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Neurology / Neuroscience

Things you need to know about stroke

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Strokes are assaults upon the brain. These can occur by blocking the blood supply to the brain. A stroke is a medical emergency which requires immediate medical care.

Stroke is the US’s fifth-leading cause of death. Close to 800,000 people each year get a stroke. That is approximately one human every 40 seconds.

This article from the Nccmed Knowledge Center will clarify why strokes occur and how they are handled, as well as discuss the various types and measures that a person can take to avoid a stroke.

Fast facts on stroke:

  • During a stroke, the brain does not receive enough oxygen or nutrients, causing brain cells to die.
  • Strokes need to be diagnosed and treated as quickly as possible to minimize brain damage.
  • Treatment depends on the type of stroke.
  • The most effective way to prevent strokes is through maintaining a healthy lifestyle and treating underlying conditions that could be a risk factor.

What is a stroke?

Stroke picture nccmed

A stroke happens when blood supply to the brain is either stopped or reduced. The brain does not get enough oxygen or nutrients when this occurs and brain cells start to die.

In the U.S. about 40 percent of people who die from stroke are male, with 60 percent of female deaths.

According to the American Heart Association (AHA), African-Americans have almost double the chance of a first-time stroke and a much higher risk of stroke mortality compared with the Caucasian people.

Treatment

Given the different causes of ischemic and hemorrhagic strokes, both require different forms of treatment.

It is necessary not only to diagnose the form of stroke rapidly to reduce the damage done to the brain, but also because a medication appropriate for one type of stroke can be dangerous when treating different types.

Ischemic stroke

Ischemic strokes are caused by blocking or narrowing the arteries and therefore care focuses on restoring an sufficient blood flow to the brain.

Care begins with medications which break down the clots and prevent the formation of others. Aspirin may be given, as can a plasminogen activator (TPA) tissue injection. TPA is very effective in dissolving clots but must be injected within 4.5 hours of the onset of stroke symptoms.

Emergency procedures involve injecting TPA directly into a brain artery, or using a catheter to dissolve the clot physically. Work on the value of those procedures is still ongoing.

There are other treatments that may be used to reduce the risk of strokes or TIAs. A carotid endarterectomy involves the expansion of the carotid artery by a surgeon and removing any plaque that may block it.

Instead, angioplasty involves a surgeon stretching a small balloon through a catheter in a narrowed artery, and then inserting a mesh tube called a stent into the cavity. It prevents drying up of the artery again.

Hemorrhagic stroke

Blood leakage into the brain causes hemorrhagic strokes, and care focuses on minimizing bleeding and reducing the pressure on the brain.

Care can begin with drugs administered to reduce brain pressure, regulate overall blood pressure, prevent seizures and prevent sudden blood vessel constrictions.

If an individual takes blood-thinning anticoagulants or an antiplatelet such as warfarin or clopidogrel, drugs may be administered to counteract the effects of medication or blood transfusions to compensate for blood loss.

Surgery can be used to repair any blood vessel complications that have led to hemorrhagic strokes or that could lead to them. Surgeons may place small clamps at the aneurysm base, or fill them with detachable coils to stop blood flow and prevent rupture.

If arteriovenous malformations (AVMs) cause the hemorrhage, surgery may also be used to remove them if they are not too large and not too deep within the brain. AVMs are intertwined artery-vein connections, which are smaller and burst more rapidly than other normal blood vessels.

Rehabilitation

Strokes are life-changing events which can physically and emotionally impact a person. Successful rehabilitation following a stroke will also require different treatments and support, such as:

  • Speech Therapy: It deals with any speech problems. Practice, relaxation and an evolving style of communication can all help.
  • Physical therapy: This can benefit a person to relearn movement and coordination. Staying involved is important even if it is hard at first.
  • Occupational therapy: It is used to help an person improve his or her ability to perform daily routine tasks such as washing, eating, dressing, sleeping, reading and writing..
  • Support groups: They help with common problems of mental health, such as depression that may occur after a stroke. Most think sharing common experiences and exchanging information are useful.
  • Friends and family care: After a stroke, people closest to a patient should be offering practical support and comfort. It’s really important to let friends and family know what can be done to help.

Rehabilitation is a significant and continuing part of treatment. Rehabilitation to a normal quality of life is possible with the right help and support from loved ones, depending on the severity of the stroke.

Prevention

The best way to prevent a stroke is to address the underlying causes. This is best achieved through lifestyle changes, including:

  • eating a healthy diet
  • maintaining a healthy weight
  • exercising regularly
  • not smoking tobacco
  • avoiding alcohol or drinking moderately

Eating a nutritious diet includes plenty of fruits, vegetables and healthy whole grains, nuts, seeds and legumes included. Make sure you eat little or no red or processed meat, and restrict cholesterol and saturated fat intake. Minimize the consumption of salt to help healthy blood pressure.

Other steps implemented to help reduce stroke risk include:

  • keeping blood pressure under control
  • managing diabetes
  • treating obstructive sleep apnea

As well as these lifestyle improvements, a doctor can help by administering anticoagulant or antiplatelet medicine to reduce the risk of possible ischemic strokes.

Moreover, arterial surgery can also be used to reduce the risk of repeat strokes, as well as some other surgical options that are still under review.

Types

There are three main types of stroke:

  • Ischemic stroke: This is the most common type of stroke. A blood clot prevents blood and oxygen from reaching the brain.
  • Hemorrhagic stroke: This occurs when a weakened blood vessel ruptures and normally occur as a result of aneurysms or arteriovenous malformations (AVMs).
  • Transient ischemic attacks (TIAs): Also referred to as a mini-stroke, these occur after blood flow fails to reach part of the brain. Normal blood flow resumes after a short amount of time, and symptoms cease.

Causes

The different types of stroke have different causes. However, stroke is more likely to affect people if they have the following risk factors:

  • being overweight
  • being aged 55 years or older
  • a personal or family history of stroke
  • an inactive lifestyle
  • a tendency to drink heavily, smoke, or use illicit drugs

Ischemic stroke

This form of stroke is caused by blockages or narrowing of the arteries that supply the brain with blood, leading to ischemia. Ischemia is a serious decrease of blood flow, which kills brain cells.

Such blockages are often caused by blood clots that can form in the arteries of the brain. In other blood vessels in the body, they can also occur before being swept through the bloodstream and into smaller arteries in the brain.

Fatty deposits inside the plaque-like arteries can cause clots that cause ischemia.

Hemorrhagic stroke

Hemorrhagic strokes are caused either by leaking blood or by bursting open arteries in the brain.

Leaked blood exerts pressure on and kills brain cells. It also reduces the blood supply that can enter post-hemorrhage brain tissue. Blood vessels may burst and blood spill into the brain or near the brain surface, sending blood into the space between the brain and the skull.

Conditions including hypertension, trauma, blood-thinning medications, and aneurysms may cause the ruptures. Aneurysms are defects in blood vessel walls.

Intracerebral hemorrhage is the most common type of hemorrhagic stroke which happens after an artery in the brain bursts when the brain tissue is flooded with blood.

Hemorrhage of subarachnoid is the second type of hemorrhagic stroke, and is less common. Bleeding occurs in that form of stroke in the region between the brain and the thin tissues that cover it.

Transient ischemic attack (TIA)

TIAs vary from the above forms because blood flow to the brain is only disrupted momentarily. TIAs are similar to ischemic strokes in that blood clots or other clots also cause them.

These should be considered medical emergencies, even though artery blockage and its consequences are temporary. These act as warning signs for potential strokes and show a partially blocked source of artery or clot is in the heart.

According to the Centers for Disease Control and Prevention (CDC), if they have not undergone any treatment, about one third of people who undergo a TIA will have a major stroke within one year. Within 3 months of a TIA, between 10 and 15 per cent of people will have a major stroke.

Symptoms

Symptoms of a stroke often appear without warning.

The main symptoms of stroke are:

  • confusion, including trouble with speaking and understanding
  • a headache, possibly with altered consciousness or vomiting
  • numbness or inability to move parts of the face, arm, or leg, particularly on one side of the body
  • vision problems in one or both eyes
  • trouble walking, including dizziness and lack of co-ordination

Strokes can lead to long-term health problems. Depending on how quickly it is diagnosed and treated, an individual can experience temporary or permanent disabilities in the aftermath of a stroke.

In addition to the persistence of the problems listed above, people may also experience the following:

  • bladder or bowel control problems
  • depression
  • pain in the hands and feet that gets worse with movement and temperature changes
  • paralysis or weakness on one or both sides of the body
  • trouble controlling or expressing emotions

Symptoms vary and may range in severity.

The acronym F.A.S.T. is a way to remember the signs of stroke, and can help identify the onset of stroke:

  • Face drooping: If the person tries to smile, does one side of the face droop?
  • Arm weakness: If the person tries to raise both their arms, does one arm drift downward?
  • Speech difficulty: If the person tries to repeat a simple phrase, is their speech slurred or strange?
  • Time to call 911: If any of these signs are observed, contact the emergency services.

The faster a person with suspected stroke receives medical attention, the better their prognosis will be, and the less likely they will be to experience permanent damage or death.

Diagnosis

Signs of a stroke require immediate medical attention.

Strokes onset rapidly and will often occur before an individual can be seen by a doctor for a proper diagnosis.

For a person experiencing a stroke to get the best diagnosis and treatment possible, they should be treated at a hospital within 3 hours of their symptoms first appearing.

There are several different types of diagnostic tests that doctors can use to determine which type of stroke has occurred:

  • Physical examination: A doctor will ask about symptoms and medical history. They may check blood pressure, listen to the carotid arteries in the neck, and examine the blood vessels at the back of the eyes to check for indications of clotting.
  • Blood tests: A doctor may perform blood tests to find out how quickly the clots occur, the levels of particular substances in the blood, including clotting factors and whether or not an infection is present.
  • CT scan: A series of X-rays can show hemorrhages, strokes, tumors, and other conditions within the brain.
  • MRI scan: Radio waves and magnets create an image of the brain to detect damaged brain tissue.
  • Carotid ultrasound: An ultrasound scan to check the blood flow in the carotid arteries and to see if there is any plaque present.
  • Cerebral angiogram: Dyes are injected into the brain’s blood vessels to make them visible under X-ray. This gives a detailed view of the brain and the blood vessels in the neck.
  • Echocardiogram: This creates a detailed image of the heart to check for any sources of clots that could have traveled to the brain to cause a stroke.

It is only possible to confirm the type of stroke someone has had by giving them a brain scan in a hospital environment.

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Cardiovascular / Cardiology

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

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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

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Mental Health

Types, conditions, and treatments of facial tics

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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/

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Bones / Orthopedics

Spinal problems causing tremors: What to know

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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

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