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Advanced Centre for Neuro Care at Fortis Hospital Chennai

 

Neurology is a branch of medicine that is concerned with the operation, disorders and diseases encompassing the nervous system of the human body. 

 

What is Neurology?


The brain is made up of billions and billions of neurons that have the power to generate specific signals. In return, they can also receive and transmit these signals from their surrounding cells. The word ‘neuron’ is translated into ‘nerve’ and ‘logia’ implies ‘the study of which together forms the term ‘neurology’.

 

The field of neurology broadly studies:


• The central nervous system, the peripheral nervous system along with the autonomic nervous system
• Any deficiencies or imperfections in the nervous system as a result of possible functional and structural conditions caused by any degenerative conditions


Neurological disorders and their impact are dramatically variable between different age groups, primarily, infants, young children and adults. In order to arrive at a diagnosis, those experiencing neurological symptoms should consult a neurologist who is an expert in treating conditions of the brain, spinal cord, and nerves. 

 

Neurology – Areas of Care


Neurology has several areas of care including:

 

Autonomic Neurology:

There are quite a few autonomic disorders that are assessed and treated, including:

  • Autonomic neuropathy/autonomic failure
  • Postural tachycardia syndrome
  • Small fibre neuropathy
  • Multiple system atrophy
  • Genetic disorders associated with dysautonomia
  • Diabetic neuropathy
  • Sweat disorders: anhidrosis (loss of sweating) or hyperhidrosis (excessive sweating)
  • Syncope
  • Cerebral blood flow abnormalities

 

Cancer Neurology:

Neurological cancers are:

  • Astrocytoma
  • Brain metastasis
  • Brain tumour
  • Brainstem glioma
  • Chordoma
  • Colloid cyst
  • Craniopharyngioma
  • Ependymoma
  • Glioblastoma (GBM)
  • Germ cell tumour
  • Glioma
  • Hemangioblastoma
  • Hemangiopericytoma
  • Lymphoma
  • Medulloblastoma
  • Meningioma
  • Mixed glioma
  • Neurofibromatosis
  • Oligodendroglioma
  • Pineal gland tumour
  • Pineoblastoma
  •  Pituitary tumour
  •  Primitive neuroectodermal tumour
  •  Spinal cord tumour

 

Cognitive and Behavioural Neurology:

The following cognitive and behavioural neurology related conditions are: 

  • Alzheimer's disease
  • Non-Alzheimer Dementias
  • Mild cognitive impairment
  • Frontotemporal lobar degeneration
  • Autism and Asperger syndrome
  • Learning disabilities

 

Neuropsychiatric disorders that are secondary to the conditions include:

  • Parkinson’s disease
  • Traumatic brain injury
  •  A brain tumour and other central nervous system cancers
  •  Cerebrovascular disease
  •  Seizures and epilepsy

 

A broad range of cognitive disorders that fall under Cognitive and Behavioural Neurology are:

  • Those involving memory-related conditions
  • Attention
  • Executive functions 
  • Language 
  • Visuospatial function

    

Critical Care Neurology:

The conditions treated are:

  • Stroke
  • AVM
  • Dural Sinus Thrombosis
  • Head Injury
  • Spinal Cord Injury
  • Brain Tumour
  • Eclampsia
  • Coma
  • CNS Vasculitis
  • Infection of the Central Nervous System (herpes simplex, bacterial meningitis...)
  • Seizure (includes a difference between seizure & epilepsy)
  • Metastasis of the Spinal Cord
  • Paraneoplastic Syndrome
  • Neuroleptic Malignant Syndrome
  • Neuromuscular weakness and paralysis

    Epilepsy and Seizure Disorders

   

General Neurology:

General neurology has several conditions that are treated including:

  • Weakness
  • All types of Headaches
  • Numbness
  • Tremors
  • Memory loss
  • Seizures

    Hospital Neurology

    

Movement Disorders:

The following conditions that affect a patient’s movement capabilities:

  • Parkinson’s disease
  • Multiple system atrophy
  • Progressive supranuclear palsy
  • Other Parkinsonian syndromes
  • Ataxia
  • Tremor
  • Myoclonus
  • Gait disorder
  • Dystonia
  • Tics
  • Gilles de la Tourette’s syndrome.
  • Focal dystonia, including,
  • Torticollis
  • Blepharospasm,
  • Occupational cramp disorder

  Multiple Sclerosis

    

Neurological Infections and Inflammatory Diseases:

The range of conditions that experts are able to treat under infections and inflammatory diseases include:

  • Lyme disease
  • Neurologic complications of HIV
  •  Neurologic opportunistic infections
  •  CNS Immune Reconstitution Inflammatory Syndrome (IRIS)
  •  Meningitis
  •  Encephalitis, myelitis, or encephalomyelitis:
  •  Abscess
  •  Neurocysticercosis
  •  Neurological infections in travellers/immigrants
  •  Neurological complications of rheumatologic conditions
  •  Sarcoidosis
  •  Paraneoplastic Syndromes
  •  Vasculitis

    

Neuromuscular Diseases and EMG:

Areas of care under neuromuscular disorder includes:


       Muscle Diseases:

  • Inflammatory myopathies
  • Inflammatory Myopathies
  • Dermatomyositis (DM)
  • Polymyositis (PM)
  • Inclusion body myositis (IBM)

     Metabolic myopathies

  • Mitochondrial myopathies such as, 
  • Kearns-Sayre syndrome
  • MERRF
  • MELAS
  • Glycogen storage disease including,
  • McArdle's disease
  • Pompe disease
  • Disorders of lipid metabolism such as.
  • CPT2 deficiency
  • Toxic myopathies, namely,
  • Statin myopathies
  • Muscular dystrophies including
  • Duchenne and Becker muscular dystrophies, 
  • Fascicular humeral dystrophy
  • Limb-girdle muscular dystrophy
  • Myotonic dystrophy
  • Congenital myopathies such as,
  • Nemaline myopathy
  • Centronuclear myopathy
  • Muscle channelopathies, for example,
  • Periodic paralyses 
  • Myotonic congenital

    Diseases of the neuromuscular transmission

  • Myasthenia gravis
  • Lambert-Eaton myasthenic syndrome (LEMS)
  • Botulism

    Motor Neuron Diseases:

  • Amyotrophic lateral sclerosis (ALS)
  • Primary lateral sclerosis
  • Spinal muscular atrophy (SMA)
  • Bulbospinal muscular atrophy or Kennedy's disease
  • Post-polio syndrome

    Neuropathies:

  • Focal radiculopathies, for example,
  • Carpal tunnel syndrome
  • Bell's palsy
  • Plexopathies such as,
  • Brachial plexopathies
  • Personage Turner's syndrome
  • Vasculitic neuropathies
  •  Peripheral neuropathies including, 
  •  Diabetic neuropathy
  •  Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP)
  •  Multifocal motor neuropathy
  •  Inherited neuropathies, namely,
  •  Charcot-Marie-Tooth disease (CMT)

    Neuro-ophthalmology: Some of the treatable conditions are:

  • Bell’s (Facial) Palsy
  • Double Vision
  • Non-Arteritic Anterior Ischemic Optic Neuropathy
  • Ocular Myasthenia Gravis
  • Optic Neuritis
  • Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
  • Temporal Arteritis
  • Thyroid Eye Disease (Graves’ Disease)
  • Trigeminal Neuralgia
  • Visual Field Deficits
  • A visual Migraine
  • Pituitary Tumours

    Migraines and Headaches: Types of headaches and some of the most complex migraine conditions include:

  • Cluster Headaches
  • Headaches
  • Migraines
  • Tension Headaches

    Pain Neurology

   Sleep and Circadian Rhythm Disorders: Some of the common conditions that are treatable are:

  • Delayed Sleep Phase Disorder
  •  Advanced Sleep Phase Disorder
  •  Jet Lag
  •  Shift Work Disorder
  •  Narcolepsy is a sleep disorder
  •  Obstructive Sleep Apnoea
  •  Central Sleep Apnoea
  •  Insomnia
  •  Hypersomnia
  •  Parainsomnia
  •  REM Sleep Behaviour Disorder
  •  Non-24-Hour Sleep-Wake Disorder
  •  Periodic Limb Movement Disorder

    Spinal Cord Disorders: Areas of care for spinal cord disorders are:
    Structural disorders of the spine, for example,

  • Cervical Spine Stenosis

    Transverse myelitis and other inflammatory diseases of spinal cord like,

  • Neuromyelitis Optica
  • Paraneoplastic Myelopathy

    Infections of the spinal cord
    Vascular disorders of the spinal cord, including,

  • Stroke or blood vessel abnormalities

    Syringomyelia
    Spinal cord trauma
    Spinal cord disorders associated with other systemic diseases, for example,

  • Systemic lupus erythematosus
  •  Rheumatoid arthritis 
  •  Sarcoidosis

    Genetic disorders of the spinal cord, such as,

  • Hereditary spastic paraplegia 

    Stroke and Cerebrovascular Diseases

 

Neurosurgery

Neurosurgery or neurological surgery is the field of medicine that practices invasive methods to prevent, diagnosis, treat and rehabilitation therapy of various health conditions affecting the nervous system including the brain, spinal cord, peripheral nerves and cerebrovascular system due to injury or disorder.

 

Neurosurgery or premediated incision into the head for easing pain has been in practice for more than a thousand years, but prominent advancements in the field of neurosurgery have come quite popular in the last hundred years. Neurosurgery mainly includes neurotrauma and neuro emergencies such as intracranial hemorrhage. Specialized branches have been developed to address the critical conditions. The field of neurosurgical care includes adult and pediatric patients.

 

Neurosurgeons are physicians who specialize in the field of neurosurgery. Neurosurgeons offer non -operative or non-invasive and surgical treatments for patients suffering from back and neck pain as well as other neurological conditions ranging from a head injury, spinal and spinal cord injury to Parkinson’s disease.

 

However, contrary to popular belief, not all neurological surgeries are complex and complicated. The expert neurosurgeon would take a call on the procedure after having a detailed study and discussion with the concerned neurologist and other specialists.

 

The road to recovery of the patient depends on various factors like being responsive to post-operative care, medication and even rehabilitation. Read More

 

Symptoms of Neurological Conditions


Symptoms of neurological conditions may greatly differ depending on the type of disorder and also the particular region of the body that has been affected by it. 


In some cases, there may be emotional symptoms that may include:
•    If you experience sudden mood swings
•    If you go through abrupt outbursts 
•    If you are constantly feeling depressed
•    If you are delusional

 

Some physical symptoms may be indicative of a neurological condition such as:


•  If you have partial or total paralysis
•  If you note that your muscles feel unusually weak
•  If there is a partial or complete loss of sensation
•  If you experience seizures
•  If you have difficulty reading and writing
•  If you notice that your cognitive abilities are deteriorating
•  If you suffer from unexplained pain
•  If you observe a lack in alertness

 

Causes of Neurological Conditions


The causes of neurological conditions are strikingly diverse. Multiple membranes insulate the spinal cord and the brain. Both may be susceptible to pressure and force. The underlying peripheral nerves located under the skin is also vulnerable to impairments. Neurological conditions may impact either a single neuron or a complete neurological route. The minutes of disturbance to the structural path of the neuron can cause dysfunction. 

 

Broadly categorising the causes for neurological conditions:


•    Lifestyle-related causes
•    Infections
•    Genetics
•    Nutrition-related causes
•    Environmental influences
•    Physical injuries


Diagnosis


There are around 600 odd neurological conditions that may impact the brain along with the central and autonomic nervous systems. In order to evaluate the damage to the nervous system, the diagnostic process is complex.


The neurological consultation begins with a thorough physical examination. Some of the common diagnostic screenings that may be prescribed by your neurologist may include the following:
•   Computed tomography scan also called a CT or CAT scan
•   Electroencephalogram or EEG
•   Magnetic resonance imaging or MRI

  • MR Angiography (MRA) and MR Venography (MRV)
  • MR Perfusion
  • MR Spectroscopy 
  • MR Diffusion Tensor Imaging
  • MRI or Functional MRI
  • MR CSF Flow

•    Electrodiagnostic tests, such as electromyography (EMG) and nerve conduction velocity (NCV)
•    EP or Evoked potential
•    Positron emission tomography or PET
•    Arteriogram also called an angiogram
•    Spinal tap also called a lumbar puncture
•    Myelogram
•    Neurosonography
•    Ultrasound or Sonography
•    EEG Monitoring


Treatment


The comprehension and analysis of symptoms play an essential part in defining how the treatment plan will advance in case of neurological conditions. However, the commonly accepted forms of treatment include:


Therapies for Neurological Disorders: As part of the treatment plan, the neurologist may place a patient in a rehabilitation centre with the objective of restoring lost functionality in specific areas. This is a constructive endeavour to drive to patient towards recovery.

Cognitive Therapy Treatments: A complementary method of treating neurological disorders is through cognitive behavioural therapy which was earlier known as talk therapy. This custom of treatment deliberates on remodelling the thoughts and behaviour of the patient that connects to their exclusive incapacity.

Surgical Options: For the best patient results, surgical therapy for neurological conditions, specifically the brain and spine is reliant on the use of the most innovative medical technology along with the proficiencies of a highly trained neurosurgeon. Surgical operations include:

  • Endovascular Neurosurgery
  • Visualase MRI Laser-Guided Therapy
  • Stereotactic Radiosurgery
  • Deep Brain Stimulation

 

About the Department


The Department of Neurology at Fortis Hospital in Chennai is a frontrunner at treating patients experiencing all types of neurological disorders. All those who choose to partner with Fortis, Chennai have access to personalized care regardless of the severity of the patient’s neurological condition. Supported by groundbreaking research, patients receive the latest therapeutic approach administered by skilled experts who are committed to adopting advanced technological practices.


Many of our neurologists and neurosurgeons have been distinguished for their cutting-edge work in neurological sciences through their continued clinical work and research efforts, both on national and international platforms. The team as a collaborative unit together is focussed on finding innovative treatment paths that are aimed at reducing and eventually eliminating the overwhelming consequences of all types of neurological disorders. 


The substance of the department is based on the fundamental principles of accomplishing excellence in service, application of pioneering medical procedures, striving to boost the skillset and approaches of treating neurological conditions and being immersed in constructive research in the discipline of neurology. Superiority in day-to-day patient care along with outstanding service to the patients and their families is something that helps Fortis, Chennai to guarantee that their core values continue to be the foundation of this healthcare establishment. 

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Meet Our Doctors

Dr. Soundappan V

Dr. Soundappan V

Senior Consultant Neuro Surgeon

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Dr. Suresh Kumar

Dr. Suresh Kumar

Consultant Neurology

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Dr. Vijay Iyer

Dr. Vijay Iyer

Consultant Neuro & Spine Surgery

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