxygen. It is a medical emergency.

If you have had several seizures and no cause can be found that can be corrected with treatment, your healthcare provider may diagnose seizure disorder, which is also called epilepsy.
How does it occur?

Seizures can happen for many different reasons, but most seizures have no known cause.

Seizures can be a symptom of many diseases and conditions, including:
head injury
brain injury at birth
brain infections such as meningitis or encephalitis
brain tumor
stroke
drug and alcohol abuse
withdrawal from alcohol and drugs such as narcotics, cocaine, tranquilizers, and sleeping pills
metabolic imbalances, such as low blood sugar or low blood sodium.
What are the symptoms?

Symptoms of a seizure can include:
aura, a peculiar sensation that occurs just before a seizure and may give you warning that a seizure is about to happen (for example, you may see flashing lights or hear noises)
rapid eye blinking or staring
twitching of the face
smacking of the lips
shaking or jerking of the arms and legs
stiffening of the body
crying or moaning
hallucinations, which may be visual or involve other senses such as hearing, touch, or taste
intense feelings of fear or déjà vu (the feeling that what you are experiencing has happened before even though you know it hasn’t)
loss of consciousness
loss of control of your bladder muscles so that you wet yourself
loss of bowel control
falling suddenly for no clear reason
not responding to noise or words for brief periods
appearing confused or in a haze
nodding the head
breathing problems from choking on food or saliva
vomiting.

You may be drowsy for several minutes after the seizure.
How is it diagnosed?

Your healthcare provider will examine you and take your medical history. You may have blood tests and one or more of the following safe and painless tests or scans to look for possible causes of your seizures:
EEG, which measures electrical activity in the brain
MRI (magnetic resonance imaging) scan, which uses magnetism, radio waves, and a computer to produce a picture of the inside of your head
CT (computed tomography) scan, in which X-rays are taken of your brain at different angles and then combined by a computer.
How is it treated?

The treatment for seizures depends on the cause. If you have a medical problem that is causing the seizures, such as diabetes, you will be treated for that problem.

Your healthcare provider may prescribe an anticonvulsant drug. This medicine will help prevent seizures. Your healthcare provider will adjust the dosage to minimize any side effects from the drug. If you keep having seizures while you are taking medicine, your healthcare provider will:
Check the level of the medicine in your blood.
Make sure you are taking your medicine as prescribed.
Make sure you aren’t drinking alcohol or using illegal street drugs.
Check to see if you are taking other medicines that may interfere with the anticonvulsant.

Medicine is the main treatment for seizures, but several new treatments are being evaluated. These include:
surgery on the area of the brain where the seizures occur
stimulation of a nerve in the neck by a device placed under the skin.
How long will the effects last?

It is not possible to know how long seizures will be a problem for any one person. Absence seizures often stop by the time you are an adult. You may keep having other types of seizures. Depending on the type of seizures you have and how often you have them, after a time your healthcare provider may recommend that you try to slowly decrease your medicines. You usually need to have not had any seizures while on medicine for at least 3 years before this is even considered. During this time it is very important to avoid driving a car or other activities where your life or the lives of others might be in danger if you had a seizure. Never stop taking your medicine without first checking with your provider.
How can I take care of myself?

Your friends and family should know first aid for seizures and CPR. When you have a seizure, they should:
Help you lie down on a bed or the floor.
Loosen clothing around your neck and remove eyeglasses.
Not try to hold you down. If possible, they should roll you onto your left side and gently hold you there. This position will help keep you from choking on vomit if you start vomiting. Objects should be moved away from you to avoid injury.
Check to make sure you are breathing.
Not put anything in your mouth. (The risk of biting your tongue is less than the danger of inhaling or being injured by anything put in your mouth. You will not swallow your tongue.)
Not move you during a seizure unless there is danger of injury.
After the seizure is over, let you rest while you wake up.

Someone should call 911 for emergency help if you are having a seizure and:
It is the first time you have had a seizure.
You have stopped breathing.
The seizure lasts 5 minutes or longer.
You have another seizure soon after the first one stopped.
You are not fully awake within a few minutes after the seizure.
Your lips or face look blue.
You fall and hit your head during a seizure.
A seizure happens after a head injury.

If you are having a seizure and not breathing, someone should start giving you CPR and keep giving it until the ambulance arrives.

If you keep having seizures one right after another or have one seizure for a long time, it is dangerous because you may not be getting enough oxygen. It is a medical emergency and you will need help.

Ways to care for yourself include:
Follow the treatment prescribed by your healthcare provider. Take medicine exactly as prescribed. Do not increase how much you take or how often you take it.
Eat a healthy diet and create a balance of work, rest, recreation, and exercise in your life.
Wear a medical ID bracelet or necklace so others will know about your condition.
Tell family, friends, and co-workers what to do if you have a seizure.
If your seizures are not well controlled, you should avoid high-risk activities that would be unsafe if you had a seizure. Some examples of risky activities might include swimming alone, cycling on a highway, scuba diving, or skiing. Ask your healthcare provider which activities are safe for you.
Avoid high-risk jobs that involve heavy or fast-moving equipment, heights, bodies of water, or other situations where you or others might be injured if you have a seizure.
Ask your provider when you may safely drive a car again. Check with your state’s Department of Motor Vehicles for rules about reporting a history of seizures.
Keep a positive attitude and develop ways to lessen stress.
Keep all of your follow-up appointments with your provider.
Call your healthcare provider if:
You have side effects from your medicine.
You keep having seizures and you are taking your medicine correctly.
The seizures change–for example, they happen more often or last longer.
You are a woman who takes medicines to prevent seizures and you want to get pregnant or you are pregnant.
You have any symptoms that worry you.

For more information, call or write:

Epilepsy Foundation of America
Phone: 800-332-1000
Web site: http://www.epilepsyfoundation.org
How can I help prevent seizures?

To help prevent further seizures:
Take your medicine as directed. Never skip a dose or stop taking your medicine without first checking with your provider.
Make sure you get enough sleep every night. Getting too little sleep can be a major cause of seizures if you have a seizure disorder.
Avoid alcohol.
Avoid mood-altering drugs, including stimulants and sedatives.
If you start having a fever, lower it right away with aspirin or acetaminophen. (Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.)


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Nov19
What are feelings?
Feelings (emotions) are inner experiences of mood. They can be pleasant or unpleasant, mild or strong. They can be kept to yourself or shared with others. Often they come along with physical sensations like a rapid heartbeat or sweaty palms. Emotions can push human beings toward action.

Most human feelings fall into one of these groups: happy, sad, angry, scared, or confused. Within each group are many other feelings described by words that express shades of meaning or the level of intensity of the emotion.
Happy: joyful, delighted, pleased
Sad: hopeless, upset, sorry
Angry: hateful, irritated, annoyed
Scared: terrified, fearful, anxious
Confused: stunned, hesitant, torn

Other important human emotions that may not fall into these main groups are sexual feelings, guilt, shame, loyalty, and forgiveness.

How much feeling is “normal?”

All human beings have feelings. No particular amount is normal, but some people have intense feelings and must struggle to control them, while others have to work hard even to know what their feelings are.

Sometimes you may not be aware of what is causing strong feelings. You may think you are overreacting to something. It may help to discuss these strong feelings in some detail with someone who cares about you. What looks like an overreaction may actually make emotional, rather than logical, sense.

You can help friends or family understand their feelings by helping them put their emotions into words. With someone who is crying and grieving a loss, for example, it can be much more helpful to say, “You are feeling sad because you miss her so much”, than to say, “Don’t cry.”

How do people deal with feelings?

People may have trouble identifying how they feel. Many feelings can be mixed together. Having too many feelings they can’t separate, such as sadness mixed with anger, can cause “feeling overload”. Strong feelings push human beings toward action. If you are angry at being cut off by another driver in heavy traffic, for example, you can act (run into the other car), or think (say to yourself, “He certainly is in a hurry,” or, “I am not going to let my anger get out of control today”). Thoughts can be used to control how we express feelings.

If you are very logical, you may not be aware of your own feelings. You may use thoughts and ideas to hide your feelings, sometimes without even realizing that you are doing so. You may be afraid that if you allow any feeling into your life you will lose control.

In order to deal with feelings, people need to learn:
how to identify what their feelings are
how to accept feelings as normal and healthy
how to talk about their feelings
how to act appropriately on their feelings

Why are feelings important?

Feelings help make you who you are. No one can take your feelings away from you, and when you understand them, you can use your feelings to guide your actions. Get to know your feelings to help you understand yourself and others better.


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Nov17
Hair Science and Hair Growth Cycle
Introduction:

With the beginning of the cultivation, mankind had the magnetic dip towards impressing others with their looks. The beauty of hair basically depends on individual’s health, diet, habits, job routine, climatic conditions and maintenance. Hair disorder is a common ailment of all age groups and both genders because of the infections, chemical agents & biological toxins present in the atmosphere and also due to physical factors, malnutrition and environmental pollution. The common problems occur with hair as hair fall, hair loss and their graying at an early age. They have become a general feature.

Hair Science:

Hair is far more complex than it appears on the surface. We all know that it not only plays a vital role in the appearance of both men and women, but it also helps to transmit sensory information. By week 22, a developing fetus has all of its hair follicles formed. At this stage of life there are about 5 million hair follicles on the body. There are a total of one million on the head, with one hundred thousand of those follicles residing on the scalp. This is the largest number of hair follicles a human will ever have, since we do not generate new hair follicles any time during the course of our lives. Most people will notice that the density of scalp hair is reduced as they grow from childhood to adulthood. The reason: our scalp expands as we grow.
Hair has two distinct structures – first, the follicle itself that resides in the skin and second, the shaft that is visible above the scalp.

Hair Growth Cycle:

Hair on the scalp grows about 0.3 to 0.4 mm/day or about 6 inches per year. Unlike other mammals, human hair growth and shedding is random and not seasonal or cyclical. At any given time, a random no of hairs will be in one of three stages of growth and shedding: anagen, catagen, and telogen.

Anagen:

Anagen is the active active phase of hair. The cells in the root of the hair are dividing rapidly. A new hair is formed and pushes the club hair (a hair that has stopped growing or is no longer in the anagen phase) up the follicle and eventually out. During this phase the hair grows about 1 cm every 28 days. Scalp hair stays in this active phase of growth for two to six years. Some people have difficulty in growing their hair beyond a certain length, because they have a short active phase of the growth. On the other hand, people with very long hair have a long active phase of growth. The hair on the arms, legs, eyelashes, and eyebrows have a very short active growth phase of about 30 to 45 days, explaining why they are so much shorter than scalp hair.

Catagen:

Catagen phase is transitional stage and about 3% of hair is in this phase at any time. This phase lasts for about two to three weeks. Growth stops and the outer root sheath shrinks and attaches to the root of the hair. This is the formation of club hair.

Telogen:

Telogen is the resting phase and usually accounts for 6% to 8% of all hair. This phase lasts for about 100 days for hair on the scalp and long for hair on the eyebrow, eyelash, arm, and leg. During this phase, the hair follicle is completely at rest and the club hair is completely formed. Pulling out a hair in this phase will reveal a solid, hard, dry, white material at the root. About 25 to 100 telogen hairs are shed normally each day.


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Nov17
Science of hair waving
Science of hair waving

Introduction
Since ancient cultures curly hair represented femininity and beauty. Women with straight hair purchased expensive wigs or spent hours for hair ondulation with water and heat, which was temporary.
Ÿ Permanent hair waving is a two-step chemical treatment modifying hair protein to achieve and retain a curly shape.
Ÿ The chemical treatment involves a thioglycolate reduction reaction that plasticizes hair while being wound on a rod. The following oxidation step with hydrogen peroxide reforms the hair in a new curly shape.
Ÿ Curl retention depends on hair thickness, rod diameter, and hair quality.
Ÿ Undesirable hair damage can occur with the wrong choice of perm and neutralizer, too much heat, incorrect processing time, or improper perm solution amount.

Chemophysical principles of hair waving

Because of hair’s great elasticity and strong resilient forces, it quickly resumes its original straight shape. Therefore it has to be softened and subsequently rehardened chemically to maintain a conformation change. Especially with permanent waving, it is important to select a reversible reaction to allow repeated treatments without hair destruction. The sulfur bridges of the amino acid cystine, linking the proteins, are best suited.
The conditions for permanent waving to be well tolerated are:

Low temperature (20-50®C), convection or contact heat;
ŸShort process time (5-30 minutes); and
Mildness to the skin.

A permanent wave occurs with two solutions:
Solution 1: the perming lotion, which contains a reducing agent, a “thiol” compound, designed to split off about 20-40% of hair cystine bonds.
Solution 2 : a fixing lotion, which contains an oxidizing agent, usually hydrogen peroxide, designed to rebuild cystine bridges between proteins at new sites in the curled hair shape. It must be emphasized that permanent waving is a two-step procedure where the chemical reaction and physical effects run in parallel reduction of disulfide-bonds, softening of hair, lateral swelling and length contraction, stress development and protein flow, then re-oxidation of cystin bonds and deswelling, fixation of a new curly shape.


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Nov14
ART OF IMMORTALITY: DR. SHRINIWAS KASHALIKAR
ART OF IMMORTALITY: DR. SHRINIWAS KASHALIKAR

Bhagavadgeeta implies; “Our turning towards (in acceptance); the Absolute Truth"; by overcoming the enormous dragging by the MOHA i.e. the relative truth (from inside and outside).

This is exactly implied in NAMASMARAN, which is a constant and continuous reaffirmation of the victory of; Absolute Truth over the relative truth, immortality over mortality and infinite over finite. It is an act of victorious celebration (not at all easy; in face of physical pain, incapacitation, old age, poverty, failures, humiliations and all “appearances” that call for disapproval, disgruntlement or point blank protest).

NAMASMARAN thus involves; the offering of everything; “good and bad” in life and its results (and total surrender) by us; the fallible, weak, humble subjectivity, relative truth (SHISHYA); to the infallible, omniscient, omnipresent and omnipotent objectivity, Absolute Truth (GURU); thus gratefully welcoming the cosmic objective desire to manifest (GURUKRUPA); towards universal benevolence and individual fulfillment.

Bhagavadgeeta upholds SWADHARMA i.e. doing every action by inspired by the Absolute Truth; as is the case in NAMASMARAN, which is therefore a choicest and supreme act of assertion.


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