Migraine treatment vary for men and women: Dr Tripathy

crop6_240x240_19aug14Dr Gautam Tripathy is a Consultant Neurologist at Dr L H Hiranandani Hospital, Mumbai. He has attended national and international conferences and has various academic and extra curricular achievements to his credit. He has published papers on epilepsy, movement disorders among other topics in national and international journals. He has been a co-investigator in international clinical trials.

His areas of interest include movement disorder including Parkinson’s disease, epilepsy, stroke and Deep Brain Stimulation (DBS). He conducts botox clinics for patients with hemifacial spasm, writer’s cramp,dystonia and migraine.

Dr. Tripathy answered Sify readers’ queries related to the above in an exclusive chat. Read the transcript below.

Sir, My 2year son born wt hydrocephalus & Meningomyloceal. He operated for both Shunt and Surgery respectively in 2013. Now he has no sensation in his left leg. He is also suffering from Sacral Agenisis. Please help and guide us for further treatment
You need to meet a Neurosurgeon immediately for further evaluation as close supervision is required.

Can DBS work for all movement disorders?
Not all types but it can be tried in some severe movement disorders not responding to routine medications.

Are there any risk factors involved in DBS?
It is overall a safer procedure with minor side effects

How safe and effective is DBS?
DBS is only given in severe cases of Parkinson’s disease and drug induced dyskinesias. It is overall a safer procedure with minor side effects.

I want to know your take on anti-depressants. Do they have serious side effects?
Long term anti depressants can lead to side effects like movement disorders and occasional memory loss.

And what about the cell phone towers? Do they also have a negative effect on our brain health?
Studies regarding this are also going on. So it is advisable to avoid it as much as possible.

Sir I had read somewhere that cell phone radiations are very harmful for the brain. Is this true?
Lot of studies are going on regarding this but none has been proved as yet. Avoid direct exposure if possible.

Are all dry fruits best for our brain health?
Dry fruits are healthy for brain health.

What type of diet alterations are required for brain health?
Have a balanced diet, good amount of protein, avoid excessive carbohydrates and fats. Adequate water intake is also important.

How much does allergy to any food type contribute to neuro disorders? Do we all need to check our food allergies?
Food allergy is an important factor.

Does drinking ample amount of water daily also help in brain blood circulations?
Adequate water intake is advised to maintain hydration but blood circulations in brain are auto regulated.

How can we maintain good blood circulations in the brain?
Brain blood circulations are auto regulated depending on blood pressure and age. Check your blood pressure regularly.

What is the right method and duration of sleeping in the night? I have heard that sleeping on one side also creates headaches or other problems.
Bed posture can lead to neck pain. So sleep straight as much as possible. Use thin and firm pillow.

Can our posture maintained during the day or even while sleeping also be responsible for some neurological problem?
It can. Use a thin and firm pillows. Sleep straight as much as possible. Avoid bending frequently. Go for neck exercises regularly.

Is computer really bad for our eyesight and even our brain?
Excessive Computer exposure can lead to a computer vision syndrome and lead to dry eyes and headaches.

Sir please tell what little changes can make our brain healthy? I usually work long hours on computer. I have minus eyesight nos. Male aged 36yrs.
I request you to exercise daily, improve your protein intake, sleep well, avoid stress. Please indulge in a healthy lifestyle.

Also please tell me the cost of the botox treatment? 
Cost may vary depending on the severity.

How frequently is the botox treatment suggested for hemifacial spasm?
It should be give once in 4 months.

How helpful is botox treatment for hemifacial spasm?
Its the main treatment for hemifacial spasm and gives excellent results.

What are the reasons behind hemifacial spasm occurrence?
It occurs due to a case of facial paralysis ( bells palsy) or it can be due to a brain stem lesion.

Do you visit Bangalore sometimes doctor? How to contact you? Thanks.
My email i.d is drgautam14@gmail.com. -02225763500.

How do you diagnose and treat Parkinson’s disease?
Parkinson’e disease i8s a clinical diagnosis by a neurologist however an imaging modalities might help in diagnosis.

What are the various treatments available now days in India for Parkinson’s disease?
There are dopaminergic drugs like Levodopa, pramiprexole, anticholinergics like trihexphenydyl,amantadine Mao-b inhibitors like rasagiline and selegeline

What is the age criteria for the onset of Parkinson’s disease?
Generally seen after 65 yrs of age but an entity called juvenile Parkinson’s disease may start before 40 yrs of age.

Can Parkinson’s disease be prevented?
There is no preventive therapy for Parkinson’s disease however early parkinson’s can be controlled by certain medications.

Is Parkinson’s disease hereditary?
In a small percentage of cases it is hereditary.

Hi Dr.Gautam. With so much information available now days on internet, How advisable is it to follow the internet information on Neurological problems?
Internet can give you limited information and sometimes can be in extremes. So please follow the doctor for rational discussion.

How is acidity responsible for headaches? I usually get one when I skip my breakfast.
Migraine is accompanied by Gastro symptoms and both could be related.

Are cluster headaches and tension headaches similar doctor?
No they are different . Cluster are frequent in males and are one sided and extremely severe. Tension headache is a generalised bilateral headache.

How much does stress contribute to neurological problems?
A lot. Common illnesses like migraine and epilepsy can be triggered due to stress.

Does the treatment for migraine vary between males and females?
Yes it does.

Actually my sister also is suffering from migraine. She is 45yrs. Are hormone changes also responsible for migraine?
Yes they are responsible. Migraine is known to worsen during menstrual cycle.

I have heard that ice packs and mint odour helps in reducing migraine pain. Is it true?
Not true.

Besides medication, what lifestyle changes can treat migraine?
Migraine can be controlled by adequate sleep, not skipping meals, by avoiding stress and by avoiding caffeine rich foods.

is it migraine lasts for a few years and then recedes on its own?
Yes true. Migraine is known to recede after 40yrs or so but not in all cases. Gradually it recedes over years.

Sir I am a guy aged 38yrs suffering from migraine. I do not know what treatment to go for. Pl advice.
Depends on the severity of the migraine and other associated illness. There are variety of medications available.

Sir I am a guy aged 38yrs suffering from migraine. I do not know what treatment to go for. Pl advice.
There are variety of medications.Depends on the frequency and other associated disease

Are there any vaccinations available to prevent epilepsy/seizures?

Is epilepsy completely curable?
Yes in some cases it is completely curable.However in severe intractable cases it might require long treatment

Can seizure and epilepsy be termed as same or there is some difference?
More than 2 seizures is epilepsy.Epilepsy is a disease/syndrome

Pl tell me what causes epilepsy?
Epilepsy is due to excessive neuronal discharge from brain.It could be genetic,idiopathic or even due to serious conditions like tumors

Are headaches related to our genes?
Yes some headaches like migraines are genetic

I have heard that all headache painkillers have side effects. How true?
Very true. Can affect stomach and kidneys

How many times in a month is it advisable to take headache painkillers?
Not more than 1-2 pain killers per week. Avoid if possible

hello dr.Tripathy, I want to know when is a headache not considered normal?
It is never considered normal. But mild headaches without vision loss, convulsions or vomiting could be benign

what are the precaution to be taken for avoiding headache
Diagnosis is important.Sleep adequately and avoid skipping meals. Caffine in excess should be avoided.

what is the main reason for head ache
Overall Primary headaches like Migraine and tension type headaches are common causes

When I get up in the morning I feel that left side of my face is slightly numb. I think I sleep to my left side. It becomes better after some time.Is it something serious.
you need to show it to a neurologist to rule out sensory loss in that area