Connect with us

Neurology / Neuroscience

Causes and effects of traumatic brain injury (TBI)

Published

on

Traumatic brain injury can occur when a sudden, brutal blow or jolt to the head causes brain damage. This is a major cause of illness and death in the United States, and elsewhere.

When the brain collides with the skull ‘s interior, the brain can be swollen, the nerve fibers teared, and bleeding. When the skull fractures, the brain tissue may be penetrated by a broken piece of skull.

Causes include falls, injuries to sports, gunshot wounds, physical assault and road traffic accidents.

The Centers for Disease Control and Prevention ( CDC) defines a TBI as “a disruption in normal brain function that may be caused by a bump, blow, or jolt to the head, or penetration of head injury.”

The severity of symptoms will depend on the part of the brain is affected, whether it is at a particular location or over a large region, and the extent of the damage.

The transient discomfort and headache can occur in mild cases. Severe TBI can lead to unconsciousness, amnesia, paralysis, coma and long-term illness or death.

The CDC reports TBI was leading to the deaths of about 50,000 people in 2013. In 2012, 329,290 people under the age of 19 applied for emergency care for a TBI arising from a sporting or recreational activity.

Parents , guardians and teachers will ensure that children are adequately monitored during sports and other events and that they wear acceptable safety equipment.

A head injury or suspected TBI needs medical attention.

Important facts about traumatic brain injury

  • The effect of a TBI, such as concussion, depends on the severity of the injury and where it occurs.
  • It is a major cause of death and disability in the United States and worldwide.
  • Causes include falls, road traffic accidents, and sports injuries.
  • Symptoms include confusion, persistent headaches, convulsions, and memory loss.
  • Anyone who receives a head injury, however mild, should consider seeking medical attention.

Symptoms

Brain injury Diagnosis

Signs and symptoms may appear immediately, within 24 hours, or may develop days or weeks after the injury. Symptoms are sometimes subtle. A person may notice an issue but does not relate it to the injury. After a TBI, some people will appear to have no symptoms but their condition later worsens.

The effects can be both psychological and physical.

The initial physical effects include swelling and bruising. Increased brain pressure can cause:

  • damage to brain tissue, as it presses against the skull or as one part of the brain pushes into another
  • pressure on blood vessels, reducing their ability to supply the brain cells with oxygen and essential nutrients

Internal bleeding

Signs of internal bleeding include bruise behind the ears (sign of battle) or around the body (body of raccoon). This can actually result in a serious or life-threatening injury. They require urgent medical treatment.

Other signs that may indicate severe injury include:

  • a loss of consciousness
  • convulsions or seizures
  • repeated vomiting
  • slurred speech
  • weakness or numbness in the arms, legs, hands, or feet
  • agitation
  • loss of coordination
  • dilated pupils
  • inability to wake up from sleep
  • severe headache
  • weakness and numbness in hands, feet, arms or legs

The following signs and symptoms can also indicate a need for urgent attention:

  • confusion
  • changes in mood
  • memory problems
  • inability to remember what happened before or after the incident
  • fatigue (tiredness) and lethargy
  • getting lost easily
  • persistent headaches
  • persistent pain in the neck
  • slowness in thinking, speaking, reading or acting
  • moodiness, for example, suddenly feeling sad or angry for no apparent reason
  • sleep pattern changes, such as sleeping more or less than usual, or having trouble sleeping
  • light headedness, dizziness
  • becoming more easily distracted
  • increased sensitivity to light or sounds
  • loss of sense of smell or taste
  • nausea
  • tinnitus, or ringing in the ears

Those can come up at once, in hours, or later. A person who has sustained a TBI but does not appear to have any symptoms should be closely watched for 24 hours, because there might not be obvious signs of injury.

Someone who suffers from the aforementioned symptoms even days or weeks after a TBI should see a physician.

A child having headache
A child with a TBI may become irritable and listless.

Children may have the same signs and symptoms but will have less chance of letting others know how they feel.

When an infant has had a hit or jolt to the head and there are any of the following signs or symptoms, call a doctor.

  • changes in sleeping patterns
  • irritability and crying
  • listlessness
  • loss of balance
  • loss of newly acquired skills, such as toilet training
  • changes in playing behavior changes
  • refusal to eat
  • loss of interest in favorite activities or toys
  • tiredness
  • unsteady walking
  • vomiting

If these signs are noticed, the child should see a doctor.

In sport, the game should be left out by the player and not play again until the doctor gives permission to enter, whether or not they lose consciousness. Not all TBI or concussion causes a loss of consciousness.

In the long run repeated head injuries can be especially damaging to the brain in rapid succession.

An individual who has had a TBI should be monitored as their condition can deteriorate rapidly and symptoms that seem mild can get serious.

Long-term effects

There is that evidence that a TBI or repeated TBIs may have long-term health consequences including increased risk of dementia and other neurological and neurodegenerative disorders. Football players with high scores on depression tests were also found to have higher levels of concussions.

Treatment

Swelling of the brain within the skull can put undue pressure on the surrounding tissues.
Swelling of the brain within the skull can put undue pressure on the surrounding tissues.

Symptoms normally go away without medication in a mild case of TBI. Repeated, mild TBIs, however, can be dangerous or fatal. That is why rest and prevent further exposure are necessary before a doctor gives the go-ahead.

More serious cases, likely with intensive care, would require hospitalisation.

Emergency care is intended to improve the state of the patient and to avoid the aggravation of brain injury.

This will involve ensuring that the airway is open, providing oxygen and ventilation and maintaining blood pressure.

Medications may be used to help control symptoms.

  • Sedation: This can help prevent agitation and excess muscle activity and contribute to pain relief. Examples include profanol.
  • Pain relief: Opioids may be used.
  • Diuretics: These increase urine output and reduce the amount of fluid in tissue. These are administered intravenously. Mannitol is the most commonly used diuretic for TBI patients.
  • Anti-seizure medication: A person who has experienced moderate to severe TBI may have seizures for up to a week after the incident. Medication may help prevent further brain damage that may result from a seizure.
  • Coma-inducing medications: During a coma, a person needs less oxygen. Sometimes, a coma may be deliberately induced coma if the blood vessels are unable to supply adequate amounts of food and oxygen to the brain.

Surgery

Surgery may be necessary in some cases.

  • Removing a hematoma: Internal bleeding can cause partly or fully clotted blood to pool in some part of the brain, worsening the pressure on the brain tissue. Emergency surgery can remove a hematoma from between the skull and the brain, reducing pressure inside the skull and preventing further brain damage.
  • Repairing a skull fracture: Any part of the skull that is fractured and pressing into the brain will need to be surgically repaired. Skull fractures that are not pressing into the brain normally heal on their own. The main concern with a skull fracture is that forces strong enough to cause it may have caused further, underlying damage.
  • Creating an opening in the skull: This can relieve the pressure inside the skull if other interventions have not worked.

Long-term treatment

Medications may be used to help control symptoms.

  • Sedation: This can help prevent agitation and excess muscle activity and contribute to pain relief. Examples include profanol.
  • Pain relief: Opioids may be used.
  • Diuretics: These increase urine output and reduce the amount of fluid in tissue. These are administered intravenously. Mannitol is the most commonly used diuretic for TBI patients.
  • Anti-seizure medication: A person who has experienced moderate to severe TBI may have seizures for up to a week after the incident. Medication may help prevent further brain damage that may result from a seizure.
  • Coma-inducing medications: During a coma, a person needs less oxygen. Sometimes, a coma may be deliberately induced coma if the blood vessels are unable to supply adequate amounts of food and oxygen to the brain.

Surgery

Surgery may be necessary in some cases.

  • Removing a hematoma: Internal bleeding can cause partly or fully clotted blood to pool in some part of the brain, worsening the pressure on the brain tissue. Emergency surgery can remove a hematoma from between the skull and the brain, reducing pressure inside the skull and preventing further brain damage.
  • Repairing a skull fracture: Any part of the skull that is fractured and pressing into the brain will need to be surgically repaired. Skull fractures that are not pressing into the brain normally heal on their own. The main concern with a skull fracture is that forces strong enough to cause it may have caused further, underlying damage.
  • Creating an opening in the skull: This can relieve the pressure inside the skull if other interventions have not worked.

Long-term treatment

An individual experiencing severe TBI may need rehabilitation.

They will need to relearn how to walk, speak and perform certain daily activities, depending on the degree and severity of their injury.

It could include hospital or advanced rehabilitation center care. Depending on the type of injury it can include a physical therapist, an occupational therapist and others.

Tips for recovery

Tips that can aid recovery:

  • Avoid activities that could cause another blow or jolt to the head.
  • Follow the instructions of healthcare professionals.
  • Do not take drugs that the physician has not approved.
  • Do not return to normal activities, including driving and sports participation, until the doctor agrees.
  • Get plenty of rest.

Following the orders of the doctor after a TBI is crucial, because the effect of a brain injury can be serious, and it is not always immediately apparent.

Types

There are two major types of TBI: open and closed. In open TBI, the skull is broken. In a close TBI, it is not.

Further classifications include:

Concussion: A shock of direct effect which may or may not cause a loss of consciousness. This is the most prevalent form of TBI. Often it’s mild but it can be fatal.

Contusion: If a direct hit triggers localized bleeding in the brain, this may lead to a blood clot.

Diffuse axonal injury: When tears occur in the structure of the brain due to skull shearing.

Penetrating injury: When the brain hits a sharp surface.

Causes

Causes and effects of traumatic brain injury (TBI)
TBIs can result from a range of incidents, from falls to collisions in sport.

TBI is caused by a severe jolt or head blow, or a head injury that penetrates and interferes with normal brain function.

The human brain is protected by the cerebrospinal fluid around it, against jolts and bumps. Within the skull the brain floats in this fluid.

A violent blow or jolt to the head can push the brain against the skull’s inner wall which can cause fibers to tear and bleed within and around the brain.

According to the CDC in 2013 TBI’s leading causes in the U.S. were:

  • Falls: Responsible for 47 percent of reported cases, notably in children aged up to 14 years and adults aged over 65 years
  • Motor vehicle accidents: These accounted for 14 percent of cases, especially in the 15 to 19-year age group.
  • Being struck by or colliding with an object: 15 percent of TBIs resulted from a collision with either a moving or stationery object.

Other causes include domestic violence and work-related and industrial accidents.

Complications

A TBI may have long-term effects and complications, in addition to the immediate risks.

Seizures: These can occur during the first week following the injury. TBIs do not tend to raise the risk of developing epilepsy, unless significant traumatic brain injuries have occurred.

Infections: Meningitis can occur when the meninges, the membranes around the brain, have a rupture. A breaking can allow bacteria to get in. If the infection spreads to the nervous system, it could result in serious complications.

Nerve damage: If the base of the skull is affected, this can affect the face’s nerves, causing facial muscle paralysis, double vision, eye movement problems and a loss of smell sensation.

Cognitive issues: Individuals with moderate to severe TBI may experience some cognitive problems including:

  • focus, reason, and process information
  • communicate verbally and nonverbally
  • judge situations
  • multitask
  • remember things in the short term
  • solve problems
  • organize their thoughts and ideas

Changes in personality: These could occur during recovery and rehabilitation. Impulse control of the patient may be altered, resulting in improper behaviour. Changes in personality can cause stress and anxiety on the part of family members , friends and carers.

Problems with the senses: These may lead to:

  • tinnitus, or ringing in the ears
  • difficulty recognizing objects
  • clumsiness, due to poor hand-eye coordination
  • double vision and blind spots
  • sensing bad smells or a bitter taste

Staying in a comatose state will finally awaken and resume normal life for a long time, but some people may wake up with long-term complications and disabilities. Some people absolutely do not wake up.

Long-term neurological problems: An increasing body of research has linked TBI to depression, Alzheimer’s disease, Parkinson’s disease, and other cognitive and neurological disorders.

Diagnosis

A serious TBI constitutes a medical emergency. Rapid diagnosis and treatment can prevent complications which could potentially threaten life.

The Glasgow Coma Scale

The Glasgow Coma Scale (GCS) is commonly used after a head injury to assess the likelihood and severity of brain damage.

Scores are given according to verbal responses, physical responses and how easily the person can open his or her eyes.

Eyes:

  1. do not open
  2. open in response to pain
  3. open in response to voice
  4. open spontaneously

Verbal response:

  1. makes no response
  2. makes incomprehensible sounds
  3. utters words or phrases
  4. speaks but is confused and disoriented
  5. communicates normally

Motor or physical response

  1. makes no movement
  2. extends arm in response to pain
  3. flexes arm in response to pain
  4. moves away in response to pain
  5. can pinpoint where the pain is
  6. obeys commands to move a part of the body

The score will be added together, and brain injury will be classified as follows:

  • Coma, if the score is 8 or less
  • Moderate, if the score is from 9 to 12
  • Minor, if the score is 13 or more

People who score on the scale of 13 to 15 when they enter the hospital are normally expected to get a good result.

Image scans

MRI or CT brain imaging scans can help decide whether any brain injury or damage has occurred and when.

Mri brain scan
Brain imaging is essential for assessing the internal damage.

Angiography can be used to diagnose any blood vessel complications, for example, after a penetrating head trauma.

Electroencephalography ( EEG) measures the electrical activity inside the brain. The findings will indicate whether a patient is having non-convulsive seizures.

Intracranial pressure control allows the doctor to assess the pressure inside the skull. This can show some inflammation in brain tissue.

Neurocognitive assessments can help determine any lack of memory or ability to interpret thoughts.

Patients or caregivers should ensure that health providers know of any medications the person normally takes, especially blood thinners, such as warfarin ( Coumadin), as these can increase the risk of complications.

Prevention

Some tips can reduce the risk of a TBI.

Drinking and drive
Never drink and drive.
  • Always use a seat belt when driving or traveling in a car
  • Children should use a suitable restraint for their age and size
  • Never drive after drinking alcohol
  • Use a helmet when playing sports or using a vehicle where an incident could involve a head injury
  • Instal grab bars in a bathroom that is used by older people
  • Use nonslip mats on floors that can get wet
  • Remove trip hazards, such as loose carpets and trailing wires
  • Install window guards and safety gates on stairs if there are children around
  • Ensure that play areas are made of a shock-absorbing surface, such as wood mulch
  • Store any firearms, unloaded, in a locked safe or cabinet, and keep the bullets in a different location

Extra caution should be taken while supervising young children or older adults. Household adaptations, such as ramps and window guards, may be required.

The American Academy of Family Physicians advises that everyone will go to a hospital after a hit to the head. If someone else hits their head and is behaving in an unusual way, the person who sees it will contact a doctor.

The Heads Up project offers advice and training on how to prevent or deal with a TBI and its effects.

Cardiovascular / Cardiology

Symptoms, causes, and treatment of transient ischemic attack (TIA)

Published

on

A transient ischemic attack (TIA), also known as a ministroke, happens when the brain’s blood supply is interrupted for a short period of time.

Although the diminished blood flow normally only lasts 5 minutes, a TIA is still a medical emergency. It could be a precursor to a massive stroke.

Because the symptoms of a TIA resolve fast, many people do not seek medical care. However, according to the Centers for Disease Control and Prevention (CDC), more than one-third of people who don’t get treatment for a TIA will have a severe stroke within a year.

According to statistics, 20% of persons who have a TIA will have a stroke within three months, and half of these will happen within two days of the TIA.

Knowing the signs and symptoms of a TIA and seeking care as soon as possible can help you avoid a more serious and perhaps life-threatening incident.

In this article, you’ll learn more about what a TIA entails and what to do if one arises.

What is a TIA?

transient ischemic attack (TIA)

A transient ischemic attack (TIA) has symptoms that are similar to those of a stroke, but it causes only a few minutes. The decreased blood flow normally only lasts a few seconds, but the symptoms can last for several minutes. They can last for a few hours on rare occasions.

TIAs occur when a blood clot stops blood flow to the brain cells for a brief period of time, preventing oxygen from reaching the cells. The symptoms usually go away when the clot breaks up or moves on. These events do not stay long enough to cause brain cells permanently.

People should not dismiss a TIA since it could be an indication of a big stroke, according to the American Stroke Association.

According to statistics, TIAs afflict about 2% of the population in the United States.

Causes

When the supply of oxygen to the brain is interrupted, a TIA ensues. This could be as a result of:

  • atherosclerosis, in which fatty deposits cause the arteries to become harder, thicker, narrower, and less flexible
  • blood clots due to heart disease, cardiovascular disease, or an irregular heart rhythm
  • blood clots due to a blood condition, such as sickle cell disease
  • an embolism or blood clot that has traveled from elsewhere in the body
  • an air bubble in the bloodstream

Symptoms

The symptoms of a TIA are determined by which area of the brain isn’t getting enough blood.

The acronym FAST (facial, arms, speech, time) might help people recall the symptoms to look for, just as it can with a severe stroke:

  • F = face: The eye or mouth may droop on one side, and the person may be unable to smile properly.
  • A = arms: Arm weakness or numbness might make it hard to raise one or both arms or keep them raised.
  • S = speech: The person’s speech may be slurred and garbled.
  • T = time: Someone should call the emergency services at once if a person has one or more of these symptoms.

The person may also have:

  • numbness or weakness, especially on one side of the body
  • sudden confusion
  • difficulty understanding what others are talking about
  • vision problems
  • dizziness
  • problems with coordination
  • difficulty walking
  • a very bad headache
  • a loss of consciousness, in some cases

TIA symptoms are only present for a short time. They can last anywhere from a few minutes to several hours, and they normally go away after 24 hours.

However, if anyone experiences symptoms that could signal a TIA, they should seek medical care right away because a massive stroke could result.

The same variables that cause temporary blood flow insufficiency in a TIA can cause a stroke, which can result in irreversible brain damage owing to a longer-lasting blood flow deficit.

Conditions with symptoms that are similar

A TIA’s symptoms can be similar to those of other diseases, such as:

Even if the symptoms of the TIA have subsided, getting an accurate diagnosis can assist a person get the proper treatment to help minimise the risk of a future stroke.

  • having a family history of stroke or TIA
  • being 55 years or above
  • being assigned male at birth
  • being Black or Hispanic, compared with being non-Hispanic white
  • having high blood pressure
  • having cardiovascular disease
  • smoking tobacco
  • having diabetes
  • getting low levels of exercise
  • having high cholesterol levels
  • eating a diet that is high in unhealthy fats and salt
  • having high homocysteine levels
  • having overweight or obesity
  • having a type of heartbeat known as atrial fibrillation

Treatment

Treatment options will be determined by the cause of the TIA. The parts that follow will go over some of the possibilities.

Medications

A doctor may recommend medicine to reduce the risk of a second blood clot and catastrophic stroke.

The treatment options will vary depending on the cause of the TIA, however they usually include:

  • anti-platelet drugs to prevent clotting, such as include aspirin, ticlopidine (Ticlid), and clopidogrel (Plavix)
  • anticoagulants such as warfarin (Coumadin) and heparin, which also help prevent clotting
  • medications to manage high blood pressure, or hypertension
  • drugs to help manage cholesterol levels
  • medications to manage heart disease and regulate irregular heart rhythms

All of these medications can cause side effects and may interact with other medications.

As a result, people should tell their doctor about any other prescriptions they’re taking, including over-the-counter drugs, supplements, and herbal therapies.

If a person has negative side effects while taking a medication, they should consult a doctor. It’s possible that another option exists.

Surgery

A doctor may propose surgery to remove a blockage or a portion of a damaged artery in some instances.

Preventive actions and lifestyle changes

A risk of lifestyle changes can help minimise your chances of having a TIA or stroke. These are some of them:

  • avoiding or quitting smoking
  • avoiding exposure to secondhand tobacco smoke
  • eating a nutritious and varied diet, with plenty of fresh fruits and vegetables
  • managing one’s intake of salt and unhealthy fats
  • getting regular exercise
  • avoiding the use of recreational drugs
  • managing body weight, if appropriate
  • following any treatment plan for heart disease, diabetes, or other conditions

Before making any major lifestyle changes, such as beginning a new workout plan, it is best to consult with a healthcare practitioner to determine the best course of action.

Diagnosis

Anyone who has signs or symptoms of a TIA should seek medical help right away to figure out why it happened and how to avoid a recurrence or a more serious occurrence.

Symptoms can fade fast, and by the time the person sees a doctor, they may be gone. A witness who was present at the time, on the other hand, may be able to assist the individual in explaining the situation to the doctor.

The doctor will likely:

  • ask what happened and ask about any ongoing symptoms
  • ask how long the symptoms lasted for and how they affected the person
  • consider the individual’s personal and family medical history
  • carry out a neurological examination, which may include memory and coordination tests

If the doctor suspects the patient suffered a TIA, he or she may be referred to a neurologist for further evaluation.

The following are some examples of possible tests:

  • blood tests to check blood pressure, cholesterol levels, and clotting ability
  • an electrocardiogram to measure the electrical activity and rhythms of the heart
  • an echocardiogram to check the pumping action of the heart
  • a chest X-ray to help rule out other conditions
  • CT scan to reveal any signs of an aneurysm, bleeding, or changes to blood vessels in the brain
  • an MRI scan to help identify damage to the brain

The doctor may also request that the patient wear a Holter monitor for a few days or weeks in order to track their heart rhythms over time.

Conclusion

The symptoms of a TIA can last anywhere from a few minutes to several hours. However, it is critical to seek medical help because a TIA can be a symptom of a massive stroke.

A TIA is marked by weakness and numbness on one side of the body, facial drooping on one side, and difficulty speaking. If you or someone you know is experiencing these symptoms, call 911 right away.

Following a TIA, lifestyle changes and the use of medicine to lower the risk of future blood clots are two choices for treatment.

Sources:

  • http://stroke.ahajournals.org/content/strokeaha/45/7/2160.full.pdf
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832890/
  • https://www.nhs.uk/conditions/transient-ischaemic-attack-tia/
  • https://www.medicalnewstoday.com/articles/164038
  • https://www.ncbi.nlm.nih.gov/books/NBK459143/
  • https://www.nhlbi.nih.gov/health-topics/stroke
  • https://www.stroke.org/en/about-stroke/stroke-symptoms
  • https://www.stroke.org/en/about-stroke/types-of-stroke/tia-transient-ischemic-attack
  • https://www.cdc.gov/stroke/types_of_stroke.htm

Continue Reading

Mental Health

Types, conditions, and treatments of facial tics

Published

on

A facial tic is an uncontrollable, involuntary spasm of the facial muscles. The tic is unwelcome and occurs frequently enough to be bothersome to the individual who has it.

A person can keep in a tic for a short period of time, similar to how a person can hold in a sneeze, but doing so frequently causes the individual to become progressively uncomfortable.

Facial tics can be caused by a variety of conditions, but they rarely signify a serious medical condition.

Facial tics are more common in children than in adults, according to a study published in Pediatric Neurology, and males appear to be significantly more prone to them than girls. After a few months, most children’s facial tics disappear.

When to consult your doctor

facial tics

Facial tics are frequently temporary and fade away on their own. If a person has a tic that lasts more than a year, they should contact a doctor.

Anyone who has severe, chronic tics that affect a variety of muscle groups should see their doctor for a correct diagnosis.

Although it is not always possible to prevent facial tics, many of them do not require treatment and will go away on their own.

For persistent tics, there are treatments that can help people manage the tic. Some people may benefit from learning stress relief techniques and consulting a therapist.

Facial tics

Involuntary muscular movements that occur anywhere on the face are known as facial tics. However, they normally occur in the same location each time and are frequent enough to annoy the individual. Tics that are severe can have a negative impact on a person’s quality of life.

The following are examples of common facial tics:

  • raising the eyebrows
  • opening and closing the mouth
  • mouth twitching
  • rapid eye blinking or winking
  • squinting
  • flaring the nostrils
  • scrunching the nose
  • clicking the tongue
  • sucking the teeth

Some people may also have vocal tics, such as clearing their throat or grunting, in addition to muscle tics.

A person can temporarily repress a tic, but it will eventually emerge.

Types of tic disorders

Facial tics can be caused by a variety of conditions. The severity of the tic, as well as the existence of other symptoms, can assist a doctor figure out what’s wrong.

Transient tic disorder

Tics are only present for a short time. A regular facial or vocal tic may be caused by transient tic condition, however the tic usually lasts less than a year.

Tics are usually only present when a person is awake with transient tic disorder. Tics are uncommon when people are sleeping.

The majority of causes of tics in children are due to transient tic disorder. They normally go away on their own without any treatment.

Chronic motor tic disorder

Chronic motor tic disorder is a type of tic disorder that lasts longer. A person with chronic motor tic disorder must have had tics for more than a year, for periods of at least 3 months at a time, in order for a doctor to diagnose them.

Chronic motor tic disorder, unlike transitory tic condition, causes tics that can occur while sleeping.

Both toddlers and adults can develop chronic motor tic condition. Young children with persistent motor tic disorder may not require treatment since their symptoms are more tolerable or go away on their own.

Adults with the illness may require medication or other forms of treatment to keep their tics under control.

Tourette’s syndrome

Tourette’s syndrome, often known as Tourette’s condition, is a persistent disorder that causes one or more motor or vocal tics.

Tourette’s syndrome affects the majority of people throughout their childhood, however it can also affect adults. Tics normally get less acute as a person gets older.

Both physical and verbal tics are present in people with Tourette’s syndrome. They may unintentionally create sounds or pronounce words.

Small motor tics, such as fast blinking or throat clearing, are common in people with Tourette’s syndrome. They may, however, have more complex motor tics, such as:

  • saying inappropriate words
  • making inappropriate gestures
  • yelling out
  • shrugging one or both shoulders
  • shaking the head uncontrollably
  • flapping the arms

Behavioral therapy can help people with Tourette’s syndrome manage their symptoms. People with any other underlying problems, on the other hand, may require medicine.

Treatment

Treatment for facial tics varies according to the tic’s nature and intensity. Many tics, such as those caused by transitory tic condition, may fade away over time if not treated.

Tics that interfere with school or work performance may require treatment. Tics that endure a long time, such as those caused by Tourette’s syndrome, may require more intensive treatment.

Tics can be treated in a variety of ways, including:

Medication

Alpha-adrenergic agonists, neuroleptic medications, and dopamine blockers are some of the pharmaceuticals used to treat tics.

Doctors may recommend Botox injections in the case of persistent facial tics or twitches. Botox injections can temporarily block facial muscles, which may be enough to prevent tic recurrence.

Any underlying diseases causing the tic, such as Tourette’s syndrome or ADHD, can also be treated with medication.

Psychotherapy

Doctors may prescribe that a person meet with a psychotherapist on a regular basis to help them change or remove their tics.

Some people may benefit from behavioural modification and habit reversal strategies to assist them overcome their tics and improve their quality of life.

The person is usually taught to recognise when the tic is about to happen as part of the therapy. When a person is able to accomplish this, the therapist will encourage them to try to replace the tic with another behaviour.

This may assist a person replace a physical habit with one that is less distracting or does not interfere with daily functioning over time.

Surgery

In severe cases of facial tics, such as those caused by Tourette’s syndrome, several surgical treatments may be helpful.

Deep brain stimulation is one surgical treatment option. Electrical currents may be able to reach specific parts of the brain via electrodes implanted in the brain, according to some experts, which could assist control brain waves and eliminate tics.

Deep brain stimulation may help ease symptoms of Tourette’s syndrome, according to a recent study, but further research is needed to find the appropriate parts of the brain to stimulate.

Natural treatments

Natural therapies for facial tics may also be recommended by doctors. Because stress is thought to play a role in the development and maintenance of tics, natural treatments will focus on lowering stress in the individual’s life.

Among the stress-relieving activities are:

  • yoga
  • imaginative play
  • meditation
  • light exercises

For people wanting to minimise stress and find relief, getting a full night’s sleep is also essential. A doctor may suggest counselling in some cases.

Sources:

  • https://www.pedneur.com/article/S0887-8994(12)00215-9/abstract
  • http://docshare02.docshare.tips/files/13658/136588307.pdf#page=607
  • https://www.medicalnewstoday.com/articles/322174
  • https://www.mayoclinicproceedings.org/article/S0025-6196(11)60071-2/fulltext
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737687/

Continue Reading

Bones / Orthopedics

Spinal problems causing tremors: What to know

Published

on

Tremors are uncontrollable shaking movements in one or more bodily parts. Muscle contractions are the cause of these unusual movements.

Tremors are usually caused by a problem with the region of the brain that governs movement. Multiple sclerosis, Parkinson’s disease, and traumatic brain damage are all examples of neurological illnesses. Anxiety, an overactive thyroid, alcohol use disorder, and certain drugs are all possible causes of tremors. Doctors, on the other hand, are frequently unable to pinpoint the source of the cause.

The majority of sources do not mention spinal issues as a possible cause of tremors. Tremors have been reported in people with spinal cord compression on a rare occasion.

Continue reading to learn more about the links between spinal problems and tremors, treatment options, and when to seek medical attention.

When to consult a doctor

Anyone experiencing tremors should see a doctor for a diagnosis and to rule out any dangerous causes.

To assess the tremor, the doctor will begin the diagnosis process by doing a physical and neurological examination. They’ll also ask about the person’s medical history. Medical tests, such as diagnostic imaging to examine brain and spinal injury and an electromyogram to diagnose muscle and nerve abnormalities, may be ordered after that.

They can prescribe the best treatment based on the results of these tests.

Tremors and spinal problems

spinal problems

Tremors are uncommon in people with spinal problems, but there have been instances of tremors in people with spinal cord compression.

In one case, a 91-year-old man got tremors as a result of cervical myelopathy, which is caused by spinal cord compression in the neck. The man developed tremors in both arms and legs over the course of two weeks, rendering him unable to feed himself or move without assistance.

Doctors initially suspected the man had Parkinson’s disease, but they eventually ruled it out because he exhibited no other symptoms. The individual had a herniated disk at vertebrae C3–C4 in his neck, according to an MRI study.

Tremors can also be caused by a condition known as cervical dystonia. This uncommon neurological condition starts in the brain and causes to uncontrollable neck muscular contractions. These contractions might be continuous or come in the form of spasms that seem like tremors. The severity of the condition varies, but it can cause in severe pain and incorrect posture, both of which can have a negative impact on one’s quality of life.

What are tremors?

Tremors are involuntary movements of the body that are difficult to control. The hands are the most common site of involuntary muscle contractions, but they can also affect the arms, hands, head, torso, legs, feet, or face muscles.

Tremors have varied effects on different people. They are able to:

  • come and go or occur continuously
  • happen on their own or occur in response to another issue
  • be mild or severe
  • affect one or both sides of the body

Tremors can be classified as follows:

  • Essential tremor: This condition is known as benign essential tremor by doctors. It’s the most frequent tremor, and it’s caused by nervous system issues. The hands are most affected, although it can also affect the head, tongue, voice, legs, and trunk.
  • Dystonic tremor: This movement issue can occur in people who have dystonia. Dystonia is a condition that causes incorrect posture due to involuntary muscular contractions. Twisted and repetitive movements can harm any muscle in the body, according to some people.
  • Parkinsonian tremor: This tremor is common in people with Parkinson’s disease. It usually affects one or both hands while lying down, although it can also affect the face and legs.

Why might spinal, back, or neck issues cause tremors?

If the spinal cord is compressed, back and neck disorders might cause tremors. Millions of nerve cells in the spinal cord connect the brain to motor neurons, which allow the body to move.

Compression of these nerves in the back and neck may impair how they communicate, resulting in tremors. However, this is a rare occurrence, with only a few accounts of people suffering tremors as a result of spinal abnormalities.

Treatment

Treatment options for tremor-related back pain may be determined by the cause.

Doctors may propose surgery in the case of a disk herniation. An anterior cervical discectomy and fusion (ACDF) technique may be used by a surgeon to treat the condition. The aberrant, bulging section of the disk that presses on the nerves in the spinal cord is initially removed during an ACDF. The bones will then be fused together to prevent them from rubbing against one another.

Cervical dystonia cannot be cured by doctors. They may, however, suggest one or a combination of the following treatment options:

Botulinum toxin (Botox) injections

This neurotoxin is injected into the neck muscles in modest dosages by a doctor. It stops nerves from sending out signals that cause muscle contractions.

Oral medications

At this time, the Food and Drug Administration (FDA) has not approved any oral drugs. Doctors may, however, suggest the following to alleviate symptoms:

  • baclofen
  • clonazepam
  • anticholinergic agents, such as benztropine
  • dopaminergic agents, such as levodopa

Surgery

There are two surgical procedures available to you. The first involves severing the nerves that supply dystonic muscles, although this can have serious adverse effects and take a long time to recover from.

Another approach is deep brain stimulation (DBS). DBS entails a surgeon implanting electrodes in the globus pallidus, a specific portion of the brain. Stimulators then provide little electrical pulses to the brain, which help to improve dystonic movements.

Prevention

People with spinal disorders may likely find it difficult to prevent tremors. Cervical spondylotic myelopathy, for example, is caused by the degenerative changes in the spine that occur as people age, and tremors are common in the elderly.

Reduced spinal strain and injury risk can help people prevent herniated disks. However, disk material degrades gradually with age, and even modest strains or twisting movements might cause disk rupture.

The cause and prevention of cervical dystonia are frequently unknown to clinicians. However, because up to 25% of people have a family history of the condition, researchers have discovered linked gene abnormalities.

Conclusion

Tremors are involuntary shaking motions that can affect the muscles of the limbs, trunk, or face. Tremors are rarely caused by spinal issues. However, if the spinal cord is squeezed, the nerves’ ability to communicate is disrupted, which can result in tremors.

Surgery, injections, and medication may be used to treat tremor-related back disorders, depending on the cause.

People who avoid putting undue strain on their spine and are aware of potential injuries can lower their risk of having tremors as a result of spinal disorders.

Anyone who has tremors should seek medical advice for a diagnosis and treatment.

Sources:

  • https://rarediseases.org/rare-diseases/cervical-dystonia/
  • https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc
  • https://www.christopherreeve.org/living-with-paralysis/health/how-the-spinal-cord-works
  • https://medlineplus.gov/tremor.html
  • https://www.medicalnewstoday.com/articles/can-spinal-problems-cause-tremors
  • https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet

Continue Reading

Copyright © 2022 NccMed.com