Max Institute of Neurosciences

A stroke or brain attack is a condition in which the brain cells suddenly die due to a lack of oxygen. It can be caused by an obstruction in the blood flow or the rupture of an artery that feeds the brain. The patient may suddenly lose the ability to speak, there may be memory problems, or one side of the body can become paralysed. Stroke is the second common cause of death and the fourth leading cause of disability worldwide. Approximately 20 million people each year suffer from stroke, 5 million of whom do not survive. In India, it is a leading cause of death and disability in the young population. There are two kinds of strokes: Ischemic Stroke - It accounts for about three-quarters (or 80%) of all strokes and occurs when a blood clot (or thrombus) forms and blocks blood flow to part of the brain. If a blood clot forms somewhere in the body and breaks off to become free-floating, it is called an embolus. This wandering clot may be carried through the bloodstream to the brain where it can cause an Ischemic Stroke. Haemorrhagic Stroke - It occurs when a blood vessel on the brain's surface ruptures and fills the space between the brain and skull with blood (subarachnoid haemorrhage) or when a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral haemorrhage). 20% of stroke cases are haemorrhagic. Many stroke patients are left with weakness on one or both sides of the body, experience difficulty speaking, incontinence, loss of speech or thinking, inability to walk or are rendered bedridden. Early action can minimize brain damage and potential complications.

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A brain tumour is an abnormal growth of cells/tissue within the brain or the skull vault. It is created by an unusual and uncontrolled cell division, usually in the brain itself, but also sometimes in the lymphatic tissue, blood vessels, cranial nerves, brain meninges (skinny layer of tissue covering the spinal cord and brain), the skull, pituitary gland, or pineal gland and from congenital vest cells. There are many types of brain tumours, combined they fit into one of the following categories: Benign Tumour: It is non-cancerous in nature. A benign tumour must be evaluated closely to determine whether it is close to vital structures such as blood vessels, nerves or the brain stem. Malignant Tumour: It is cancerous in nature. It is important to determine if a malignant tumour is primary or metastatic in nature. The tumour’s size, type and location is important in planning the optimal treatment. Metastatic Tumour: A malignant brain tumour that is caused by the spread of cancer cells from another area of the body is a metastatic tumour. The original source (primary site) of metastatic brain tumours is often the lung, breast, kidney, colon or metastatic melanoma. Metastatic brain tumours may cause symptoms in some patients before the primary site is diagnosed. The primary source of the metastatic tumour is possible to be determined in approximately 90% of the patients.

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Seizures are episodes of disturbed brain function, caused by abnormally excited electrical signals in the brain. Epilepsy is a term used for recurrent seizures caused by increased firing in the brain cells resulting in short-circuiting of the brain circuits. Epilepsy is not a psychological illness. Epileptic seizures can be of different types with some being mild while the others causing spasms and uncontrollable muscle twitches. About 1% of people worldwide (70 million) have epilepsy, and nearly 80% of cases occur in developing countries. In India, it’s prevalent in between 6 to 10 per 1000 people.

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A headache or cephalalgia refers to pain anywhere in the different areas of the head or neck. This includes the nine pain-sensitive structures, which include the cranium (the periosteum of the skull), muscles, nerves, arteries and veins, subcutaneous tissues, eyes, ears, sinus and mucous membranes. A chronic daily headache (CDH) is commonly defined as a headache occurring for 15 or more days in a month or at least for three months. Chronic daily headache (CDH) is where a person experiences frequent headaches that are challenging to manage. A recent population-based survey shows that nearly 5% of the unselected population has daily headaches. Most of the patients with persistent headaches have a primary headache syndrome. Headache is the most common complaint which brings a patient to a neurologist. Although most headaches are benign in origin, some can have severe and sometimes life-threatening causes.  

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In multiple sclerosis, the communication within the brain, and between the brain and body is disrupted. It is caused by damage to the myelin sheath, a protective covering that surrounds nerve cells. Multiple sclerosis is a chronic, unpredictable and often disabling disease which affects the central nervous system, spinal cord and optic nerves. It is categorized as an autoimmune disease caused by the immune system attacking and damaging the nervous system. Following are the types of multiple sclerosis: Relapsing-remitting (RRMS): Patients have occurrences of symptoms, with or without recovery, but between attacks, there is no interval worsening. Secondary-Progressive (SPMS): This stage comes a few years after RRMS and the pattern changes from a relapsing one to a progressive one in between the attacks. Primary-Progressive (PPMS): Gradual onset from the beginning with no attacks. Progressive-Relapsing (PRMS): One of the rare forms of multiple sclerosis, it begins with a progressive course which later transforms into developing attacks. Fulminant: A rare yet extremely severe and rapidly progressive multiple sclerosis.

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Neuromuscular disease is a broad term that encompasses many diseases and ailments that impair the functioning of the muscles. These may directly involve the muscle directly or indirectly by involving the nerves or the Neuromuscular junction (the meeting point of the motor nerves and muscle fibre). The symptoms of Neuromuscular diseases may include- Numbness, painful abnormal sensation, muscle weakness, muscle atrophy, muscle pain or twitching (fasciculation). The Neuromuscular diseases may be categorised into the following groups: Diseases of Anterior Horn Cells (Junction between spinal cord and motor nerve) – Motor Neurone Diseases Diseases involving motor and sensory nerves – Peripheral Neuropathies Disorders of the Neuromuscular function – Myasthenia Gravis and related diseases Diseases of the muscles (Myopathies)- Muscular Dystrophy and Inflammatory myopathies

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It is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination. Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging. Symptoms may affect one or both sides of the body, and can include: Slow blinking (tremors involving half of the body) Constipation Difficulty swallowing Drooling Problems with balance and walking No expression in the face (like you are wearing a mask)

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