Benign Positional Paroxysmal Vertigo (BPPV) Benign Positional Paroxysmal Vertigo (BPPV) Home Overview Benign positional paroxysmal vertigo refers to brief intermittent attacks of rotatory vertigo, that is a sudden spinning sensation. It is precipitated by rapid change in head position. Posterior semicircular canal is affected the most followed by anterior semicircular canal in the ear. Causes It is caused by movements of canalith (calcium crystals in inner ear) in endolymph (fluid in inner ear) Risk factors Age: Most common in people aged >50 years but can occur at anytimeGender: BPPV is common in womenVitamin D deficiencyHead traumaOther disorders including:LabyrinthitisVestibular neuronitisMeniere diseaseMigraineInner ear surgeryOther conditions including:HypertensionDiabetes mellitusHyperlipidaemiaOsteoporosisNon-apnoea sleep disorders Symptoms Vertigo (spinning sensation of head) on turning head, while sitting up or lying down, and looking up or bending downMay be associated with nausea or vomitingImbalanceUsually comes in episodesRelieved by resting in one position Specialist to approach Neurologist Diagnosis Clinical examination using head impulse test or Dix Hallpike manoeuvreMRI brain to detect unusual features Treatment Repositing manoeuvres - Epley’s, Semont’s, Brandt-Daroff exercisesRegular vestibular rehabilitation exercisesMedicines for symptomatic treatment Read more about Benign Positional Paroxysmal Vertigo (BPPV) Filter Alphabet B
Autosomal Dominant Nocturnal Frontal Lobe Epilepsy Autosomal Dominant Nocturnal Frontal Lobe Epilepsy Home Overview Autosomal dominant nocturnal frontal lobe epilepsy is a rare genetic condition characterized by seizures that primarily occur during sleep. It originates from the frontal lobe of brain and is inherited in an autosomal dominant pattern. Thus, it has up to 75% likelihood of genetic mutation being transferred to the offsprings. Causes Mutations in CHRNA2, CHRNA4 and CHRNB2 genes Risk factors Being born with brain abnormalitiesFamily history of seizures or epilepsyDevelopmental disabilityBrain infections or infectionsSeizures in infancy or early childhood Symptoms Seizures during sleepHand clenchingArm raising or loweringVocalizationsSense of fearDizziness Specialist to approach Neurologist Diagnosis Clinical examination and family historyEEG Treatment Antiseizure medications Read more about Autosomal Dominant Nocturnal Frontal Lobe Epilepsy Filter Alphabet A
Alcoholic Fatty Liver Disease (AFLD) Alcoholic Fatty Liver Disease (AFLD) Home Overview Alcoholic fatty liver disease (AFLD) is the earliest stage of ALD, and is characterised by abnormal hepatic accumulation of fat (steatosis) in response to alcohol consumption; such a liver generally appears light yellow in colour. AFLD. Importantly, it can progress to more severe liver conditions, such as alcoholic steatohepatitis, liver fibrosis, cirrhosis, and liver cancer. Causes and risk factors Chronic alcohol abuse is the primary cause of AFLD. Other factors include: Genetic factors: Some people are genetically predisposed to developing AFLD due to differences in how their liver metabolises alcohol or their ability to tolerate alcohol-related damage.Nutritional deficiencies: Malnutrition and poor diet—often associated with chronic alcohol use (heavy and prolonged)—can accelerate liver damage and increase the risk of AFLD.Obesity: Overweight individuals are at higher risk of developing AFLD.Other liver diseases: People with pre-existing liver conditions (like hepatitis B or C infection) are more susceptible to developing AFLD.Age and gender: The risk of developing AFLD increases with age, and women may be more susceptible to AFLD than men, even with lower levels of alcohol consumption.Other health conditions: Diabetes, high cholesterol, and high blood pressure may increase the risk of developing AFLD. Symptoms In the early stages, AFLD may exhibit no symptoms (asymptomatic) or very mild symptoms. As the condition progresses, more symptoms can manifest; these include:Fatigue: Feeling unusually tired or lethargic.Pain or discomfort in the upper right abdomen: This generally observed as the upper right abdomen is the place where the liver is located.Enlarged liver (hepatomegaly): The liver may become palpable (feel enlarged) upon examination.Jaundice and dark urine: These conditions can occur in more advanced stages of AFLD, when the liver loses its ability to process bilirubin.Loss of appetite: Reduced desire to eat.Nausea and vomiting: These are often seen in more advanced liver disease.Most people with AFLD do not exhibit symptoms until the disease progresses to more serious stages, such as alcoholic steatohepatitis. Diagnosis The first stage of diagnosis includes a full review of the patient’s medical history, including alcohol consumption patterns and assessment of liver disease signs and any pre-existing conditions, like diabetes or obesity. Other diagnostic strategies have been enumerated below.Physical examination: This involves checking for liver enlargement or tenderness.Blood tests: A multitude of blood tests are available for diagnosing AFLD; these include,Liver function tests: Elevated ALT and AST levels can indicate liver injury; however, these tests are not specific to AFLD.Alcoholic biomarkers: Elevated GGT levels and mean corpuscular volume (MCV) may indicate alcohol-related liver damage; however, these are not specific to AFLD.Complete blood count (CBC): CBC can help detect signs of liver dysfunction (e.g., low platelet counts), including AFLD.Imaging techniques: A variety of imaging techniques can be used to detect liver damage, including AFLD.Ultrasound: This non-invasive test can assess fat accumulation in the liver.CT or MRI: These can provide more detailed images of the liver and detect fat deposits.Elastography: This specialised ultrasound technique can measure liver stiffness, which can indicate liver damage.Liver biopsy: In some cases, liver biopsy may be used to confirm the presence of fat in the liver and assess the degree of liver damage. Biopsies are typically done when the diagnosis is uncertain or to rule out other liver diseases. Treatment Abstinence from alcohol is the cornerstone of AFLD treatment. Continuing to drink alcohol can worsen the liver damage, and AFLD can progress to more severe conditions, like alcoholic steatohepatitis and cirrhosis. The treatment and management modalities of AFLD include:Support for cessation of alcohol consumption: Programs, therapy, or medications (such as disulfiram or naltrexone) may be prescribed to help individuals stop drinking.Nutritional and lifestyle changes: A few dietary and lifestyle changes can help manage AFLD.Proper nutrition: A healthy, balanced diet rich in vitamins, minerals, and antioxidants can support liver health and improve outcomes.Weight loss: Gradual weight loss (5‒10% of the body weight) can help reduce liver fat and improve liver function, especially in individuals with obesity.Avoiding fatty foods: Reducing the consumption of saturated fats and processed foods can help lower the liver’s fat load.Managing underlying conditions: Management of pre-existing conditions can also help manage AFLD.Diabetes: Proper management of blood glucose levels can help prevent further liver damage.High cholesterol levels: Lowering the cholesterol levels with medications like statins may help protect the liver.High blood pressure: Controlling blood pressure with medications can reduce the strain on the liver.Medications: Currently, there are no medications specifically approved for AFLD; however, some studies suggest that vitamin E may help reduce liver inflammation in individuals with AFLD (especially non-diabetic individuals). Prevention The most effective way to prevent AFLD is to reduce or eliminate alcohol intake. Other preventive measures include:Maintaining a healthy weight: Obesity contributes to the development of fatty liver disease, so maintaining a healthy weight can reduce the risk of AFLD.Eating a balanced diet: Avoiding excessive fats and sugars, and focusing on a nutritious diet rich in fruits, vegetables, lean proteins, and whole grains can help manage AFLD.Exercising regularly: Physical activity helps manage weight and improves liver health.Monitoring and managing underlying conditions: Proper management of diabetes, high cholesterol levels, and high blood pressure can reduce the strain on the liver and help prevent AFLD. Read more about Alcoholic Fatty Liver Disease (AFLD) Filter Alphabet A
Autonomic Neuropathy Autonomic Neuropathy Home Overview Autonomic neuropathy involves the autonomic nervous system and is caused by damage to the nerves controlling automatic body functions. Causes Guillain-Barre syndromeParaneoplastic neuropathyAmyloid neuropathyMultisystem atrophyFabry’s disease Risk factors Uncontrolled diabetes.Other diseases including amyloidosis, porphyria, and hypothyroidismCancer Symptoms DiarrhoeaGastroparesisPostural dizzinessAbdominal painPseudo-obstruction Diagnosis Autonomic function testsGastrointestinal testsTilt-table testQuantitative sudomotor axon reflex test Treatment Treatment of underlying conditionsManaging the specific symptomsMedications Read more about Autonomic Neuropathy Filter Alphabet A
Autism Autism Home Overview Autism or autistic spectrum disorder (ASD) refers to a neurodevelopmental disorder impacting social behaviour, communication, and social interaction. Causes Exact cause is not fully understood. Risk factors Biological male sexFamily historyMedical conditions like fragile X syndrome, Rett syndrome, or tuberous sclerosisBabies born prior to 26 weeks of gestationBeing born to older parents Symptoms No attention to auditory stimulus during infancyLack of verbal and non-verbal communicationRepetitive behavioursRestricted interestsLack of peer interactionSensory sensitivitiesResistance to change of environment. Specialist to approach Neurologist Diagnosis Clinical assessment with various scales available to diagnose ASDMRI brain and EEG to rule out acquired causes Treatment Cognitive and behavioural therapiesOccupational therapiesTo provide inclusive environment Read more about Autism Filter Alphabet A
Athetosis Athetosis Home Overview Athetosis is a disorder that involves hyperkinetic movements, which is a slow writhing movement of fingers and hands. It may be associated with abnormal postures of the extremities, stiffness and difficulty in performing voluntary movements. Causes Brain injuryStrokeCerebral palsyNeurodegenerative diseases such as Huntington’s diseaseInfections or inflammationsGenetic disorders Risk factors Brain damageBirth challenges such as asphyxia, haemorrhage, or stroke during pregnancy, birth, or shortly after birthJaundice in newbornsStrokeMedications for Parkinson's disease or psychiatric disordersToxicity due to medications that elevate brain dopamine levelsMetabolic disorders such as Wilson's disease Treatment Medicines to control muscle overactivitySurgical interventions (deep brain stimulation)Orthotic devices or other assistive technologiesPhysical and occupational therapy Read more about Athetosis Filter Alphabet A
Ataxia Ataxia Home Overview Ataxia is a neurological disorder that causes imbalance while walking or incoordination while using hands and legs. It may be due to disorders of cerebellum and its pathways. Causes Toxins such as- alcohol, drugs like phenytoin and lithium, mercury, cyanide, and othersVascular- ischemic or haemorrhagic strokeInflammatory- demyelinating disordersMalignancy- primary brain tumours/ metastasis/ paraneoplastic syndromesInfections- herpes/ measlesNeuro-degenerative diseases like Multiple System Atrophy Cerebellar type (MSA-C) and Spinocerebellar Ataxias (SCAs)Nutritional- vitamin E deficiency, Wernicke’s encephalopathyLoss of joint position sense secondary to involvement of peripheral nerves or spinal cordChronic inflammatory demyelinating polyneuropathyParaproteinemic neuropathyDisorders of metabolism- Refsum’s diseaseSensory ganglionopathy- paraneoplastic or Sjogren’s syndromeSpinal cord disorder- spondylosis or demyelination Risk factors Excessive and chronic alcohol intakeHypothyroidism/hypoparathyroidismCeliac disease (an illness due to immune reaction to gluten)Sarcoidosis (a disease that causes inflammatory cells to build up in parts of the body)Multiple system atrophyMultiple sclerosisIntake of anti-seizure sedatives and medicationsCancer-triggered paraneoplastic syndromeExposure to heavy metals (mercury or lead) or solvents (paint thinner)Deficiency of vitamin E, B6, B12, or B1Getting too much vitamin B-6 Specialist to approach Neurologist Diagnosis Physical and neurological examsBlood testsGenetic testingImaging studies Treatment Treatment is based on the underlying conditions Read more about Ataxia Filter Alphabet A
Aphasia Aphasia Home Overview Aphasia and dysphasia are language function disorders, whereas dysarthria is disorder of articulation, which is abnormal motor production of speech. Aphasia may be associated with various neurological conditions affecting the brain cortex such as stroke, demyelination, and dementia. Causes Aphasia occurs due to damage in the part of the brain responsible for language comprehension and expression. Symptoms Spontaneous speech disturbance such as difficulty in articulation, fluency, grammar, word substitution, and loss of intonationDifficulty in remembering the names of objects or peopleInability to comprehend words or instructions or conceptsInability to repeat words or phrasesDifficulty in reading and writing Risk factors Learning disabilities such as dyslexiaRare gene changes Specialist to approach Neurologist Diagnosis Clinical examinationMRI brain to detect the underlying cause of aphasia or dysphasia Treatment Treatment of underlying disorderSpeech therapy to improve comprehension and verbal output Read more about Aphasia Filter Alphabet A
Amyotrophic Lateral Sclerosis (ALS) Amyotrophic Lateral Sclerosis (ALS) Home Overview Amyotrophic lateral sclerosis (ALS), also referred to as motor neuron disease, is a progressive neurological condition that impacts the nerve cells responsible for regulating muscle movement. The average life expectancy is 2–5 years, but the actual prognosis varies on an individual basis. Causes Unknown aetiology, but mutations in certain genes are responsible for 5–8% of cases Symptoms Progressive weakening of muscles in various body partsProgressive muscle thinning and wastingDifficulty in speaking or swallowingFlickering and twitching of musclesWeakness of muscles involved in respiration, causing respiratory failure and aspiration of food and oral secretions, ultimately leading to death Risk factors Trauma to the head, neck, or spineTraumatic brain injuries Specialist to approach Neurologist Diagnosis Clinical examinationElectrophysiological tests like electromyography (EMG)/nerve conduction study (NCV)MRI of spinal cord and other blood tests to eliminate possible conditions causing similar complaints like cervical myopathy, IGLON5 disease, and paraneoplastic syndromes Treatment Clinical management of symptomsRiluzole and edaravone can prolong the life expectancy by a few months Read more about Amyotrophic Lateral Sclerosis (ALS) Filter Alphabet A
Alzheimer’s Disease Alzheimer’s Disease Home Overview Alzheimer’s disease accounts for one of the most prevalent causes of dementia among people aged ≥65 years (with a prevalence rate of 4.4%) and is presented more commonly in females than in males. Familial cases are observed at a younger age. Genes involved in Alzheimer’s disease include APP, presenilin 1 and 2, and apolipoprotein E4. The initial stage of dementia is manifested as mild cognitive impairment, and presents a progression risk of 10–15% to Alzheimer’s disease. Causes Deposition of abnormal amyloid proteins in brain Symptoms Memory impairment involving recent memory and daily eventsChallenges in acquiring and remembering new informationVisuospatial impairment (such as getting lost while driving)Difficulty in doing learned motor activities (apraxia) like wearing clothesDifficulty in finding wordsRepetitiveness or asking the same thing repeatedlyForgetfulness of past events in advanced stagesBehavioural changes in the form of decreased social interaction, aggressiveness, and occasionally hallucinations Risk factors Family historyAgeCardiovascular diseasesSedentary lifestyleHead injuriesLoneliness and depressionDown’s syndrome Specialist to approach Neurologist Diagnosis Clinical scores like detailed neurocognitive assessment, mini-mental state examination (MMSE), and Montreal cognitive assessment (MOCA)MRI brain to evaluate loss of hippocampal volume and temporal lobe atrophyFDG PET scan to check hypometabolism in these areas Treatment Cognitive rehabilitationMedical management through acetylcholine receptor inhibitors, N-methyl-D-aspartate receptor antagonistsManaging behavioural and psychiatric complications Read more about Alzheimer’s Disease Filter Alphabet A