Tension headache? Parkinson’s? Dr. Rahul Chakor has the answers

Dr. Rahul Chakor is Associate Professor of Neurology at B.Y.L. Nair Hospital, Mumbai.

A Research Fellow in Clinical Neurophysiology/EEG and Epilepsy, Cleveland Clinic Foundation, US, Dr. Rahul teaches at the T. N. Medical College and B. Y. L. Hospital Mumbai, India.

His areas of interest include epilepsy, Parkinson’s disease, migraine, stroke, tension headache, Alzheimer’s, dementia, vertigo, neurocysticercosis, cerebral venous sinus thrombosis, myasthenia gravis, carpal tunnel syndrome, Wilson disease, meningitis and febrile seizures.

Dr. Rahul took time off his busy schedule to answer Sify readers’ questions on neurological issues. Read the chat transcript here.

hi doctor, is there any way to be sure your kid doesnt get epiliesy once he has hurt his head while playing? even in future
Epilepsy may not always happen after every head injury. Medicines are only prescribed if there are seizures after an head injury (Post traumatic epilepsy).

sir, my son aged 13 years is MR Child infected by torch infection. On investigation, multiple calcification in brain. is there any possiblity of treatment. pl advise
Treatment is available if he has seizures.

I am 53 yrs and diabetic for the past 25 years, fairly under control with no diabetic complications. Offlate I get cramps in my legs, is there any remedy for this?
Could be due to electrolyte disturbance or neuropathy. Pls consult a doctor.

parkinsonsproblem,tell me treatment ? day activities food ? exercise ?please let me know if i can meetu? emergency medicine /he need to carry round the clock -also its mentioned that 18th ur their in chat at 12 place
A complete evaluation is necessary for advising medicines.

Sir, I am 35 yr old and feel shivering even in normal days and shave twice a week, and got muscle cramps. I wanted to know is this a normal symptom are a problematic symptom.
Muscle cramps are due to may causes like electrolyte disturbance, hypocalcemia etc. You need to consult and have a evaluation.

Dear Sir, I am feeling headache (not on forehead) all over the Head (may be call as Skul Ache); sometimes the pain may be for fraction of seconds – sometimes more than an hour. Please advice
A detailed evaluation is necessary, history and neurological examination. Could be primary headache.

After eating any cold items , the next day minor headache in backside. Please give me the remedy
Please do a dental evaluation. If not severe and infrequent no specific therapy.

1. is depression also related to neurological problems.? 2. what kinds of neuro problems can lead to depression.? 3. will medicines for such problems have to be taken lifelong?
Yes. Diseases like temporal lobe epilepsy, parkinsons disease, stroke have associated depression. Any chronic neurological disease can lead to reactive depression. Duration of treatment will depend on the underlying disease.

My husband age is 66 he is on epilepsy treatment from his 10 year and now from past 10 years he is a diabetic. he wets the bed very during sleep can it be stopped.
This can be due to several causes. Autonomic disturbance, seizures, etc. He needs to be evaluated.

Sir, My Son is 6 years old and his weight is 15 KG only. Recently he is doing a slight jerk with his head (sometimes upwards and sometimes downwards) and it will last for 2 to 3 sec. In a day he does it 5 to 6 times. Kindly advise. Thanks.
These movements may be tics or myoclonus. He needs a neurological evaluation.

family history of parkinsons. lost my mother and uncle to this disease and one aunt also has it. what precautions can we take to prevent it. im 47 and get stressed out easily.
No preventive medicines available. Eat food rich in antioxidants.

how can we make out when the lumbar disc degenaration is getting worse, having 4 disc bulges and pain agrravates at times unbearable. how to prevent further nerve damage? age 40.
By doing neurological examination, looking at the symptoms and imaging. Back exercises within limits of pain.

have cervical disc bulge, in spite of my correct posture at work on pc, my neck pain increases at times. what can we do to prevent this
Neck and shoulder exercises with proper posture and avoiding long time on computer.

had stroke in ’02. left cerebellum numbness for 2 mths right hand, leg; recovered completely since. was taking ecospirin AV till last year. stopped nw. get stressed a lot. cholesterol, bp under control since then. what precautions to prevent recurrence.
Aspirin has to be continued like long if no other contraindications along with control of blood pressure, cholesterol, blood sugar.

i am under a lot of stress of late. since last 2 days, suddenly my upper lip twitches whenever im tense. what could be the reason? will this lead to parkinsons. the twitch starts only when im nervous or thinking about a particular stressful event
This is due to anxiety. Not a symptom of parkinsons disease

Is there a cure for Notalgia Paresthetica? I was diagnosed with this condition in 2005 and I was treated for 5 years but there was no change in my condition. I eventually stopped all medication. I want to know if this can be treated.
For meralgia paresthetica you can try nerve block.

I am 36 yrs old having Anxiety Neurosis with OCD and at times feels some sort of pain at a particular point in the LHS side of the brain with some sort of connecting pain from waist to knee. I also have Diabetes & Psoriasis.
You need a consultation with examination

my dad was treated for high grade glioma with operation and whether radiotherapy r chemo needed?
A combination of radiotherapy and chemotherapy.

Iam 62 years old. I have taken anti depresant medicine for 5 years. Now I have stopped. For the last 3 years Iam suffering from involuntary movement in the face.Twitches in the mouth.Facial tics.
These could be dyskinesias. You have to be evaluated.

Sir, how can i get rid of schizophrenia and boost my confidence level.I have completed my Mba but currently i am unemployed. How should i muster courage.Thank you
You need to follow up with a psychiatrist.

Sir, My hand vibrates when i write, due to this i am becoming conscious there after i cannot continue it is affecting me professionally.kindly advise me . Thanks Ravinder
Could be essential tremors or primary writing tremors. You need to consult a neurologist.

Dear Sir, I am suffering from Migraine. everyday headeache on my regular life. i cannot concentrate anything.
You need prophylactic medications. Consult a neurologist.

Iam 62 years old suffering for the last five years from facial tics.twitches in the mouth.(Tourette syndrome)Any remedy for me
Medicines can control the symptoms.

whether high grade glioma need chemo and radiotherapy?
Combination of both.

Now since 2005 i did not have any jerks so this year he started to reduce the dosage and am now haing 1mg Rivotril(0-0-1) and Epilex chrono 200mg (0-0-1). Am getting married this year end. Is it ok to proceed with my marriage
Yes. You should share this medical history with all concerned.

Hi Sir,I had Myoclinic jerks way back in 1996 and I was diagonosed with low Valporic acid so i was prescribed Epilex chrono 500 (1-0-1)and Rivotril 2mg (0-0-1). My doctor name is Mr. Deepak Arjundas.
If you are free from myoclonic jerks for more than 2 years a trial of gradual medication withdrawal can be done under strict supervision

My elder sister use to get fits and unconsiseous from 4 year . In may 12 we have shown we consalted to doctor neruo logists.
Do a EEG and follow the doctors instructions

Father age 74, multiple infarct brain in ’06. symptom was weak left leg. has CHD. on medication. nw occasionally he feels same weakness in leg especially if he stops going for walks. also has arrhythmia. shd we do a CT brain again?
CT is needed if he has developed new symptoms like weakness, difficulty in walking etc

my son 17 gets a pounding headache when stressed and a vein on right forehead is seen pulsating and bulging. pl advice..he is a very difficult child at times and wants attention and recognition most of the time
These could be migraine headaches or just tension type headaches. But other secondary causes have to be looked at by examination and investigations (CT or MRI)

My father,age 63, is having spinning sensation and his arms and legs I feel shaking involuntary most of the times though he does not think he has when he exerts himself. He has seen many neurologists and undergone tests like CT but no significant disease.
It could be essential tremors and peripheral vertigo (cause needs to be investigated)

Sir I am suffering from mixed motor neropatthy since last four years pl advice me pefect medicine
The etiology has to be known for correct therapy in case.

Sir,I am 70 year active businessman. I had CABG done in1988 at Housten,USA.I have no heart attack till now. Symptoms I got Angio done in 2010 and it reveiled all 3 vail grafts Blocked and LIMA with LAD is Patent with calaries developed during these years.
Since April,2010. and now I developed a problem that I lose my consciousness for few minutes and get revived itself.It has occured everytime between 7 AM to 9 AM. All sorts of tests have been done like,EEG (3 times),Halter test (3 times), Eco Cardiogram, Carotid Color Eco, Brain MRI, Chest and spine Ex-ray,All types of Blood tests,etc,etc. I have consulted all specialists in Kolkata. But no one could diagnose as to why I get this Blankness. This happens in a minute ,remains for few minutes, and passes off. I feel unsecured in my daily routine work.

Sir, can you tell me the cause of this problem, so that it can be diagnosed. I can send you any further details if required.
You can do a MRI of the cervical spine and look for dynamic vertebral artery compression. Look for positional compression of the vertebral arteries.

i am venkidasamy aged 30 from childhood i have tremours in my hands predominant in the left hand… now i have tremours all over my body… i ve under gone all tests and everything seems to be normal i feel the tremours have increased on age… my neuro has diagonised it as essential tremours… and i ve been prescribed betacap 40 mg.. mean while at age of 19 i had facial palyse and now i also have ulnar numbness however it has improved from what it was before couple of months after doctor asked me to rest my left hand… what is wrong with my nervous system?
Unfortunately you have had three independent neurological problems. Good that you have recovered. All the best.

Sir, I am Vasudeva Rao from Hyderabad working as a journalist. My son, currently two and half years old has delayed milestones…he can’t sit still and keep his head straight…..as his mother developed complications due to high fever in her eighth month, doctors performed caesarian fearing decreasing foetal heart rate. He was fine for first two days but suffered seizures in hospital when he was admitted with high fever. Later after going through EEG, when he was about one year, a neuro physician here Mr VS Prasad said, he has serious disturbance in brain…….currently we are taking him to physio therapy…….he can’t take but only produces sounds….please advise for his improvement……
Rintu babu
Your child may have had hypoxic brain injury. Continue with physio and rehab.

Sir, My elder sister use to get fits and unconsiseous from 4 year . In may 12 we have shown we consalted to doctor neruo logists in Kolhpaur Dr Prabhu .He informed to take all necceary test like MRI and other etc after tests they told we have operate as there is tumar .In May we done operation to her after they told operation is success. After week she was again gone for test they they informed there some post surgeial complex and they done another surgery.
After this surgery she not getting recover in proper way now doctor says it glocercomo type cancer.
In june again she got surgery due some bockage of water in brain . She nearly 50 days in icu ,please tell what will her recovery chances .Her feeding is now from pipe and she getting vomitting and again shiftted ICU

She needs a thorough neurological evaluation. Will need X rays of the spine or MRI of the spine (of the relevant region as guided by the neurological examination). The chances of recovery depend on the type of cancer. If it is highly malignant than survival is for 3 to 5 years.

My son post accident had contusion edema at C4&C5 spine. Has spasticity in hands/fingers. Latest MRI, small Syrinx at C4 level, post trauma. Please tell, if Syrinx would disappear and why spasticity even now? Thks
Syrinx may remain the same or rarely can increase (post-traumatic syrinx). Will need periodic MRI if symptoms increase. Spasticity usually remains for a variable period of time.

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