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Thrombolysis in Acute stroke is  the third commonest cause of death and leading cause of adult disability in India. Recently the thrombolytic agent, received a license for the treatment of acute ischemic stroke within 4 1/2 hours (Golden Hours) of symptom onset. The benefits of thrombolysis can be substantial. By promoting the rapid recognition of Stroke symptoms in the community, prompt transport of patients to specialized stroke units for early investigation, Neuro imaging, stabilization and treatment there would be substantial net benefit for all patients with stroke. Clearly we have the long way to go before BRAIN ATTACK is gives the same degree of priority and urgency as heart attack currently is. We have successfully trombolysed many patents in our hospital.

Thrombolytics restore cerebral blood flow in patients with acute ischemic stroke. Prompt treatment with thrombolytic drugs can restore blood flow before major brain damage has occurred. Successful treatment could mean that the patient is more likely to make a good recovery from their stroke. Fortis Escorts Hospital, Faridabad doing Thrombolysis in Acute Stroke on regular basis. We have successfully thrombolysed more than 150 patients till date which is among the one of the highest number in DELHI & NCR.

Intravenous Thrombolysis has become an important part of the Ischemic Stroke Management. For patients who meet criterias for IV Thrombolysis, research has shown good results of it in all subtypes of Ischemic Stroke.

The centre is facilitated by CT scan and MRI facility. We have Deptt. Of Neurology which is headed by a senior Neurologist, who has expertise in Neuro-Radiology and interprets head CT Scans to determine whether to administer thrombolytic agents to stroke patients with in golden hours.

Botulinum toxin type A(BOTOX) is therapeutic muscle-relaxing agent that cause weakening of overactive muscles. It will effectively weaken the muscle for a period of three to four months.

Mechanism: Botox injection contains botulinum toxin type A, which is a toxin produced by the bacteria Clostridium botulinum. Botox blocks signal transmission at the neuromuscular junction by preventing the release of acetylcholine from the presynaptic terminal. The effect is reversed when the preterminal neurite sprouts and reinnervates the muscle. The level of chemical denervation is dependent upon the amount of Botox injected into the muscle.

Conditions treated by Botox: Botox is used to manage a variety of disorders like: Hemifacial spasm, Cervical Dystonia, Blepharospasm, Facial synkinesis, Post stroke Spasticity, Writer’s cramp, cerebral palsy & Chronic Migraine.

Botulinum toxin (Botox)-famous for smoothing out wrinkles on the face-has been approved by the FDA to treat chronic migraine in adults. The FDA says Botox injections have been shown to be effective in the prevention of migraines which are debilitating headaches that causes intense pulsating or throbbing pain and affect about 12% of population.

Chronic migraine is one of the most disabling forms of headache, “Patients with chronic migraine experience a headache more than 14 days of the month. This condition can greatly affect family, work, and social life, so it is important to have a variety of effective treatment options available.

Migraine is the commonest cause of headache, affecting about 10-15% of women and 5-8% of men. In many cases, migraine becomes chronic and leads to frequent headaches. Oral preventive therapies for migraine are available, but are ineffective in some and lead to adverse events in others. In these patients, botox therapy has a great role to play. Botox is injected in scalp and neck muscles (frontalis, temporalis, occipitalis, cervical, trapezius, etc) using a very thin needle. The procedure can be done in the office, with little discomfort to the patient, and is completed within 15-20 minutes.

What is botulinum toxin? Botulinum toxin is produced by bacterium, Clostridium botulinum. Seven different subtypes of botulinum toxin (A-G) are known. A highly dilute preparation of botulinum toxin type A (Botox) was introduced in clinical practice in the 1970s and 1980s to treat squint and blepharospasm. Since then it has found uses in other areas of neurology including hemifacial spasm, writer’s cramp, cervical dystonia, post-stroke spasticity.

Botulinum toxin and headache In the mid-1990s a number of people reported improvement in headaches in patients receiving botulinum toxin for other reasons. Well-conducted clinical trials of botulinum toxin in various types of headache followed. Detailed analysis of the results suggested, however, that there might be a subgroup of patients with chronic migraine who could benefit, and further trials were undertaken.

Botox® in chronic migraine: the PREEMPT trials Two Phase 3 Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials recruited 1384 patients with chronic migraine, and randomised them to treatment with Botox® or placebo. These patients were suffering on average 20 days of headache each month, of which 18 were moderate or severe. Those randomised to Botox® received fixed-site, fixed dose injections every 12 weeks over 56 weeks. These injections covered seven specific areas of the head and neck, with a total dose of between 155-195 units. At six months, after two cycles of treatment, those treated with Botox® had on average eight less days of headache each month. After 12 months, 70% of those treated had ≤50% the number of headaches that they had done originally.

How does botulinum toxin work in chronic migraine? Unlike many of the other conditions in which it is used, it is not thought to work by relaxing overactive muscles. Botulinum toxin has been shown to reduce pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain, and bladder pain. Botulinum toxin is believed to inhibit the release of peripheral nociceptive neurotransmitters, which may then have a knock-on effect on the central pain processing systems that generate migraine headaches.

Is Botox® right for me? Only patients with chronic migraine are eligible for treatment with Botox®. Chronic migraine is defined as headaches occurring on 15 or more days each month, at least half of which have migrainous features.

In general, all botox injection therapies are done on an out-patient basis. Patients can come after eating (fasting is not necessary). It is done without any anaesthesia, in the office setting. The entire procedure is completed in less than 30 minutes and patients are free to return home immediately after the procedure. No leave from work is required and they can join work the next day.

Neurology dept Fortis Escorts Hospital, Faridabad is running dedicated botox clinic for treating disorders like chronic migraine, hemifacial spasm, blepharospasm, post stroke spasticity, cervical dystonia, cerebral palsy & writer cramp.

Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue.

They include

-Infections
-Injuries
-Tumors
-Conditions, such as ankylosing spondylitis and scoliosis
-Bone changes that come with age, such as spinal stenosis and herniated disks
-Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.her to administer thrombolytic agents to stroke patients with in golden hours.

Myasthenia gravis is an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatigue. Muscle weakness is caused by circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction, inhibiting the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors at neuromuscular junctions.

Myasthenia is treated medically with acetylcholinesterase inhibitors or immunosuppressants, and, in selected cases, thymectomy. The disease incidence is 3–30 cases per million per year and rising as a result of increased awareness. MG must be distinguished from congenital myasthenic syndromes that can present similar symptoms but do not respond to immunosuppressive treatments.

Headaches do happen to everyone at one time or another. Headaches can last for minutes or hours or days. It can happen due to numerous reasons such as fasting, improper sleep, certain foods, exposure to sun or day to day stressful situations.

Type of Headaches:

Vascular headache – The most common type being migraine. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach and at times disturbed vision.
Muscle Contraction – Headache It is also known as tension headache, it involves contraction of neck, face and scalp muscles due to stressful events.

Epilepsy is a medical condition wherein seizures occur due to sudden, excessive electrical discharge from cells in the brain. Some more common causes of epilepsy include:

-Stroke
-Traumatic brain injury
-Infections (Including brain abscess, meningitis, encephalitis, neurosyphilis, and AIDS)
-Prenatal brain damage (injuries before the time of birth)
-Structural brain lesions (such as tumors, metastasis, hematomas, AVM(Arterio Venous Malformation)

Stroke, also known as brain attack can happen to anyone and you could be one of them. This is a serious medical condition that may happen when blood supply to a part of the brain is disrupted (Either blockage of brain arteries or rupture), causing brain cells to die. The common symptoms are:

Numbness or weakness of the face, arm or leg, especially on one side of the body
Trouble in speaking or understanding.
Trouble seeing from one or both eyes, Walking, dizziness,loss of balance.
We offer excellent care to patients with hemorrhagic and ischemic stroke. The clinic provides a complete range of diagnostic neuro-imaging with medical, surgical and rehabilitation therapy along with optional neuro- interventional capabilities.

Movement disorders affect the speed, fluency, quality and ease of movement. At Fortis Escorts Hospital, Faridabad our doctors are provide personalized care to the patients with the help of medicines, deep braing stimulation, and botulinum toxin injections. Common movement disorders are Parkinsons’s disease, Parkinsons’s plus syndrome, cerebellar ataxia, dystonia, myoclonus, restless legs syndrome (RLS), tics and tremors.

Vertigo refers to the symptoms of giddiness or imbalance. Facilities available in the clinic are neurological evaluation and audiological tests for cochlear and retro-cochlear pathology in the neuro lab.

Our aim to provide each of our patients with personalized and timely care. It is aimed at helping the people suffering from peripheral and central vertigo problems.

Fortis Escorts Hospital, Faridabad deals with all cases of dementia and memory impairment. Dementia is a progressive and degenerative disorder of the brain caused by multiple cognitive deficits due to impairment in memory. Common causes are Alzheimer’s disease, vascular dementia, normal pressure hydrocephalus(NPH), fronto-temporal dementia and dementia with lewy body.

The peripheral nervous system is made up of the nerves that branch out of the spinal cord to all parts of the body. Peripheral Neurology clinic studies all types of disorders of peripheral nervous system i.e. roots, plexus, peripheral nerves and Muscles thereby including such diverse diseases as radiculopathy, plexopathy, neuropathy, myopathy, dystrophy and myotonias etc. the common symptoms are:

-Tingling/numbess/unusual sensation
-Painful cramps
-Weakness in limbs/face/neck
-Thinning/wasting of muscles
-Myopathy is a disorder of muscles commonly of arms and legs and rarely can involve the trunk, neck, face and heart. Myopathy usually results in muscle weakness, thinning of muscles with stiffness and spasm and sometimes pseudo hypertrophy as in muscular dystrophy.

Sleep Disorders

We have a fully functional neuro sleep laboratory and undertake Poly Somnography (PSG) and Multiple sleep latency Test (MSLT). These are used especially for evaluating the diverse range of neurological sleep disorders and sleep related seizures.

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