Health Tips - Head/Neurological/Psychiatry
New Tool Help Predict Risk of Alzheimer's Disease - A new risk index test helps predict whether an elderly person has an increased risk of developing Alzheimer's disease. This test is a 15-point scale that has shown that persons who score 8 or more have an increased risk of developing dementia within 6 years.
Several of the items on the scale are well-known risk factors for Alzheimer's disease; such factors include older age, low scores on tests of thinking skills, and having the gene that has been linked to the disease. Other risk factors for predicting dementia include being underweight, not drinking alcohol, having had coronary bypass surgery, or being slow at performing physical tasks such as buttoning a shirt.
Surprisingly the presence of these latter factors in someone 65 years or older is indicative that such a person is more likely to develop dementia than people who do not have these risk factors. This tool is not only likely to be very important for research, however, it would also allow us to identify high-risk individuals thereby facilitating early intervention and by extension helping such persons extend their cognitive skills and quality of life.
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Brain Haemorrhage - It’s assumed that a “brain haemorrhage” always begins as a sudden onset severe (clap of thunder) headache that is worse than any headache previously experienced. The latest studies show this is only the case in less than 40 % of brain haemorrhages.
Cerebral aneurysms are the most common cause of spontaneous brain haemorrhages, but only 10% to 20% of them are diagnosed before rupture. 60% of those with brain haemorrhages experience a number of warning symptoms that predate the brain haemorrhage by 1 to 6 days. Such headaches are often diagnosed as migraine, sinusitis, tension headache, or cervical spine disorder. Symptoms and risk factors of a brain haemorrhage include:
- 1. New onset pulsatile headache
- The most severe headache ever experienced by the patient
- Most frequently the headaches were frontal or fronto-temporal
- Some experience neck stiffness associated with severe headaches
- Up to 25% had an abnormal gait
- Other less frequent symptoms include:
- Seizure
- Reduced power in a limb
- Abnormal eye movements
- Transient loss of consciousness
- Hypertension
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Dementia - Dementia is a medical term that refers to the loss of mental functions such as memory and reasoning (cognition). Alzheimer's disease is by far the leading cause of age-related dementia for those individuals who are over age 65. Alzheimer's disease attacks nerve cells in parts of the brain that control thought, memory and speech. As more and more cells are destroyed, patients experience memory loss (starting with short-term and progressing to long term) the ability to reason and communicate, and personality and behavioural changes. Eventually patients require total care.
People with the disease die on average four to six years after diagnosis, but the duration of the disease can vary from 3 to 20 years.
There is no cure for Alzheimer's and its course tends to be progressive. The rate of progression varies from person to person. There are two groups of drugs that can be used to modify symptoms. The newer group of medicines are aimed at improving the patient's cognitive symptoms; thought understanding and memory. The more traditional group of drugs are used to treat the behavioural problems associated with Alzheimer's, such as aggressiveness, agitation, insomnia, depression and anxiety.
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Dementia - Some Blood Pressure Drugs May Help Protect Against Dementia - A particular class of medication used to treat high blood pressure could protect older adults against memory decline and other impairments in cognitive function, according to a study that appeared in Archives of Internal Medicine.
Research suggests that some of the drugs classified as angiotensin-converting enzyme (ACE) inhibitors, specifically those types of ACE inhibitors that affect the brain by crossing the blood-brain barrier, may reduce inflammation that could contribute to the development of Alzheimer's disease, a major cause of dementia.
There was a significant cognitive benefit seen in those individuals treated with the centrally active ACE inhibitors specifically, such as captopril, fosinopril, lisinopril, perindopril, ramipril, and trandolapril.
The study found an association between taking centrally active ACE inhibitors and lower rates of mental decline as measured by the Modified Mini-Mental State Exam.
Researchers also found that non-centrally active ACE inhibitors were associated with an increased risk of dementia.
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Eating Disorders - Eating disorders are associated with psychiatric issues that can ultimately lead to life-threatening health complications. People with eating disorders often have a distorted image of their body. An eating disorder may have a behavioural, learned, emotional, psychological, social or genetic component. Eating disorders were very uncommon in our population two decades ago. Studies have shown that persons with a history of incest or child abuse are more likely to develop eating disorders. Teenage girls and young women account for 90% of people with eating disorders. Eating disorders can lead to serious health issues including:
- Disturbances in the heart's rhythm
- Low blood pressure
- Low body temperature
- Kidney failure
- Osteoporosis
- Retarded physical growth
- Irregular periods
- Infertility
- Anaemia
- Acid reflux
- Dental problems
- Constipation
- Dehydration
Substance abuse, depression and anxiety often co-exist in people with eating disorders.
Teens and young adults, who are still developing attitudes about themselves and food, are more likely to respond to therapy. For others, eating disorders can be a lifelong battle. Get help if you suspect you or your child has an eating disorder.
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Emotional Pain - New brain scanning technologies reveal that the part of the brain that processes physical pain also processes emotional pain. The same way that some people post-injury have great difficulty overcoming chronic pain, science now reveals that up to 10% will be challenged to get over a heartbreak.
Emotional pain can take many forms – e.g.: a relationship break-up or the death of a loved one.
Physical pain warns us not to do something, for example walk on a broken ankle. Similarly emotional pain can be a warning - "don't go near that sort of man/ woman again". Sometimes emotional pain can become chronic, long outlasting its original purpose. Many with chronic emotional pain may experience bitterness and anger.
Studies have shown that there is an increased risk of dying in the six months after bereavement and it's particularly marked amongst men. Generally the bereaved are much more likely to die as a result of accidents, heart attacks and stroke.
Identifying depression in the bereaved is essential for treating those whose emotional pain can become chronic, leading to debilitating depression or even death.
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Kids and Internet Addiction Is your child's Internet use affecting their homework, school performance, health (e.g. obesity) and relationships with family/ friends? If the answer is “yes” to any of these your child may be Internet dependant. Children can become 'hooked' on on-line activities – e.g. multi-user games, instant messaging, pornography and chat rooms.
- Compulsive Internet use may be symptomatic of other problems – e.g. depression, anger and low self-esteem. If your child demonstrates strong signs of Internet addiction, seek professional counselling.
- Examine your online habits. Remember, you are your child's most important role model.
- Don't ban the Internet. Establish rules about where your kids can go online and what they can do there - and stick to them.
- Keep your computer in an open area of your house, not in a child's bedroom.
- Encourage your child's participation in other activities - particularly physical pastimes with other children.
- Investigate software that monitors and restricts Internet use.
- If your child seems interested only in playing particular type of online games, try to encourage her or him to read books with a similar theme.
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Memory Loss Associated With Higher Risk for Stroke - In a February 2010 print issue of the journal Neurology it concluded that people who experience memory loss or a decline in their thinking abilities may be at higher risk of stroke.
It was suggested by the study’s author Bernice Wiberg, MD, Uppsala University, Uppsala, Sweden that identifying such a risk factor can allow the managing doctor to implement preventive measures.
The study followed 930 men in Sweden around the age of 70 over a period of 13 years. Three recognised types of mental status examinations were performed on each member of the study periodically.
Interestingly the study found that those participants who were in the lowest 25% of performers on the mental status exam were three times more likely to suffer from a stoke when compared to those who scored in the top 25% on the test.
"Our results support the idea that cognitive decline regardless of whether a person has dementia may predict risk of stroke," said Dr. Wiberg.
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Meningitis This is the inflammation of the membranes and fluid surrounding the brain and spinal cord; it is usually as a result of an infection. Most cases are caused by a virus, but some are caused by bacteria and fungi. Some cases can be a life-threatening emergency. Early treatment can prevent complications. The early signs and symptoms of meningitis can be mistaken for the flu. Classically the symptoms develop over a 48 hour period. Common symptoms include:
- Fever
- Severe headache
- Confusion
- Stiff neck
- Seizures
- Drowsiness
- Anorexia
- Skin rash in some cases
If meningitis is suspected seek medical attention immediately. There are certain factors that can predispose one to meningitis, such as:
- Not completing the childhood vaccine schedule
- Children less than 5
- Community living e.g. College campus dormitories
- Compromised immune system e.g. HIV
- Working closely with animals
Complications can include hearing loss, blindness, speech loss, learning disabilities and paralysis. In order to diagnose such a lumbar puncture (spinal tap) will be performed.
Treatment will be tailored based on the cause.
Specific immunization may prevent meningitis.
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Migraine - Recent studies have proven that a combination drugs taken within an hour after the start of a migraine is effective in relieving symptoms. This combination includes the drugs sumatriptan and naproxen sodium.
It is well known that most migraine suffers put off treatment. This lost window of opportunity can essentially turn the initially treatable migraine into a refractive headache. The recent study unequivocally proves that treating a migraine at the first sign of pain increases the likelihood of relief.
The study involved well over 1,000 patients who frequently suffered with migraine headaches. Half of the participants (of the study) were given the sumatriptan/naproxen drug within an hour after migraine pain started and while the pain was still mild. The other half was given a placebo (false drug). Neither group were aware of what they actually received.
The study showed that the migraine suffers who received the combination of sumatriptan/ naproxen were more likely to be relieved of their headaches, nausea, light and noise sensitivity, or other symptoms when compared to those who received the placebo.
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Teenage Depression Teenagers that are depressed commonly have the following symptoms:
- Irritable or angry mood –They are often grumpy, hostile, easily frustrated, or prone to angry outbursts.
- Unexplained aches and pains - Frequently they complain about physical ailments such as non-specific headaches or stomach aches.
- Extreme sensitivity to criticism – They are plagued by feelings of worthlessness, making them extremely vulnerable to criticism, rejection, and failure.
- Withdrawing from some, but not all people - Teens with depression may socialize less than before, pull away from their parents, keep up at least some friendships or start hanging out with a different crowd.
The consequence of untreated teenage depression includes:
- A drop in school grades
- Violence
- Suicide
- Running away from home
- Internet addiction
- Anorexia
- Substance abuse
- Self injury
- Bulimia
- Low self-esteem
- Reckless behaviour
- Binge eating
The first thing you should do if you suspect depression is to talk to your teen about it in a loving and non-judgmental way. Encourage your child to open up about what he or she is going through.
Just remember once you identify any of depression’s warning signs, seek professional help.
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Transient Ischemic Attack (TIA) - A TIA is often referred to as a ‘warning stroke’ or ‘mini-stroke’ that last only a few minutes. Stroke-like symptoms may last for up to 24 hours. Persons who experience a TIA are more likely to have a ‘full blown’ stroke than persons who have not, and are of the same age and sex. Treating the underlying cause of a TIA can often reduce the chances of a ‘full blown’ stroke.
A TIA occurs when a blood clot temporarily clogs an artery to a part of the brain. Unlike a stroke, when a TIA is over, there is no permanent damage to the brain. It is very important to recognize the warning signs of a TIA or stroke, which can occur suddenly; these may include:
- Numbness or weakness of the face, arm or leg on one side of the body
- Confusion, trouble speaking or understanding
- Trouble seeing out of one eye
- Difficulty walking, dizziness, loss of balance or coordination
- Severe headache with no known cause
