Zydus Neurology

Neurology

Medical Specialities
Neuro Sciences
Neurology

Neurological diseases are on a constant rise owing to our sedentary lifestyle and other multiple factors. Social stigma and inadequate infrastructure also play a role in delayed diagnosis of Neurological disorders. Early diagnosis can also help save thousands of lives. We at Zydus aim to provide the best and complete neurological care covering from the smallest test to intense diagnosis to complete treatment, all under one roof. With an extensive compassionate and skilful staff, the complete cure is available at Zydus. Some of the common disorders being treated are:

- Stroke: Acute Stroke with medicines and interventions
- Paralyses of all types
- Epilepsy, Refractory Epilepsy
- Headaches like migraine, tension & cluster headache
- Parkinson's disease (slowing of daily activities)
- Ataxia and gait disorders
- Atypical Parkinsonism
  - Multiple System Atrophy (MSA)
  - Lewy Body Dementia (LBD)
  - Progressive Supranuclear Palsy (PSP)
  - Corticobasal Syndrome (CBS)
- Dystonia (abnormal twisting movements)
- Tremor disorders
- Chorea and Huntington’s disease
- Wilson’s disease
- Tics and drug-induced movement disorders
- Functional movement disorders
- Dementia (loss of memory)
- Tingling & numbness in limbs (Peripheral Neuropathy)
- Reduced or loss of sensation
- Sudden loss of vision
- Involuntary movements of the body (chorea, hemi-ballismus)
- Myasthenia Gravis
- Guillain–Barré syndrome
- Myopathy
- Multiple Sclerosis
- Loss of coordination
- Treatment with Botulinum Toxin: Cervical Dystonias, Writer's cramp, Spasm of half face (hemifacial spasm), Involuntary closure of eyes (blepharospasm) & post-stroke spasticity

Facilities available for Neurology Patients

- Dedicated Neurology and Neuro-critical care Team
- Investigative Neuro-radiology facilities
- Multi-slice Computerized Tomography (256 slice CT with Gemstone Spectral Imaging Technology) - most advanced state-of-the-art medical imaging technology aiding in precise neurological diagnosis.
- 3T -32 Channels Magnetic Resonance Imaging (MRI) - Delivers the best in class resolution brain imaging to identify any brain malfunctions / malformations, tumours, strokes, ruptures or injury that may generate a seizure like disorder.
- Dedicated Neuro Catheterization Lab - Digital Subtraction Angiography (DSA) - Detects abnormalities of the blood vessels of the brain such as narrowing and blockage, aneurysms or malformations.
- 3D rotational angiography to identify disease of blood vessels in the brain with 40 - 60% reduction of radiation to the patients
- Neurophysiology Lab - EEG, Continuous EEG, Video EEG, NCS, EMG, and VEP and BEAR
- First best quality, high definition (HD) operating microscope (LEICA-OH 5) with neuro navigation
- RIMED TCD machine

Parkinson’s
Parkinson’s disease is caused due to degeneration of cells in a region of the brain known as substanEa nigra, which produces a chemical called dopamine. Reduced dopamine in the brain produces the clinical manifestaEons of Parkinson's disease. Common symptoms are slowness in activities, stiffness, and tremors. As the disease progresses, walking and balance are also affected.
There are many eﬀective oral medications available for the treatment of Parkinson’s disease. In mild and young cases dopamine agonists are usually prescribed.
In extreme cases, surgeries are also performed like DBS. DBS is considered in Parkinson’s disease when symptoms are not adequately controlled with medications.

As the disease progresses, patients develop unpredictable Off periods and dyskinesia (involuntary dance-like movements). after a certain stage, oral medications may not be eﬀective in controlling these symptoms. DBS is an eﬀective surgical option in these patients and symptoms of tremor, stiﬀness, and slowness are well controlled after the surgery. As medications are reduced post-surgery, dyskinesias also improve.
Before the surgery, a movement disorders specialist conducts an extensive assessment including evaluation of medications, symptoms, and response to oral medication. A detailed evaluation of cognition by a neuropsychologist is also done.

Dystonia
Dystonia is involuntary muscle contractions causing abnormal posturing of body parts. It can aﬀect any part of body including eyes (forceful eye closure), jaw, neck, arms and legs,
Some of the common problems are:
Blepharospasm:
Blepharospasm is forceful closure of both the eyes. In the initial stage, it may present as excessive blinking. Forceful eye closure can lead to functional blindness, making activities like reading and driving diﬃcult. Oral medications are of limited use. Botulinum toxin in eyelids can improve the symptoms.
Cervical dystonia:
Abnormal twisting movements of the neck is known as torticollis or cervical dystonia. It is one of the most common types of dystonia manifesting in middle age. Neck tremors can be an associated feature. Treatment of choice for cervical dystonia is botulinum toxin injections.
Writer's cramp:

Writer’s cramp is usually seen in people who write a lot. In this condition, the activity of writing causes abnormal posturing of hand or arm. Using a thick pen can improve writing in some patients. Botulinum toxin is the ﬁrst line of therapy.
In some cases, Dystonia is caused because of an abnormal gene. In others, it can be due to a birth injury, infection or stroke. Dystonia occur in patients doing repetitive activities like writing (writer’s cramp), playing a musical instrument (musicians dystonia) and typing. In some cases, the cause for dystonia can't be ascertained even after extensive investigations.
Anticholinergics drugs are the most commonly used oral therapy for treating dystonia. There are various other medications which are being used for the same. If one notices, any such symptoms, best is to connect with the medical help.

Stroke
Stroke is a condition when a part of the human brain is deprived of blood (thrombosis or embolism) or a blood vessel bursts and blood puts pressure on the brain. There are two types of Stroke, Ischaemic stroke and Haemorrhagic stroke. One is caused by a blockage, cutting off the blood supply to brain and Haemorrhagic stroke is when there is bleeding in or around the brain.
The common symptoms of stroke are face shift or drooping or numbness, arm movement shift, speech slurry, trouble in vision and more. The usual risk factors could be old age or even family history, high blood pressure, high cholesterol, diabetes can also play a role.
After the clinical examination, the CT scan of the brain (done in seconds) reveals haemorrhagic or ischemic stroke.

If Stroke is haemorrhagic, treatment is surgical and/or conservative. If stroke is ischemic, treatment depends upon the time lag. The earlier a stroke patient is brought to Hospital, the better are his/her chances of recovery. The first 4.5 hours are critical for treatment and are considered as Golden Window. Thrombolysis is also a common treatment in such cases often given within this golden period. This means breaking down and dispersing the clot which is preventing blood from reaching the brain.

Other Movement Disorders
There are various clinics here like Botulinum Toxin Clinic which offers Botulinum toxin therapy for dystonia, hemifacial spasm, tremor, post-stroke spasticity, cerebral palsy and drooling and EMG guided injections.
Deep Brain Stimulation (DBS) and Neuromodulation:
Deep brain stimulation for Parkinson’s disease, essential tremor and dystonia.
Transcranial direct current stimulation for ataxia and balance rehabilitation.
Electrophysiology (Tremor/ Myoclonus/ Dystonia)
Tremor analysis with wireless wearable sensors

Multichannel surface EMG recordings
Entrainment and coherence analysis
EEG back-averaging and Cortical SSEP
Long latency reflex, startle and blink reflex
Functional movement disorders electrophysiology
Autonomic Function Lab
- Parasympathetic and sympathetic system assessment
- Beat to beat blood pressure measurement
- Head-up tilt table test
- Evaluation of orthostatic hypotension and syncope.
Gait and Balance Assessment
- Assessment of gait using wearable sensors
- Dynamic balance assessment including transfer and turns
- StaEc balance assessment
- Fall risk assessment
Gait and Balance Rehabilitation
- Dedicated physiotherapy team for balance and gait training
- Targeted gait training using specialized rehabilitation treadmill with biofeedback
- Center of pressure biofeedback training for ataxia
- Vestibular rehabilitation
Neuropsychology
- Cognitive assessment in dementia and mild cognitive impairment
- Complete battery of neuropsychological tests
Speech and Swallowing Therapy
- Speech therapy for Parkinson’s disease using biofeedback
- Swallowing therapy using surface EMG biofeedback and functional electric stimulation
Preventive measures such as vaccination against common pathogens, including Streptococcus pneumoniae and influenza, can help reduce the risk of pneumonia in children.
By recognizing the signs and symptoms of pneumonia and seeking prompt medical attention, caregivers can help mitigate the impact of this respiratory infection and promote the health and well-being of children in their care.

FAQ

Ataxias are a group of disorder that affects balance, coordination, and speech. Common symptoms include loss of balance, falls, change in speech, tremor, and difficulty with ﬁne motor activities. Balance can be affected by diseases of the brain (cerebellum), vision, inner ear, and peripheral nerves.

Essential tremor is the most common movement disorder. It usually presents with shaking of hands. Other body parts like head, vocal cords, and legs can be affected. The tremors are more prominent while doing activities like eating, drinking and writing. Many patients with Essential tremor have a relative with the same disorder. Age of onset has a bimodal distribution with a peak in the 2nd-3rd decade and the second peak in the 7th-8th decade. Sometimes it can be confused with Parkinson's disease, but they are different conditions with different treatment.

B stands for Balance. E means eyes. If there is a blurred or sudden loss of vision. F stands for Face drooping, A stands for weakness in arm, S means difficulty in speech and T means, how crucial is time.