Can you lead a normal life with Mysthenia Gravis? By Dr Gautam Arora MD DM Neurologist.

Can you lead a normal life with Mysthenia Gravis? By Dr Gautam Arora MD DM Neurologist.

Myasthenia gravis is characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. It’s caused by a breakdown in the normal communication between nerves and muscles.

Though this disease can affect people of any age, it’s more common in women younger than 40 and in men older than 60.MG affects about 20 out of every 100,000 people

What causes myasthenia gravis?

Myasthenia gravis is not inherited and it is not contagious. It generally develops later in life when antibodies in the body attack normal receptors on muscle. This blocks a chemical needed to stimulate muscle contraction.

A temporary form of myasthenia gravis may develop in the fetus when a woman with myasthenia gravis passes the antibodies to the fetus. Generally, it resolves in 2 to 3 months.

These factors increase risk:

What are the symptoms of myasthenia gravis?

Visual problems, including drooping eyelids (ptosis) and double vision (diplopia)/Muscle weakness and fatigue may vary rapidly in intensity over days or even hours and worsen as muscles are used (early fatigue)/Facial muscle involvement causing a mask-like appearance. Trouble swallowing or pronouncing words

Your doctor may check your neurological health by testing:

  • Reflexes
  • Muscle strength
  • Muscle tone
  • Senses of touch and sight
  • Coordination
  • Balance

Two-thirds of young people with MG have overactive thymic cells (thymic hyperplasia). About one in 10 people with MG have thymus gland tumors called thymomas, which may be benign (not cancer) or cancerous.

How is myasthenia gravis diagnosed?

Your healthcare provider will perform a physical exam and assess your symptoms. You may undergo these tests:

  • Antibody tests: About 85% of people with MG have unusually high levels of acetylcholine receptor antibodies in their blood. Approximately 6% patients have muscle-specific kinase (MuSK) antibodies.
  • Imaging scans: An MRI or CT scan can check for thymus gland problems like tumors.
  • Electromyogram (EMG): An EMG measures the electrical activity of muscles and nerves. This test detects communication problems between nerves and muscles.

What are the complications of myasthenia gravis?

Weakness and fatigue from MG can keep you from participating in activities you enjoy. This may lead to depression.

Up to one in five people with MG experience a myasthenic crisis or severe respiratory muscle weakness

Treatments for MG focus on improving symptoms. Treatments include:

  • Medications: Cholinesterase inhibitors (anticholinesterase) boost signals between nerves and muscles to improve muscle strength. Immunosuppressants, including corticosteroids.
  • Monoclonal antibodies: You receive intravenous (IV) infusions of biologically engineered proteins. These proteins suppress an overactive immune system.
  • IV immunoglobulin (IVIG): You receive IV infusions of donor antibodies over a period of two to five days. IVIG can treat myasthenia crisis as well as generalized MG.
  • Plasma exchange (plasmapheresis): An IV line removes abnormal antibodies from your blood.
  • Surgery: A thymectomy is surgery to remove the thymus gland. Even if tests don’t show a problem with your thymus gland, surgical removal sometimes improves symptoms.

Dr Gautam Arora MD DM ( Neurology and Pain Management )

NPMC
Block A 90 Kamla Nagar
Delhi North
Ph 8595168656
www.neuroandpain.clinic

Multiple Ways to Treat Chronic Back Pain Without Surgery By Dr Gautam Arora Neurologist and Pain Management Specialist

Multiple Ways to Treat Chronic Back Pain Without Surgery By Dr Gautam Arora Neurologist and Pain Management Specialist

Back pain is considered chronic if it lasts three months or longer. It can come and go, often bringing temporary relief, followed by frustration. Despite a wealth of research in recent years about how to treat back pain, too many patients still receive unnecessary and often excessive treatment. Instead of being urged to continue to work and stay active, which has been shown to be effective, patients often are told to take time off to rest, referred for scans and surgery, and prescribed painkillers, including opioids.

Common Causes of Chronic Back Pain

Chronic back pain is usually age-related, but can also result from a prior injury. The most common causes include:

Nonsurgical Treatments for Chronic Back Pain

Physical Therapy
Physical therapy for chronic back pain may include:

o   Retraining your posture

o   Testing the limits of pain tolerance

o   Stretching and flexibility exercises

o   Aerobic exercises

o   Core strengthening

Diet
Some diets are highly inflammatory, especially those high in trans fats, refined sugars and processed foods. Consult with your doctor to see if your diet could be contributing to your chronic back pain and how you could change it. Maintaining a healthy weight could also help lessen your back pain by reducing the pressure on your spine.

Lifestyle Modifications

Take note of the activities that worsen your pain and avoid them if possible. Not only could this help your back feel better, it could also prevent the underlying condition from advancing. Another important lifestyle change to try is giving up smoking. Nicotine is scientifically known to accentuate pain and delay healing.

Injection-based Treatments
Nerve blocks, epidural steroid injections, nerve ablations and other types of injection-based procedures are available for chronic back pain. They are used when the source of the pain is known and can sometimes help rule out certain causes if the treatment doesn’t work. Injections may stop or lessen pain for a certain period of time, but are not intended as long-term solutions and shouldn’t be used in isolation.

Alternative Treatments
Acupuncture, massage, biofeedback therapy, laser therapy, electrical nerve stimulation and other nonsurgical spine treatments can also make a difference for chronic back pain. Talk to your spine specialist about alternative treatments that could benefit you.

Pharmacologic Treatments
Analgesics, anti-inflammatory drugs, muscle relaxants and other medications can be used to help control chronic back pain. However, most come with unwanted side effects and are not intended for prolonged use.

However, surgery is not always necessary. Other treatment options that can improve or relieve back pain include home remedies, alternative medicine, and lifestyle changes. A person may wish to try these options before deciding on surgery.

Dr Gautam Arora MBBS MD DM

Neurology and Pain Management Clinic ( NPMC )

90 A kamla Nagar Delhi North 110007

Ph: 8595168656

www.neurandpain.clinic

Peripheral Neuropathy can be prevented By Dr. Gautam Arora MBBS MD DM Neurologist and Pain Specialist at NPMC

Peripheral Neuropathy can be prevented By Dr. Gautam Arora MBBS MD DM Neurologist and Pain Specialist at NPMC

Peripheral Neuropathy

Peripheral neuropathy refers to any condition that affects the nerves outside your brain or spinal cord. This can happen for several reasons, from trauma to infections to inherited conditions.

Causes of Peripheral Neuropathy

Injury

Physical trauma is a common cause of injury to the nerves. This can include car accidents, falls, or fractures. Inactivity, or holding still too long in one position, can also cause neuropathy.

Increased pressure on the median nerve, a nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome. This is a common typeTrusted Source of peripheral neuropathy.

Alcohol can have a toxic effect on nerve tissue, putting people with severe alcohol use disorder at a higher risk of peripheral neuropathy.

Exposure to toxic chemicals like glue, solvents, or insecticides, either through chemical abuse or in the workplace, can also cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition.

Infections and autoimmune disorders

Certain viruses and bacteria directly attack nerve tissue.

Viruses such as herpes simplex, varicella-zoster virus (which causes chickenpox and shingles), and Epstein-Barr virus damage sensory nerves and cause intense episodes of shooting pain.

Bacterial infections such as Lyme disease can also cause nerve damage and pain if they aren’t treated. People with HIV or AIDS can also develop peripheral neuropathy.

Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to severe nerve pain in the extremities.

Some forms of neuropathy involve damage to only one nerve (mononeuropathy). Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathy or mononeuropathy multiplex. More often, many or most of the nerves are affected (polyneuropathy).

Certain medications may also cause nerve damage. These include:

  • Anticonvulsants, which people take to treat seizures
  • Drugs to fight bacterial infections
  • Some blood pressure medications
  • Medications used to treat cancer
  • Peripheral Neuropathy Symptoms

The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected.

  • Muscle weakness
  • Cramps
  • Muscle twitching
  • Loss of muscle and bone
  • Changes in skin, hair, or nails
  • Numbness
  • Loss of sensation or feeling in body parts

Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts.

The most common types of tests for peripheral neuropathy (either to confirm the diagnosis or rule out other conditions) include:

Blood tests (these can detect many problems, ranging from immune system problems to toxins and poisons, especially metals like mercury or lead).

Genetic testing.

Magnetic resonance imaging (MRI).

Peripheral Neuropathy Treatment

Usually, peripheral neuropathy can’t be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your healthcare provider will treat that first and then treat the pain and other symptoms of neuropathy.

In some cases, over-the-counter pain relievers can help. Other times, prescription medicines are needed. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face, and some classes of antidepressants, including tricyclics such as amitriptyline.

Lidocaine injections and patches may help with pain in other instances. And in extreme cases, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.

Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize the use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization (IVF) to prevent transmission to future generations.

By Dr. Gautam Arora MBBS MD DM Neurologist and Pain Specialist

Contact Dr. Gautam Arora

Neurology and Pain Management Clinic

Address – A 90 Kamla Nagar Delhi North 110007

Contact Number – 8595168656

www.neuroandpain.clinic