Search Results

The Definition of Dementia Dementia is a general term used to describe progressive and neurodegenerative diseases in which alterations in the chemical composition of the brain compromise one’s cognitive ability. Specifically, dementia is characterized by a decline in mental ability severe enough to interfere with everyday activities. Dementia is sometimes incorrectly referred to as “senility” or “senile dementia” reflecting the widespread but incorrect belief that dementia is a normal part of aging. At this time, there is no cure or remedy for any type of dementia, including Alzheimer’s disease. The only thing that existing medication can do is lessen symptoms and delay disease progression in some people and, in the interim, help support their mood and quality of life. Cortical vs. Subcortical Dementia While these classifications are not always used, some physicians find it helpful to classify dementia into one of two groups, depending on the initial brain area that is primarily affected.There will typically be visible physical changes in the brain wherever the damage is, such as atrophy or shrinkage. The definition of cortical dementia is that it is a type of dementia that primarily targets the brain’s gray matter (in the cortex). Cortical dementia typically causes difficulties with language (such as word-finding or understanding others), social behaviors, and memory. Examples include Frontotemporal dementia, Creutzfeldt-Jakob disease, and Alzheimer’s disease. Subcortical dementia targets the parts of the brain underneath the cortex, and are linked to the white matter of the brain. Subcortical dementias are more likely to impact personality and thought processes. Language and memory tend to be largely unaffected in the early stages of these conditions. Parkinson’s, Huntington’s disease, and AIDS dementia complex are subcortical dementias. Typically, categorizing dementia as cortical or subcortical is of less value than determining the specific type of dementia someone is experiencing, as different types of dementia have unique symptoms, causes, and prognosis. Alzheimer’s Disease (AD) Alzheimer disease is by far the most prevalent form of dementia, accounting for 60 to 80 % of all individuals with dementia. This chronic illness predominantly afflicts people in the 65+ age bracket, with the exception of “early onset” Alzheimer’s,rendering it the sixth leading cause of mortality in America. Almost 6 million people in the United States are estimated to have Alzheimer’s disease, and this number is expected to grow dramatically with the aging of our population. Alzheimer’s Disease Signs and Symptoms The first signs of Alzheimer’s disease include issues with memory, typically having difficulty recalling people’s names. These initial signs are commonly referred to as mild cognitive impairment (MCI). With Alzheimer’s, these symptoms progress to the point that the individual needs incrementally more assistance with everyday tasks and gradually becomes more dependent. Other symptoms of Alzheimer’s disease include: Confusion and disorientation Language and communication difficulties Advanced memory loss Agitation and possible combativeness Possible sleeplessness and wandering Repetitive talking Stages of Alzheimer’s Disease Alzheimer’s disease is sometimes broken down into three stages: mild, moderate, and severe. In the mild stage , it is typical for the individual to: Start wandering, at first mostly inside the home Experience difficulty managing finances independently Repeat phrases and questions In the moderate stage , the individual can experience symptoms such as: Impairment in their reasoning skills Language issues Confused thought patterns Difficulty recognizing familiar faces Difficulty learning new things In the advanced stages , people typically: Lose their ability to communicate effectively Become completely dependent on others Often become bed ridden Experience body systems shutting down Causes of Alzheimer’s Disease Scientists are still working to determine exactly what causes Alzheimer’s disease. Like other types of dementia, Alzheimer’s seems to be brought on by progressive death of brain cells that happens over time, causing parts of the brain to shrink. Scientists also attribute Alzheimer’s disease to genetic mutations as well as environmental and lifestyle factors. See our article on Alzheimer’s risks, causes, and prevention for more detailed information. PART II Vascular Dementia (VD) Vascular dementia, usually results from a succession of small strokes, is also referred to as a post-stroke or multi-infarct dementia. It ranks only second to AD as the most prevalent dementia, accounting for approximately 10% of all dementia cases. Strokes can cause a weakening of the blood flow to the brain, which in turn brings about confusion and the failure to think or speak clearly. When the brain is starved of oxygen and nutrients, brain cells start to weaken and die. Vascular Dementia Signs and Symptoms Like Alzheimer’s, vascular dementia symptoms can vary across a wide range and depend largely on how bad the blood vessel damage is and what portion of the brain is impacted. After a stroke, patients can experience symptoms like confusion, difficulty speaking, disorientation, and the inability to focus. Compared to Alzheimer’s, vascular dementia primarily affects judgment or ability to make decisions, as opposed to memory. Following one or more strokes, vascular dementia may also be characterized by physical symptoms like vision or speech problems and weakness in limbs, but these symptoms might get better with rehabilitation. Causes of Vascular Dementia Vascular dementia is primarily caused by strokes, causing the brain to go without nutrients for an extended period of time. When this blockage occurs, it leaves the brain partially or severely damaged. Another cause is the constricting of blood vessels or the prevalence of damaged blood cells. Those with heart conditions, Diabetes, high blood pressure, or high cholesterol may be at greater risk of developing vascular dementia. Treatment and Prognosis of Vascular Dementia There are currently no approved medical therapy for the treatment of vascular dementia. There is, however, some evidence that certain medical therapy used to treat the symptoms of Alzheimer’s disease may provide some benefit to those with vascular dementia. The most important thing you can do for now is control the risk factors that contributed to the dementia in the first place (e.g. blood pressure or cholesterol levels). Individuals with vascular dementia live for about 5 years on average after their symptoms begin. Dementia with Lewy Bodies (LBD) Dementia with Lewy Body (LBD) is the third most prevalent type of dementia, after Alzheimer’s and vascular dementia. Individuals with LBD experience both deficits in their memory and difficulty thinking. At first, the LBD symptoms look similar to Alzheimer’s. As LBD progresses, the disease acquires its own set of symptoms, notably a blank facial expression, tremors, difficulties walking and hallucinations. Lewy Body Dementia Signs and Symptoms Symptoms of LBD worsen over time and include memory loss, difficulty planning and executing functions, paying attention, and making decisions, and problems completing and following through on routines. Difficulties with visual perception and visual hallucinations are also common, as are concentration difficulties, restlessness, sleeplessness, and spontaneous, Parkinson’s-like tremors. Individuals with LBD may also experience depression and/or apathy, or loss of motivation. Causes of Lewy Body Dementia LBD is caused by an abnormal buildup of proteins called alpha-synuclein that get lumped into clusters known as Lewy Bodies and affect chemicals in the brain. People with LBD have plaques and tangles, associated with Alzheimer’s disease, in their brains as well. In LBD, the part of the brain that is affected the most is the center cortex, associated with thinking, memory, and movement. Treatment and Prognosis of Lewy Body Dementia Though there is currently no cure for LBD, existing medications can help manage some symptoms of the disease. These medications are called cholinesterase inhibitors (used to treat AD) and they can help if a person with LBD is experiencing memory problems. Examples of these medications include Donepezil, Rivastigmine and Galantamine. If a person with LBD has movement problems, medications used for Parkinson’s disease, such as Levodopa (L-dopa), may be recommended. Sleep problems can also be managed by sleep medications including melatonin. The disease lasts an average of 5 to 7 years from the time of diagnosis to death, but depending on the person, it can last anywhere from 2 to 20 years. Mixed Dementia Mixed dementia is a term used when Alzheimer’s and other dementias co-exist in the same person. In the most common type of mixed dementia, the protein deposits linked to Alzheimer’s disease co-exist with the blood vessel problems associated with vascular dementia. Alzheimer’s disease also is likely to co-exist with Lewy Body Dementia. In some cases, a person might display brain changes characteristic of all 3 types of dementia. It is not known how many people have mixed dementia, as it may often be misdiagnosed as a single type, but autopsies suggest that the condition may be much more prevalent than previously thought. Mixed Dementia Signs and Symptoms Symptoms of mixed dementia likely vary, as they will depend on the changes in the brain and the brain regions that are affected. Symptoms in many cases resemble Alzheimer’s disease or another type of dementia. In other cases, a person’s symptoms might more clearly suggest that they are experiencing more than one type of dementia. Causes of Mixed Dementia The causes of mixed dementia depend on the mix of symptoms they are experiencing. In most cases, mixed dementia seems to be caused by the abnormal protein build up linked to Alzheimer’s disease in addition to blood vessel linked to vascular dementia. It is not known why some individuals experience more than one type of dementia, but it is thought that those with more than one type may experience worse brain damage. Mixed Dementia Treatment and Prognosis As most people with mixed dementia are mistakenly diagnosed with a single type of dementia, physicians often prescribe medication based on the type of dementia that’s been diagnosed. No medications are approved by the U.S. Food and Drug Administration (FDA) to treat mixed dementia specifically. However, if your loved one is experiencing symptoms that most resemble Alzheimer’s disease, Alzheimer’s medications may provide some help with some of their symptoms. As vascular dementia is one of the most common co-occurring forms of dementia, it cannot hurt to control vascular risk factors like high blood pressure and cholesterol. It is hard to provide a disease duration for mixed dementias as experiences can vary a great deal depending on the unique combination of diseases, as well as age and coexisting health conditions. Parkinson’s Disease Dementia An estimated 50 to 80 percent of those with Parkinson’s eventually develop dementia as their disease worsens. The average duration of time from a Parkinson’s diagnosis to the development of dementia is about 10 years. Parkinson’s Dementia Symptoms Parkinson’s disease dementia impairs one’s ability to think and reason clearly. Symptoms include: Changes in memory, concentration, and judgment Difficulty interpreting visual information Muffled speech Rapid eye movement (REM) sleep disorder Visual hallucinations, delusions, and paranoia Depression, irritability, anxiety, and sleep disturbances Possible daytime drowsiness Causes of Parkinson’s Disease Dementia Some factors at the time of a Parkinson’s diagnosis might increase individuals’ likelihood of developing dementia, including older age, more severe motor symptoms, and mild cognitive impairment (MCI). People may also be more at risk if they experience hallucinations, excessive daytime drowsiness, and Parkinson’s symptoms of postural instability and gait disturbance, which can include freezing mid-step, shuffling the feet, and problems with balance and falls. Treatment and Prognosis of Parkinson’s Disease Dementia There are currently no treatments to slow or stop the cognitive decline caused by Parkinson’s disease dementia. Current strategies focus on helping with certain symptoms.  Like other types of dementia, Parkinson’s disease dementia gets progressively worse with time, though the rate of progression can vary from person to person. Frontotemporal Dementia (FTD) Frontotemporal dementia involves a diverse group of uncommon disorders that directly affect the frontal temporal lobes of the brain. As a result, one’s personality, behavior, and language begin to show radical decline. The brain typically shrinks due to atrophy. Typically, people are diagnosed with Frontotemporal dementia when they are in their 40’s, much earlier than Alzheimer’s disease is usually diagnosed. Frontotemporal Dementia Signs and Symptoms People with FTD typically exhibit changes in behavior and personality. The symptoms can include: Inappropriate behaviors Loss of interpersonal skills like empathy Lack of judgment and inhibition Apathy Repetitive compulsive behaviors A decline in personal hygiene Changes in eating habits, usually overeating Oral exploration and consumption of inedible objects Lack of awareness of thinking or behavioral changes Speech and language problems Movement problems (more rare) Causes of Frontotemporal Dementia In FTD, the frontal and temporal lobes of the brain atrophy or shrink. Some genetic mutations have also been linked to certain subtypes of frontotemporal dementia. However, more than 50% of those who develop frontotemporal dementia have no family history of the disease. In some cases, the disease seems to result from pick cells or pick bodies that develop inside the nerve cells in the brain. These cells have an abnormal amount of a protein known as Tau. There are no known risk factors for FTD other than a family history of dementia. Treatment and Prognosis of Frontotemporal Dementia Like Alzheimer’s and other types of dementia, there is no cure for frontotemporal dementia. There are also no treatments to slow down the progression of FTD. There are medical therapies that might help ease behavioral symptoms like irritability, depression, and agitation. The speed of decline will vary, but symptoms of FTD tend to progress at a rapid, steady rate. Individuals with frontotemporal dementia can survive anywhere between 2 and 15 years with the disease. Creutzfeldt-Jakob Disease (CJD) Creutzfeldt-Jakob Disease is an extremely rare brain disorder in which the brain breaks down. Once contracted, usually around age 60, most people die within a year. The disease destroys brain cells, and then begins to look like a sponge. It affects approximately one person out of every one million people per year worldwide, with about 300 cases per year in the U.S. Signs and Symptoms of Creutzfeldt-Jakob Disease In the early stages of the disease, individuals experience failing memory, behavioral changes, poor coordination and visual impairment. People with CJD may also experience insomnia, depression, or unusual sensations. As it progresses, individuals may experience worsened mental deterioration, involuntary or jerky movements, muscle weakness, blindness, and coma. Pneumonia and other infections often occur in the later stages of the disease and can lead to death. Causes of Creutzfeldt-Jakob Disease Causes for this type of dementia have yet to be discovered. What is known is that the disease begins when prion proteins begin to accumulate in the brain and then begin to mutate. Familial CJD results from prion protein genes that guarantee that an individual will develop CJD. CJD Treatment and Prognosis Since there is no cure for CJD, current treatment focuses on alleviating symptoms and making the individual as comfortable as possible.  Towards the end of the disease, changing the person’s position frequently can keep him or her comfortable and prevent bedsores. Catheters can be used to drain urine if the individual cannot control bladder function, and intravenous fluids and artificial feeding can also be used. Normal-Pressure Hydrocephalus (NPH) Normal-Pressure Hydrocephalus is a condition that is characterized by abnormal buildup of fluid in the brain. In a healthy being, the cerebrospinal fluid (CSF) is able to circulate around the brain and the spinal cord. Those with NPH have an abnormal build-up of CSF in the brain’s cavities, causing the ventricles to enlarge and putting pressure on the brain. When this happens, the brain has difficulty controlling basic function such as speaking and memory. NPH primarily affects individuals over age 60. Normal-Pressure Hydrocephalus Signs and Symptoms Signs and symptoms for this condition include those that are typical only of NPH patients. Frequent urination, gait disturbance, and mild dementia are among those. Individuals with NPH also feel like their feet are glued to the floor, causing difficulty with walking. This is different from Parkinson’s in which the individual will likely experience tremors. Also, in comparison to Alzheimer’s disease, individuals with NPH will not have memory loss or confusion until the later stages.

Dr. Prem Pillay, Singapore Senior Consultant Neurosurgeon with super specialty training in Neurosurgical Oncology (Fellow at MD Anderson Cancer Center and Hospital, U of Texas, USA) Selection Criteria Deep brain stimulation (DBS) has become a standard treatment for advanced Parkinson’s disease (PD), but selecting the right candidates is crucial for optimal outcomes. Traditional selection criteria, such as those outlined in the Core Assessment Program for Surgical Interventional Therapies in Parkinson’s Disease (CAPSIT-PD), are considered outdated due to advances in understanding PD’s heterogeneity. Current practices emphasize a comprehensive assessment of both motor and non-motor symptoms, including genetic and phenotypic characterisation, to better predict surgical outcomes. An interdisciplinary team often reviews potential candidates to evaluate the risk-benefit profile, ensuring realistic expectations are set 7 . Currently too few patients are receiving DBS globally states Dr Prem Pillay because of the lack of trained Neuro Specialists, Equipment costs and availability,and patient access to specialized Neuro Centers. Targets The subthalamic nucleus (STN) and globus pallidus internus (GPi) are the primary targets for DBS in PD. Both targets have shown similar efficacy in improving motor symptoms, but they differ in their impact on medication reduction and mood. STN DBS allows for a greater reduction in dopaminergic medication but may negatively affect speech and mood, whereas GPi DBS is associated with better mood outcomes. Emerging targets, such as the pedunculopontine nucleus and the caudal zona incerta, show promise for addressing specific symptoms like axial symptoms and tremor. Methods and Techniques The DBS procedure involves precise localization of the target area, often using ventriculography and/or high definition MRI (Magnetic Resonance Imaging ) and intraoperative neuronal microrecording to ensure accurate placement. In leading Neuro centers for example, DBS is typically performed bilaterally in a single session with awake anesthesia, using frame-based techniques and microelectrode recordings for final lead positioning. Advances in neuroimaging are expected to further refine targeting accuracy. Results DBS has been shown to significantly improve motor function and quality of life in PD patients, with benefits sustained even in advanced stages of the disease. A meta-analysis of randomized controlled trials indicates that both STN and GPi DBS provide similar motor benefits, although STN DBS allows for a greater reduction in medication. However, axial symptoms such as speech and balance may not improve as much and can sometimes worsen post-surgery. Future Innovations of Brain Stimulation of Parkinson's Disease The future of DBS in PD includes the development of adaptive DBS systems, such as closed-loop approaches that adjust stimulation in real-time based on patient needs. New hardware with directional stimulation capabilities and advanced imaging techniques are being explored to enhance precision and efficacy. Research is also focused on identifying new brain targets and refining programming strategies to address treatment-resistant symptoms. Conclusion Deep brain stimulation remains a highly effective treatment for Parkinson’s disease, with ongoing innovations aimed at improving patient outcomes. Careful patient selection, precise targeting, and advanced programming are essential for maximizing the benefits of DBS. Dr Prem Pillay explains that future advancements in technology and methodology hold promise for further enhancing the efficacy and scope of this treatment. Apart from Parkinsons disease , patients with morbid obesity, treatment resistant depression and other functional conditions may benefit from the techniques and technologies used for Parkinsons disease in the near future. References 1.An update on best practice of deep brain stimulation in Parkinson’s diseaseCareful patient selection, individualized target localization, and evaluation of stimulation parameters are crucial requirements for optimal results in deep brain stimulation for Parkinson’s disease. 2019·106Citations·C. Hartmann et al.· Therapeutic Advances in Neurological Disorders 2.Deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: methodologic aspects and clinical criteria.Proper selection of patients and accuracy in targeting the subthalamic nucleus (STN) are crucial for achieving the best possible results in Parkinson’s disease deep brain stimulation. 2000·242Citations·A. Benabid et al.· Neurology 3.Deep brain stimulation for Parkinson’s disease: meta-analysis of results of randomized trials at varying lengths of follow-up.Motor benefits of GPi and STN DBS for Parkinson’s disease are similar, but STN stimulation allows for greater medication reduction and better mood compared to GPi stimulation. 2017·84Citations·A. Mansouri et al.· Journal of neurosurgery 4.Deep Brain Stimulation Selection Criteria for Parkinson’s Disease: Time to Go beyond CAPSIT-PDRethinking the selection process for DBS in Parkinson’s disease should include a broad assessment of non-motor symptoms, quantitative measurement of gait, posture, and balance, and in-depth genotypic and phenotypic characterization. 2020·33Citations·C. Artusi et al.· Journal of Clinical Medicine 2022·3Citations·F. Mancini et al.· Journal of neurosurgical sciences 6.The latest evidence on target selection in deep brain stimulation for Parkinson’s diseaseSTN and GPi DBS both improve motor scores in Parkinson’s disease, but STN DBS has more negative effects on speech and mood, while GPi DBS has less impact on speech and mood. 2014·44Citations·T. Lukins et al.· Journal of Clinical Neuroscience 7.Current Practice and the Future of Deep Brain Stimulation Therapy in Parkinson’s DiseaseDBS therapy for Parkinson’s disease is effective, with subthalamic nucleus and globus pallidus internus targets being the most widely used, and research focuses on improving symptom control and efficiency of stimulation delivery. 2017·25Citations·L. Almeida et al.· Seminars in Neurology 2022·10Citations·Carina França et al.· Arquivos de Neuro-Psiquiatria 9.Deep Brain Stimulation in Movement Disorders: From Experimental Surgery to Evidence‐Based TherapyDBS has shown better motor, nonmotor, and quality-of-life outcomes for patients with fluctuating Parkinson’s disease, disabling dystonia, tremors, and refractory Gilles de la Tourette syndrome. 2019·135Citations·P. Krack et al.· 10.Deep brain stimulation for Parkinson’s disease: Patient selection and evaluationDeep brain stimulation for Parkinson’s disease requires proper patient selection and evaluation using the Core Assessment Program for Surgical Interventions and Transplantation in Parkinson’s Disease (CAPSIT-PD). Movement Disorders 2002·172Citations·A. Lang et al.·

Understanding Arm Pain Causes Symptoms and When to Seek Help Understanding Arm Pain in the Modern Ag e Arm pain is becoming more common in modern life. This is largely due to work and lifestyle habits  that place stress and strain on the neck, shoulders, arms, and hands . These issues can cause pain, stiffness, and difficulty with work and sports activities . The overuse of computers and mobile devices , including smartphones and tablets , is a major factor contributing to arm-related pain . Poor posture, prolonged screen use, and incorrect ergonomics  lead to neck strain and cervical spine issues , which can cause nerve compression that radiates pain down the arm . Sports-Related Arm Pain Certain sports and physical activities  also contribute to arm injuries , including: Tennis, badminton, golf Weight training and gymnastics Martial arts (judo, karate, jujitsu, kendo, etc.) Rugby and football Horse riding Even yoga and pilates, if done incorrectly Common Causes of Arm Pain 1. Nerve-Related Pain (Radiculopathy & Nerve Compression) Cervical spine (neck) disc protrusions  can press on or irritate nerves, causing pain in the neck, shoulders, and arms . Radiculopathy  occurs when a pinched nerve in the spine  causes pain that radiates down the arm . Carpal Tunnel Syndrome  – Pressure on the median nerve in the wrist , leading to pain, numbness, and weakness in the fingers. 2. Joint, Tendon, and Muscle Injuries Frozen shoulder  – Causes stiffness and reduced shoulder mobility. Rotator cuff injuries  – Partial tears or strains in the shoulder muscles. Tennis elbow & Golfer’s elbow  – Tendon injuries causing pain in the elbow. De Quervain’s tenosynovitis  – Pain at the base of the thumb and wrist. Muscle strains or tears  – Common in shoulders, arms, and wrists  due to repetitive movements or trauma. 3. Repetitive Stress Injuries (RSI) Common in office workers, musicians, and manual laborers . Prolonged computer use can lead to wrist, elbow, and shoulder pain . Overuse of small muscles in the hand and arm can lead to chronic inflammation and pain . Diagnosing Arm Pain Many people try traditional massage therapy, chiropractors, or physical therapy  to relieve arm pain. However, if the pain does not improve after three visits or worsens , seeking medical attention from a spine and nerve specialist  is crucial. Clinical Examination Posture assessment and joint mobility tests Muscle strength evaluation Nerve function assessment Diagnostic Imaging & Tests MRI scans  – Detects nerve compression, disc herniation, and joint injuries . X-rays  – Assesses bone structure and joint alignment . Nerve conduction studies (NCS) & Electromyography (EMG)  – Measures nerve function. Treatment Options for Arm Pain 1. Non-Surgical Treatments Medications  – Anti-inflammatory drugs and muscle relaxers to reduce pain. Physical therapy  – Strengthens muscles, improves posture, and prevents further injury. Ergonomic adjustments  – Correcting sitting posture and computer workstation setup . Laser therapy and ultrasound  – Helps reduce inflammation and pain . 2. Minimally Invasive Procedures For persistent nerve pain , advanced spinal and nerve treatments  include: Laser spine injections  – Reduces nerve pressure from disc protrusions . Endoscopic carpal tunnel release  – Relieves nerve compression in the wrist . Minimally invasive spine surgery (MISS)  – Removes herniated discs pressing on nerves . 3. Surgical Options for Severe Cases When nerve compression is severe or prolonged , surgery may be necessary. Microsurgical decompression  – Removes pressure from pinched nerves . Disc replacement surgery  – For serious cervical spine disc problems . Shoulder or elbow arthroscopic surgery  – Repairs joint injuries . When to Seek Immediate Medical Attention ⚠ Pain radiating down the arm with numbness or tingling . ⚠ Weakness in the hand, fingers, or grip strength . ⚠ Severe pain that does not improve with rest or medication . ⚠ Loss of coordination in the arm or hand movements . If the nerve is compressed severely or for too long , recovery may be incomplete even after surgery . Early diagnosis and intervention  are essential for preventing long-term damage . Preventing Arm Pain To reduce the risk of developing chronic arm pain , I recommend: ✅ Maintaining good posture  – Avoid slouching and keep your screen at eye level . ✅ Stretching exercises  – Keep shoulders, arms, and wrists flexible . ✅ Using ergonomic workstations  – Ensure keyboard and mouse placement reduce strain . ✅ Taking frequent breaks  – Avoid prolonged sitting and repetitive movements . ✅ Strengthening exercises  – Build shoulder and arm strength  to support joints. Expert Arm Pain Care at Singapore Brain Spine Centre At Singapore Brain Spine Centre , I provide: Comprehensive evaluations for nerve and joint-related arm pain . Advanced imaging and nerve function tests for accurate diagnosis . Minimally invasive and surgical treatment options for long-term pain relief . Struggling with Arm Pain? Get Expert Help Today If you have persistent shoulder, wrist, or arm pain , do not ignore the symptoms. Early diagnosis and proper treatment  can prevent long-term damage and nerve complications . Book a consultation today at Singapore Brain Spine Centre  and take the first step toward pain relief and recovery.

Preventing Back Pain in Children  The Rising Problem of Back Pain in Children & Adolescents Back pain in children and adolescents is a growing concern , with studies showing prevalence rates between 28% to 48%  among school-aged children. Older teenagers  are particularly at risk due to poor posture, excessive screen time, prolonged sitting for schoolwork and gaming, and heavy school bags . While most cases are mild , some can indicate serious underlying conditions . Early diagnosis and treatment  by a Spine Specialist  are essential to prevent long-term complications . Common Causes of Back Pain in Children Primary Categories of Back Pain Muscular pain  – Due to poor posture, heavy school bags, and lack of exercise. Bone-related pain  – Scoliosis, growth-related conditions, or spinal injuries. Discogenic pain  – Caused by disc degeneration or injury. Spinal nerve pain  – Due to pinched nerves or spinal instability. Risk Factors for Back Pain Lack of physical activity or sports-related injuries Obesity and poor posture from excessive computer and mobile phone use Family history of spinal conditions Psychological stress and mental health issues Smoking and vaping, which impact bone and nerve health Serious Spine Conditions That Can Cause Back Pain Muscle strain or spasms Scoliosis (abnormal spine curvature) Scheuermann’s disease (juvenile kyphosis) Spondylolysis (stress fractures in the spine) Spinal tumors (rare but serious) Spinal infections (bone or disc infections) Spinal disc injuries (slipped or damaged discs) How is Back Pain Diagnosed in Children? Clinical Evaluation A detailed medical history and physical examination  assess: Posture and spinal symmetry Range of motion and gait assessment Leg length and movement limitations Special Tests for Back Pain One-legged hyperextension test – Checks for stress fractures Straight leg raise (SLR) test – Assesses nerve involvement FABER test – Detects hip and lower spine issues Imaging Studies X-rays – Initial spine assessment Digital Spine Movement Analysis – AI-based test to track spinal mobility MRI Spine – Detects soft tissue, disc, and nerve abnormalities CT Spine Scan – Used only for specific conditions Laboratory Tests (For Infection or Inflammation) Complete blood count (CBC) Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) Treatment Approaches for Childhood Back Pain 1. Conservative Management (Non-Surgical Treatment) Physical therapy – Focuses on active exercises and posture correction Ergonomic adjustments – Proper study chairs and desks, reducing mobile and computer use Core strengthening – To support spinal stability 2. Psychological Support Cognitive Behavioral Therapy (CBT) – Effective for chronic pain management 3. Medication Guidelines Muscle relaxers – Only prescribed when necessary 4. Physical Interventions Stretching and strengthening exercises Postural education and movement training Activity modification – Reducing strain from heavy school bags and prolonged sitting Preventing Back Pain in Children & Teens 1. Set a Good Example Children learn by copying adults, so practicing good posture and movement habits yourself is important. 2. Check Their School Bags Choose a well-fitted backpack Ensure they wear both straps to distribute weight evenly Keep the weight at 10-20% of body weigh 3. Watch Their Weight Overweight children are at higher risk for back pain—encourage healthy eating and exercise. 4. Adjust Their Study Space As children grow taller, adjust chairs, desks, and tables to maintain a comfortable and supportive posture. Recent Advances in Pediatric Spine Care Multimodal Pain Management Combines physical therapy, lifestyle changes, and psychological support Focuses on non-opioid treatments for pain relief Rapid Recovery Protocols Structured rehabilitation programs to restore function quickly Early mobilisation and multimodal pain management to prevent long-term disability When to Seek Urgent Medical Attention Children under 10 with back problems Severe or persistent pain that does not improve Neurological symptoms like numbness, weakness, or loss of sensation Fever or unexplained weight loss Changes in bladder or bowel function (possible nerve damage Long-Term Outlook for Childhood Back Pain Most cases resolve with proper treatment Early diagnosis of serious conditions like scoliosis, spinal instability, or tumors leads to better outcomes 10-15% of children with back pain may develop chronic pain in adulthood Prevention, early intervention, and structured care are key to reducing long-term disability Back pain in children and adolescents requires a structured, age-appropriate approach. While most cases respond well to conservative treatments, serious spinal conditions must be identified early for the best outcomes. Specialist Pediatric Spine Care at Singapore Brain Spine Centre At Singapore Brain Spine Centre , I provide: Expert pediatric spine evaluations Advanced imaging and digital spine analysis Minimally invasive treatments for spinal conditions Concerned About Your Child’s Back Pain? Get Expert Help Today If your child is experiencing persistent back pain, posture issues, or movement difficulties, early diagnosis is key. A specialist assessment can ensure the best treatment and prevention strategies for lifelong spinal health. Book a consultation today at Singapore Brain Spine Centre  and take a proactive step toward your child’s spinal well-being.

The link between Cognitive Health and Your Sleep The Importance of Sleep for Brain Health The importance of sleep  is well-documented, but the scale of sleep deprivation  has become so severe that the World Health Organization (WHO)  has declared it a global sleep loss epidemic  in first-world nations. Lack of sleep , both in quantity and quality has been linked to: Increased risk of stroke and heart attack Depression and anxiety Cognitive decline, dementia, and brain fog Delayed recovery from brain tumors and central nervous system disorders Slower healing of spinal conditions, including slipped discs Recovery from brain and spine conditions  can be significantly affected  by poor sleep. Ensuring adequate and quality sleep  is crucial for neurological and spinal health , as it supports brain function, nerve regeneration, and overall healing . Singapore’s Growing Sleep Deprivation Problem A recent study  highlighted that Singaporeans are among the world’s worst sleepers . The Philips 2019 Sleep Study  found that: Singaporeans sleep an average of 6.3 hours on weekdays  and 6.7 hours on weekends —both below the global average . Experts recommend at least 8 hours of sleep daily . Key Statistics on Sleep Quality in Singapore 7 in 10 Singaporeans  rated their sleep as “somewhat well” or “not well at all” . 39%  reported that their sleep quality has worsened  over the past 5 years. 65%  experienced daytime sleepiness multiple times a week . Common Causes of Poor Sleep in Singapore 61%  – Stress and worry  ( higher than the global average of 54% ). 35%  – Poor sleeping environment . 30%  – Entertainment media (TV, internet, social media before bed) . 14%  – Partner’s snoring . 10%  – Disrupted sleep schedule . Amidst this crisis, 81% of Singaporeans  want to improve their sleep and brain health, but many do not know where to start . How to Improve Your Sleep for Better Brain and Spine Health 1) Struggling with Insomnia? Exercise May Help Regular physical activity  can improve sleep quality  by promoting energy depletion and tissue recovery . Avoid exercising right before bed . Exercise at least 3 hours before sleep  to avoid overstimulation. 2) Boost Your Melatonin Naturally Melatonin  is a hormone that regulates sleep . As we age, melatonin production decreases, making it harder to fall asleep. Eat melatonin-rich foods , including: ✅ Eggs ✅ Salmon ✅ Pistachios & walnuts ✅ Tomatoes, peppers, grapes, strawberries, cherries 3) Improve Your Sleeping Habits Go to bed at a fixed time every night , including weekends. Avoid screens before bed . Reduce exposure to blue light  from phones, tablets, and TVs. Relax before sleeping. Try meditation or herbal tea  to promote calmness. 4) Reduce Blue Light Exposure at Night Blue light suppresses melatonin , tricking your brain into thinking it’s daytime. Reduce blue light exposure by: ✅ Using red or orange reading lamps  instead of bright white lights. ✅ Activating blue light filters  on your smartphone in the evening. 5) Sleeping Enough but Still Feeling Tired? You May Lack Deep Sleep Deep sleep  is the most restorative sleep stage , essential for: ✅ Brain cell repair ✅ Tissue growth and recovery ✅ Memory consolidation Tips to enhance deep sleep: ✅ Maintain a consistent sleep routine , even on weekends ✅ Manage stress  through relaxation techniques. ✅ Exercise regularly . ✅ Eat nutrient-rich foods  to support sleep cycles. The Link Between Sleep and Cognitive Function Lack of REM sleep and deep sleep  has been linked to reduced cognitive function , including: Brain fog and forgetfulness Slower reaction times Difficulty concentrating Increased risk of Alzheimer’s and dementia By prioritising sleep , you can protect your brain health  and reduce your risk of neurological disorders . Sleep & Brain Health Care at Singapore Brain Spine Centre At Singapore Brain Spine Centre , we specialise in: ✅ Diagnosis & management of sleep disorders affecting brain function . ✅ Treatment for cognitive decline, brain fog, and neurological conditions .✅ Comprehensive brain and spine health evaluations . Struggling with Sleep Deprivation? Improve Your Brain Health Today If you experience sleep deprivation, brain fog, or cognitive decline , it’s time to prioritise quality sleep . A well-rested brain is essential for memory, focus, and overall well-being . 📞 Book a consultation today  at Singapore Brain Spine Centre  and take the first step toward a healthier brain and better sleep!

Common Causes and Prevention The Rise of Neck and Back Pain in the Modern Workplace There is an increase in neck and back pain worldwide , particularly among office workers and executives . One of the main causes  of this growing problem is our modern 21st-century lifestyle , which involves: Prolonged sitting at work Long hours using computers and devices Frequent business travel Poor posture habits Unhealthy executive lifestyle choices Neck and back pain were once primarily seen in physically demanding jobs  like construction workers, bricklayers, and miners . However, I have noticed a significant rise in executives suffering from these conditions . How Sitting for Long Hours Affects the Spine The spine is made up of 33 bones  with soft gel-like discs in between  that allow for flexibility and movement . Sitting for too long  and maintaining poor posture  increases pressure on these discs , leading to degeneration and slipped discs . A slipped disc  can press on nerves in the spine , causing: Neck pain  and arm pain Back pain  and leg pain Numbness, tingling, and weakness in the limbs Severe cases  may result in difficulty walking or loss of bladder and bowel control When Should You See a Specialist? Executives with neck or back pain  often seek relief through massage therapy . However, I warn that: If pain does not improve after three sessions , you should see a spine and nerve specialist . Unqualified therapy  or incorrect techniques  can worsen the problem . A proper spine and nerve examination , followed by an MRI scan , is necessary to accurately diagnose  the issue. Common Conditions Causing Neck & Back Pain 1. Slipped Discs (Herniated Discs) Occurs when a damaged spinal disc  puts pressure on nerves. Can cause chronic pain, numbness, and weakness in the limbs . 2. Spinal Stenosis A narrowing of the spinal canal  that compresses the nerves . Common in older executives  and may cause: Neck pain or arm pain Difficulty walking or leg weakness 3. Postural Strain from Office Work Poor sitting posture  and incorrect ergonomics  contribute to chronic pain . Looking down at screens for long hours  can strain the neck . Treatment Options for Executive Neck & Back Pain 1. Non-Surgical Treatments ✅ Medications and therapy Organised by a spine specialist  to relieve pain and restore function ✅ Posture correction and ergonomics Adjusting sitting posture  and workstation setup . ✅ Exercise and lifestyle changes Encouraging movement to reduce strain on the spine . 2. Advanced Spine Injections For persistent pain , spine injections can: Reduce inflammation and pain. Treat the root cause, such as slipped discs. Be performed as a day procedure without surgery. 3. Minimally Invasive Spine Surgery If the condition becomes severe , modern techniques such as microsurgery and microneurospine surgery  provide: Low-risk procedures Fast recovery times Spinal nerve monitoring for safety Preventing Neck & Back Pain in the Workplace To maintain a healthy spine , I recommend: ✅ Less sitting, more movement Take breaks and adjust posture regularly . ✅ Ergonomic workstation setup Use a properly positioned screen and chair . ✅ Strengthening exercises Build core and back strength  to reduce strain . ✅ Healthy diet and hydration Support bone and nerve health . Comprehensive Spine Care at Singapore Brain Spine Centre At Singapore Brain Spine Centre , my team and I provide: ✅ Expert diagnosis for executive neck and back pain ✅ Advanced MRI and imaging for accurate assessments ✅ Minimally invasive treatment options for pain relief Struggling with Neck or Back Pain? Get Expert Help Today If you experience chronic neck or back pain , numbness, or weakness , don’t wait for it to worsen. Early diagnosis and treatment  can prevent long-term damage . 📞 Book a consultation today  at Singapore Brain Spine Centre  and take the first step toward a pain-free life!

Understanding Brain Fog Causes, Diagnosis, and Treatment What is Brain Fog? Brain fog is a term used to describe a range of cognitive symptoms  that affect thinking, memory, and concentration . It is characterised by: Confusion Forgetfulness Lack of mental clarity Difficulty focusing Brain fog is not a disease itself  but a symptom of underlying conditions  that can significantly impact daily life and productivity . Early diagnosis and treatment  of its causes are crucial in preventing its progression to mild cognitive decline (MCI)  and significant cognitive decline (SCI) . Brain fog may also be an early indicator of brain disease , including conditions that precede strokes, vascular dementia, and Alzheimer’s disease . Cases of young-onset strokes and young-onset dementia  are increasing worldwide , making early detection even more important. Causes of Brain Fog Brain fog can result from multiple factors , including physiological, medical, environmental, and lifestyle influences . 1. Physiological Factors Hormonal changes   Pregnancy, menopause, and other hormonal fluctuations can affect cognitive function. Nutrient deficiencies Lack of vitamin D, omega-3s, magnesium, vitamin C, and B-complex vitamins  may contribute to brain fog. Sleep disturbances Poor sleep quality or insufficient rest can impair brain function. Chronic stress Long-term stress can exhaust the brain , making it harder to think and concentrate. 2. Medical Conditions Long COVID Nearly 50% of long COVID patients  experience brain fog. Chronic musculoskeletal pain Common in neuropathy, nerve pain, and chronic pain conditions . Autoimmune disorders Diseases like multiple sclerosis  can cause cognitive impairment. Mental health disorders Anxiety and depression can contribute to brain fog symptoms. Cerebrovascular disorders Reduced blood flow to the brain , often linked to diabetes, hypertension, high cholesterol, and metabolic syndrome . 3. Environmental & Lifestyle Factors Electromagnetic radiation Excessive screen time  may contribute to brain fog. Toxins and pollution Exposure to environmental pollutants  can impact cognitive function. Diet Poor nutrition and certain food sensitivities may exacerbate brain fog symptoms. Diagnosing Brain Fog Brain fog is a symptom, not a condition , so diagnosis involves identifying the underlying cause  through a comprehensive medical approach . Key Diagnostic Steps: Medical History Review A Neuro Specialist  assesses sleep patterns, diet, and stress levels . Symptom Evaluation Identifies duration, intensity, and daily life impact . Laboratory Tests Checks for vitamin deficiencies, hormonal imbalances, and immune issues . Cognitive Assessments , Includes: Montreal Cognitive Assessment (MoCA) Wechsler Memory Scale (WMS) Neurowyzr Digital Brain Function Screening Scan Neurological Evaluation In severe cases, MRI scans  can detect neuroinflammation and brain microvascular impairment . Psychiatric Evaluation Assesses possible mental health contributions  to brain fog. Treatment Approaches for Brain Fog 1. Lifestyle & Natural Remedies Sleep Improvemen Following good sleep hygiene  for better cognitive function. Stress Management Meditation, deep breathing, and relaxation exercises. Physical Activity Regular exercise, walking, and yoga  to boost brain function. Cognitive Stimulation Brain exercises such as puzzles and memory games . Diet Optimisation A nutrient-rich diet  with proper hydration. 2. Medical Interventions Treating Underlying Conditions Managing diabetes, hypertension, and metabolic disorders . Medications In some cases, antidepressants or stimulants  may be prescribed. Hormone Therapy For cases linked to hormonal imbalances , such as hypothyroidism 3. Supplementation Vitamin & Mineral Supplements Including Vitamin D, B-complex vitamins, folate, and omega-3 fatty acids . L-Theanine Found in green tea , known for improving mental alertness and memory . Other Supplements Ginkgo alkaloids, curcumin, and nootropics  may help relieve brain fog. Current Research & Future Directions Latest Scientific Findings on Brain Fog Recent studies have revealed key mechanisms behind brain fog, particularly in long COVID patients : Blood-Brain Barrier Disruption Increased permeability in brain blood vessels. Clotting Markers Higher levels found in long COVID patients with brain fog. Neuroimaging Findings MRI scans show a leaky blood-brain barrier  in affected individuals. Implications for Future Treatment Targeted Therapies Research is leading to more precise treatments  for brain fog. Broader Applications Understanding post-viral syndromes  could change the way we treat neurological conditions . Advanced Diagnostic Tools Biomarker identification and imaging improvements  may enhance early detection. Interdisciplinary Approach Collaboration across multiple medical specialties  to address brain fog comprehensively. Personalised Medicine Tailored treatment strategies based on individual health profiles . Expert Brain Fog Care at Singapore Brain Spine Centre With years of experience  in diagnosing and treating brain fog , Dr. Prem Pillay  provides cutting-edge neurological care  using the latest medical advancements . At Singapore Brain Spine Centre , we offer: ✅ Comprehensive Brain Function Assessments ✅ Advanced Diagnostic Imaging (MRI, PET Scans, Neuropsychological Tests) ✅ Personalised Treatment Plans for Cognitive Health Struggling with Brain Fog? Get Expert Help Today If you or a loved one is experiencing brain fog, memory problems, or difficulty concentrating , early diagnosis is key . Our specialised team will create a personalised, evidence-based treatment plan  to restore mental clarity and brain function . 📞 Book a consultation today  at Singapore Brain Spine Centre  and take control of your cognitive health!

Brain Checks and Scan Most people undergo regular health check-ups  throughout their lives—such as school health checks, employment screenings, and executive health checks . These tests are effective in screening for conditions like diabetes, hypertension, high cholesterol, kidney disease, heart disease, and some cancer markers . However, these general health checks  are often inadequate for detecting brain conditions . The brain is the most important organ , responsible for thinking, movement, and overall body function . Unfortunately, it is also vulnerable to diseases such as: Cerebrovascular disease (stroke-causing blood vessel blockages or bleeding) Brain tumors, including brain cancer Epilepsy and other seizure disorders Brain infections Dementia and memory loss conditions Neurodegenerative diseases such as Parkinson’s disease Increasingly, younger individuals are being diagnosed with brain-related diseases . Early detection  can make a significant difference in treatment , preventing long-term brain damage, which is difficult to reverse . Who Should Get a Brain Check? A Brain Check  is recommended for individuals experiencing any of the following symptoms: Persistent and severe headaches Dizziness, vertigo, or spinning sensations Seizures, including epilepsy Sudden weakness in the limbs Loss of consciousness Sudden loss of senses (hearing, vision, smell, taste, or touch) Difficulty understanding speech or expressing oneself Tremors or uncontrollable movements of the hands and limbs Memory problems and forgetfulness What is Done During a Brain Check? A Specialist Brain Check  involves a consultation with a Brain Specialist at a Brain Center . The Process Includes: Detailed Medical History  – Assessment of current and past health conditions . Physical Examination  – Evaluates gait, movement, speech, hearing, vision, sensation, strength, and reflexes . S pecialist Brain Scans & Tests  – Ordered based on clinical findings  for accurate diagnosis . What Are the Specialist Brain Scans and Tests? Your Brain Specialist  may recommend the following brain imaging and diagnostic tests : Imaging Scans MRI (Magnetic Resonance Imaging) of the Brain CT (Computed Tomography) of the Brain PET (Positron Emission Tomography) Brain Scans, including PET-MRI Brain Function & Neurological Tests NeuroMetrics & PsychoMetrics Digital Brain Function Tests EEG (Electroencephalogram), including Video EEG Blood Vessel & Circulatory Tests Cerebral Angiograms, including CT Angiogram, MR Angiogram, and Catheter Angiograms Hearing & Balance Tests Audiograms and Vestibular Function Tests ( This is not an exhaustive list. Your Brain Specialist will determine the necessary tests based on your symptoms and clinical diagnosis. ) Specialist Brain Care at Singapore Brain Spine Centre At Singapore Brain Spine Centre , we provide: ✅ Comprehensive Brain Health Assessments ✅ Advanced Brain Imaging (MRI, CT, PET Scans) ✅ Specialist Neurological Tests for Accurate Diagnosis Prioritise Your Brain Health, Book a Brain Check Today If you are experiencing persistent headaches, dizziness, memory issues, or unexplained neurological symptoms , early diagnosis can be life-changing . 📞 Schedule a consultation today  at Singapore Brain Spine Centre  and take a proactive step toward better brain health.

Neck Pain and its connection to neurological health There are more people suffering from head and neck pain in today’s world. Over the last 10 years, Dr. Prem Pillay, a Spine & Pain Specialist, has observed an increase in cases, which he attributes to work-style and lifestyle changes. In the 21st century, the use of computers, laptops, tablets, and smartphones for both work and recreation has become common. Prolonged sitting, poor posture, and long hours staring at screens contribute to muscle tension, headaches, and neck pain. Common Causes of Head & Neck Pain Frequent Causes of Headaches Migraine and tension headaches Less common but serious causes  such as strokes and brain tumors Neck-related headaches  caused by muscle tension and spine issues Spinal Issues and Slipped Discs Spinal disc protrusion  – A gel-like substance between the bones of the spine can slip out of place , pressing on nerves. Gradual spine damage  from bad posture, prolonged sitting, carrying heavy objects, and impact sports . Sudden injuries  from car accidents or falls . Other Contributing Factors Repetitive strain from work-style and daily activities . Osteoporosis  leading to spinal fractures from minor falls . Spinal infections or tumours  such as tuberculosis of the spine . Ways to Relieve Neck Pain For neck pain caused by strain or muscle spasms , you can try: ✔ Improving your posture  and adjusting your sleeping position. ✔ Taking breaks  from sitting or standing in the same position for too long. ✔ Stretching exercises  for the neck and shoulder muscles. ✔ Applying heat therapy  – hot showers, warm compresses, or heating pads. ✔ Using over-the-counter pain relief  when necessary. When to See a Doctor If head and neck pain  persists for more than a week , it is important to seek medical attention. ⚠ Seek emergency care  if you experience: Sudden, severe head and neck pain – the worst pain you’ve ever had . Pain that radiates down the arm or is accompanied by numbness or tingling . Recurring pain that does not improve with massage therapy or medication . Dr. Prem Pillay advises that persistent or worsening pain could indicate a serious condition such as a stroke or a brain infection like meningitis. A spine and nerve specialist can conduct MRI scans of the head and spine to determine the cause of the problem. Modern Treatment Options For patients whose head and neck pain  does not improve with conservative treatments , modern medical approaches may be considered, including: Non-Surgical Treatments Medications  to reduce inflammation and relieve pain. Advanced physiotherapy  to improve posture and muscle strength. Spine injections  for targeted pain relief. Minimally Invasive Procedures Laser-assisted spine injections  – performed as a day procedure  without major surgery. Advanced microsurgery techniques  – considered in select cases. Dr. Prem Pillay shares the case of Mrs. Tan, who suffered from head and neck pain that could not be relieved by massage therapy or medications. After spine and nerve evaluations, including MRI scans, it was found that her pain was caused by weak or injured spine discs. She underwent a minimally invasive spine injection procedure and was able to return home within hours. Over the following weeks, her pain significantly improved, and she was able to regain normal function with the help of physiotherapy and lifestyle adjustments. Prevention and Lifestyle Adjustments To reduce the risk of head and neck pain , Dr. Prem Pillay  recommends: ✔ Using an ergonomic desk and chair  for better posture. ✔ Taking frequent breaks from prolonged sitting . ✔ Strengthening exercises  to support the spine. ✔ Raising awareness in schools, universities, and workplaces  about posture-related spinal health . You Don't Have to Live with Pain, Take the First Step Toward Relief Head and neck pain can affect daily life, making even simple activities uncomfortable and frustrating. If your pain keeps coming back, limits your movement, or is affecting your quality of life, it may be time to seek expert medical advice. At Singapore Brain Spine Centre, we understand how chronic pain can impact your work, relationships, and well-being. Our goal is to help you find relief and restore your comfort, so you can return to doing the things you love. If you are struggling with persistent head or neck pain, reach out today. You deserve to feel better.

Causes, Diagnosis & Treatment What is Epilepsy? Epilepsy is a neurological disorder characterised by repeated seizures. A seizure is a sudden alteration in behaviour caused by temporary changes in the brain’s electrical activity. Normally, the brain generates tiny electrical impulses in an orderly pattern, which travel along neurons and throughout the body via neurotransmitters. In epilepsy, the brain’s electrical rhythms become imbalanced, leading to recurrent seizures. These sudden bursts of electrical energy can affect consciousness, movement, and sensations. How is Epilepsy Diagnosed? Epilepsy is usually diagnosed after a person has had at least two seizures  that were not caused by another medical condition  (such as alcohol withdrawal  or low blood sugar ). If seizures originate from a specific area of the brain , the initial symptoms  may reflect the functions of that brain region . For example, if a seizure begins in the right side of the brain , which controls movement on the left side , the seizure may start with jerking of the left thumb or hand . Types of Seizures Seizures are broadly classified into two categories : 1. Primary Generalised Seizures Begin with a widespread electrical discharge  that involves both sides of the brain . Hereditary factors  are more likely to play a role in primary generalised epilepsy . 2. Partial Seizures Begin with an electrical discharge in a limited area of the brain . Some are related to brain injury, infection, stroke, or tumors , but in most cases, the cause is unknown . Consciousness may be impaired or preserved  depending on the seizure type. Risk Factors for Seizures The following factors can increase the risk of seizures in individuals predisposed to epilepsy : Stress Sleep deprivation or fatigue Skipping meals Alcohol or drug use Failure to take prescribed anticonvulsant medication Approximately 50% of individuals  who experience one unprovoked seizure  will have another within six months . The risk of developing epilepsy  increases if the seizure is associated with a brain injury or abnormality . Prevalence of Epilepsy According to the Epilepsy Foundation : 50 million people worldwide  have epilepsy. Three million people in the U.S.  are affected. 10% of the population  will experience a seizure at some point in life. More than 300,000 children  under the age of 15 have epilepsy. 570,000 adults over 65  suffer from epilepsy, often due to strokes or neurodegenerative diseases like Alzheimer’s . Common Causes of Epilepsy by Age Children  – Birth defects, infections, or head injuries. Young Adults  – Severe head injuries  or brain infections . Middle Age  – Strokes, tumors, and injuries. Older Adults (65+)  – Stroke is the leading cause , followed by Alzheimer’s disease . Epilepsy Risk Factors Premature birth or low birth weight Brain trauma (lack of oxygen during birth, severe head injuries) Abnormal brain structures Brain tumors or stroke Infections such as meningitis or encephalitis Family history of epilepsy Alcohol or drug abuse Diagnosing Epilepsy A doctor diagnoses epilepsy using: Electroencephalogram (EEG)  – Measures electrical activity in the brain . MRI or CT Scan  – Detects brain abnormalities  such as tumours or structural issues . Video-EEG Monitoring  – Records seizures and brain activity . Neuropsychological Testing  – Assesses memory and cognitive function . Proper diagnosis is essential  to determine the type of epilepsy and seizures . Treatment Options for Epilepsy 1. Medications (Antiepileptic Drugs – AEDs) First-line treatment  for epilepsy. Prevent seizures by reducing abnormal brain activity . Effective in 70% of patients . 2. Diet Therapy Ketogenic Diet  – High-fat, low-carbohydrate diet. Modified Atkins Diet  – Less restrictive alternative. Used for children with drug-resistant epilepsy . 3. Surgical Treatment For patients with medically-resistant epilepsy , surgery may be the best option. Dr. Prem Pillay , an expert in epilepsy surgery  at Singapore Brain Spine Centre , explains that surgical intervention is considered for patients: ✅ Whose seizures originate from a specific part of the brain . ✅ Who do not respond to medication . ✅ Who have a brain tumor, AVM, or other structural abnormality causing epilepsy . Surgical Procedures Include : Lesionectomy  – Removes a tumour or lesion  causing seizures. Lobectomy  – Removes the affected brain lobe  ( most commonly the temporal lobe ). Corpus Callosotomy  – Cuts nerve fibers connecting the left and right brain hemispheres . Vagus Nerve Stimulation (VNS)  – A device implanted in the chest  to reduce seizure frequency . Responsive Neurostimulation (RNS)  – A device implanted in the brain  to detect and stop seizures . Living with Epilepsy People with epilepsy may face risks such as: Status Epilepticus  – Prolonged seizure activity, a medical emergency. Sudden Unexpected Death in Epilepsy (SUDEP)  – Rare but serious condition. Despite these risks, 70-80% of epilepsy patients can successfully control seizures  with medication or surgery . Key Takeaways for Managing Epilepsy : Follow prescribed treatments  carefully. Identify and avoid seizure triggers . Maintain a healthy lifestyle with proper sleep, nutrition, and stress management . Regularly consult with your doctor for optimal care . Comprehensive Epilepsy Care at Singapore Brain Spine Centre At Singapore Brain Spine Centre , we offer: ✅ Expert epilepsy diagnosis & management . ✅ Advanced medical imaging (EEG, MRI, CT scans) . ✅ Surgical treatment options for drug-resistant epilepsy . Take Control of Epilepsy, Seek Expert Care Today If you or a loved one is struggling with seizures, nerve pain, or chronic epilepsy , expert neurological assessment and treatment  can help improve quality of life . 📞 Book a consultation today  at Singapore Brain Spine Centre  and take the first step toward better epilepsy management.

Understanding Headaches and Their Causes Headaches are one of the most common medical complaints, affecting people of all ages. While most headaches are harmless and temporary, some can indicate a more serious underlying condition. Understanding the different types of headaches , their causes , and when to seek medical attention can help in finding the right treatment and relief. Dr. Prem Pillay, a specialist in neurology and pain management , advises that persistent or severe headaches should be properly evaluated to rule out serious conditions such as brain tumors or aneurysms . Types of Headaches Headaches are generally classified by cause: Primary Headaches A primary headache  is caused by overactivity or issues with pain-sensitive structures in the head . It is not a symptom  of an underlying disease. Factors contributing to primary headaches  include: Chemical activity in the brain Nerves or blood vessels surrounding the skull Muscles of the head and neck Genetic predisposition Common Primary Headaches: Cluster headache Migraine Migraine with aura Tension headache Trigeminal autonomic cephalalgia (TAC) Some less common  primary headaches have distinct features, such as unusual duration or pain linked to specific activities . Examples of Uncommon Primary Headaches: Chronic daily headaches  ( chronic migraine, chronic tension-type headache, hemicrania continua ) Cough headaches Exercise headaches Sex headaches Lifestyle Triggers for Primary Headaches: Alcohol consumption  ( especially red wine ) Certain foods  ( such as processed meats with nitrates ) Changes in sleep patterns  ( or lack of sleep ) Poor posture Skipped meals Stress Secondary Headaches A secondary headache  is a symptom of an underlying disease  that activates pain-sensitive nerves in the head . These can range from mild conditions  to severe, life-threatening illnesses . Possible Causes of Secondary Headaches: Acute sinusitis (sinus infection) Arterial tears (carotid or vertebral dissections) Brain aneurysm  ( a bulging artery in the brain ) Brain tumour Carbon monoxide poisoning Concussion or post-concussion syndrome Dehydration Dental problems Ear infections  ( middle ear infections ) Encephalitis (brain inflammation) Glaucoma (acute angle-closure glaucoma) Hangovers High blood pressure (hypertension) Influenza (flu) or other fever-related illnesses Meningitis  ( brain infection ) Overuse of pain medications  ( rebound headaches ) Panic attacks and panic disorder Stroke Toxoplasmosis Trigeminal neuralgia  ( nerve irritation affecting the face and brain ) Specific Types of Secondary Headaches External compression headaches  ( caused by tight headgear, such as helmets or goggles ) Ice cream headaches  ( commonly known as brain freeze ) Medication overuse headaches  ( from excessive use of pain relievers ) Sinus headaches  ( due to inflammation and congestion in the sinus cavities ) Spinal headaches  ( caused by low cerebrospinal fluid pressure, possibly from a spinal tap or spinal anaesthesia ) Thunderclap headaches  ( sudden, severe headaches with multiple possible causes ) When to Seek Medical Attention for Headaches Dr. Prem Pillay , an expert on headaches , recommends that if headaches are severe or persistent , you should seek a neurological consultation . A neurological examination  may include: MRI of the Brain Imaging tests  to rule out serious conditions Although serious problems such as brain tumours, ruptured brain aneurysms, or arteriovenous malformations  are not common , failing to detect them early can lead to serious, life-changing consequences . Specialist Headache Assessment at Singapore Brain Spine Centre At Singapore Brain Spine Centre , we offer: ✅ Expert neurological evaluation for chronic headaches ✅ Advanced MRI and imaging tests for accurate diagnosis ✅ Personalised treatment plans for headache relief Don’t Let Headaches Disrupt Your Life , Get the Right Diagnosis Today If you are experiencing persistent, severe, or unusual headaches , it’s important to seek expert medical advice . Identifying the root cause early  can prevent serious complications . 📞 Book a consultation today  and take the first step toward a pain-free life.

Understanding the Causes of Excessive Hand Sweating and When to Seek Help Sweaty palms, or palmar hyperhidrosis, is a condition where the hands produce excessive sweat beyond what is needed for temperature regulation. This can affect daily activities, social interactions, and work performance, often causing discomfort and embarrassment. While some treatments offer temporary relief, Mini-Endoscopic Sympathectomy (MES) provides a permanent solution for those struggling with severe sweating. Understanding Hyperhidrosis and Its Treatments Sweaty palms, also known by the medical term Hyperhidrosis, refers to excessive sweating of the palms. People with this problem may also have sweaty armpits and sweaty feet. Why Does Sweaty Palms Occur? This is not caused by an injury, infection, or eating the wrong food. It results from overactivity in a part of the nervous system, which starts in childhood. The overactivity occurs in the hypothalamus and is transmitted to the hands and feet through a relay system called the sympathetic nervous system. Who Gets Sweaty Palms? This condition can occur in anyone, but it is more common in certain ethnic groups, including Chinese and Israelis. It usually starts in childhood and becomes more noticeable in the teenage years. It can run in families, with brothers and sisters sometimes sharing the problem. However, the gene is not strong, so the likelihood of passing it to children is low. How is Sweaty Palms Medically Treated? Topical Treatments Medical treatment for excessive sweating  includes agents that dry up the hands , such as Drichlor (Aluminium Hydroxide) . This is not a cure  and must be used daily . It is effective for mild cases  but less effective for severe sweating . Hands may feel tight  after application. Oral Medications Pills for sweaty palms may help, but they cause side effects , including: Blurred vision Dry mouth Difficulty passing urine Most doctors do not recommend them. Iontophoresis (Electrical Treatment) A treatment that uses electric current  to reduce sweating for a few days . Not a cure  but can be useful for students before examinations . Can Sweaty Palms Be Cured? Yes, sweaty palms can be cured by an operation called Mini-Endoscopic Sympathectomy (MES) . This surgery interrupts the abnormal nerve signals  to the hands by burning a nerve relay station called the T2 sympathetic ganglion . Recommended for patients troubled by sweaty palms at work or socially . Suitable for those who have not found medical treatments useful . How is the MES Operation Done? Performed under general anaesthesia . A tiny incision (3mm) is made in each armpit . A mini-endoscope  (telescope-like device) is inserted to burn the T2 sympathetic ganglion . The procedure takes approximately 1 hour . At the end of the surgery, a single stitch  is used to close the incision. Hospital Stay & Recovery How Long Do I Have to Stay in Hospital? Option 1:   Stay overnight before surgery  and be discharged the same evening  after recovery. Option 2:   Same-day surgery  ( Day Surgery Admission in the late morning, MES in the afternoon, discharged at night ). When Can I Return to Work After Surgery? You can return to work the next day  if you feel comfortable. The stitches are removed after one week . Pain & Discomfort After Surgery Minimal pain and discomfort  due to the small incision size . The scar is almost invisible  after healing. What is the Success Rate for MES Surgery? The success rate is approximately 98%  for MES surgery for sweaty palms. Take Control of Sweaty Palms – Find a Lasting Solution Today If excessive sweating  is affecting your daily life , Mini-Endoscopic Sympathectomy (MES) offers a proven, permanent solution . 📞 Book a consultation today  and take the first step towards a sweat-free life!