Dr Gary HottonPatient Information
Headache
Headache is a condition which whilst unpleasant and distressing is usually of a benign origin. It is most commonly due to migraine, which can affect up to 20% of the population and can usually be easily treated with medications and lifestyle changes. Other rarer benign causes of headache such as cluster headache, SUNCT, paroxysmal hemicrania need to be identified however as the treatment is often very different from that of migraine. Rarely however it can be a manifestation of a more serious condition such as a cerebral hemorrhage, brain tumor, meningitis or venous thrombosis. As a result a specialist should assess all patients with a new onset headache.
Sometimes if patients take too much of the wrong type of treatment for their headache the treatment can make the headache worse. This effect often goes unrecognized but can usually be managed effectively if identified and analgesic medications reduced in synchrony with the administration of a migraine preventative medication.
For more information visit www.migrainetrust.org
Brain Tumors
Brain tumors are relatively uncommon tumors comprising around 2% of all cancer types in the UK. They can occur in patients of all ages and can present with a variety of symptoms such as black outs, dizzy spells, paralysis, speech difficulty, headache and memory difficulties. All patients with a suspected brain tumor should have a brain scan to determine the nature of the tumor and plan any attempted surgery. The care of all patients with brain tumors requires the input from a multi-disciplinary team to best tailor care of the patient to their needs. Dr Hotton is a core member of the National Hospital for Neurology Neuro-oncology Multi-Disciplinary Team and all his patients with suspected brain tumors are discussed in the weekly National Hospital for Neurology and Neurosurgery Neuro-oncology Multi-Disciplinary Team Meeting.
For more information www.braintumouruk.org.uk and www.thebraintumourcharity.org
Parkinson's Disease
Parkinson's disease is a slowly progressive condition in which patients experience increasing difficulty moving, tremor, stiffness of muscles and an increased tendency to fall. Patients may also experience low mood, sleep difficulties and personality change. Whilst the condition does get worse over time it tends to do so very slowly and patients are often able to maintain employment years into the condition. There are many treatment options available for patients with Parkinson's disease that are effective at alleviating symptoms such as L-dopa, dopamine agonists, COMT inhibitors, MAOI inhibitors and on occasion surgical intervention. The choice of treatment however often needs to be individualised to the patient with different approaches taken based on patient age, co-morbidities and stage of the disease.
For more information visit www.parkinsons.org.uk
Epilepsy
Seizures can affect patients of any age and are caused by a disturbance of electricity within the brain if the seizures occur in a repeated manner without a clear provoking factor the patient is said to have epilepsy. 1 in 20 people will have a seizure at some point in their life and 1 in 50 will have epilepsy at some point in their life. Seizures can vary widely from brief episodes of confusion to episodes of collapse and convulsion of the body. Treatment is often very effective and around 70% of patients with epilepsy can be made seizure free with appropriate medications.
Advice for patients with epilepsy
You should not drive or operate dangerous machinery until you see the neurologist.
You should avoid potentially dangerous work or leisure situations e.g. climbing ladders, swimming and cycling until you see the neurologist.
You should not consume alcohol.
You should avoid bathing and use showers.
Advice for family and carers of patients with epilepsy
If your friend / family member has another seizure
Do
- If the episode occurs in a seated or standing position lower or assist the patient to the lying position.
- Watch the seizure carefully and if possible let it run its natural course.
- Keep calm and note the time of seizure onset and how long it lasts.
- Clear space around the person.
- Cushion the persons head with whatever is available.
- Loosen any tight clothing around the person's neck and gently remove any glasses.
- Turn the person onto their side into the recovery position once the convulsions stop.
- Stay with the person until any confusion passes.
- If you have a mobile telephone with video recording capacity consider recording the event on your mobile telephone.
Do not
- Move the patient whilst the seizure is happening unless there is an immediate danger (e.g. near a fire, at the top of a flight of stairs or on a busy road).
- Make any attempt to keep them seated or upright.
- Try to restrain the person.
- Attempt to put anything between the teeth or into the mouth.
- Attempt to give medication during the seizure.
- Attempt to give the person a drink during the seizure.
You should call 999
- If one seizure follows another without recovery in between.
- If a seizure lasts more than 5 minutes.
- If the person has been badly injured.
- If you are unsure.
For more information visit www.epilepsysociety.org.uk
Dizziness and vertigo
Dizziness can be one of the most unpleasant and disturbing medical symptoms. It can be a very challenging symptom for the non-neurologist because of the range of possible symptoms the sensation encompasses such light-headedness, weakness, unsteadiness, giddiness and vertigo spanning many conditions involving the heart, blood vessels, ear and brain. However it is often possible to determine the cause of the symptoms by carefully assessing the patient.
Of these symptoms vertigo is the most specific and is the perception of movement that dose not exist. This is usually a consequence of a problem affecting the ear or its connections to the brain and often is best treated with specific head maneuvers rather than medications.
For more information visit: www.brainandspine.org.uk/vestibular-rehabilitation-exercises and www.menieres.org.uk