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[back] Common Neurological Ills Anthony Thanasayan (The Star) - 26 August 2010

Wheel power: Common neurological ills

Thursday August 26, 2010

Most people still do not know what neurologists do.

CONSIDER these real-life situations. Case 1: A 26-year-old woman is admitted to hospital after experiencing seizures. She had episodes of loss of consciousness associated with limb-jerking movements. One side of her body became paralysed.

A brain scan revealed a blood clot in a major vein of her brain. Following blood-thinning medication, the clot cleared and her condition gradually improved and she was back to her normal self.

Case 2: A 35-year-old man suddenly developed a fever, followed by headache and stiffness of neck. He was confused and agitated by the time he was brought to hospital several hours later by his family.

The doctors wasted no time in getting him started on powerful antibiotics via an intravenous drip. A spinal tap confirmed that he had a bacterial infection of the brain. A right choice of antibiotics was selected and he recovered quickly.

Case 3: A 48-year-old man with longstanding Parkinson’s disease finds it harder to move his “frozen body”. This is because each dose of medication only works for two hours, instead of providing day-long benefit as it did in the early years of his illness.

During these “off” periods, he is unable to walk because his feet are “glued” to the floor. When he needs to go to the toilet, he has to crawl to get there.

A surgery on his brain brought about marked improvement within months. It was such a success that he is now looking forward to being able to work again.

“Without prompt diagnosis and treatment, the first two patients would likely have suffered permanent brain damage, or even died,” says Dr Lim Shen-Yang, consultant neurologist at University Malaya Medical Centre.

Dr Lim points out that despite the critical role that neurologists play in the lives of people, most people still don’t know what they do.

“As neurologists, we face many challenges on a day-to-day basis,” he says and went on to explain what a neurologist is.

“We are doctors who specialise in diagnosing and treating disorders of the nervous system, which includes the brain, spinal cord, nerves, and muscles.

“Our job is to care for patients with neurological disorders that are treated primarily with medicines. Although there is obviously some overlap in what we do, this is in contrast to neurosurgery where neurosurgeons are specialists who perform surgeries for neurologic disorders like removal of brain tumours,” explains Dr Lim who has authored numerous publications in medical journals and books, and also serves as associate editor of Neurology Asia.

Dr Lim points out that neurological disorders are more common than what many people believe.

“People of all ages and backgrounds can be affected. Nobody is immune. As society becomes more affluent and lifespans increase, age-related or degenerative conditions such as dementia and Parkinson’s become increasingly common.”

In the first two cases cited above, Dr Lim points out that a good outcome was possible because of several reasons.

Firstly, the patients themselves or through the help of family members, sought appropriate medical consultation early. Secondly, the patients were given accurate diagnosis and immediate treatment.

“Had there been a significant delay in appropriate treatment – which sad to say is common today – permanent brain damage would likely have occurred.

“It is important for all of us to remember that the treatment options for a wide variety of neurological conditions have improved greatly over the last few decades,” Dr Lim added.

For more information on today’s topic, Dr Lim can be reached at limshenyang@ymail.com.