Neuroscience Health

Headaches

They happen to most of us at one point or another: Nearly half of all adults have had a headache at least once in the last year, according to the World Health Organizations, with more than 10 percent experiencing a migraine. Thanks to hormonal changes, women are more prone to developing headaches—particularly migraines—especially around menstruation when estrogen levels drop.

There are many types of headaches, each with its own set of triggers.

  • Tension headaches are the most common type of head pain. They’re caused by tightness in the muscles along the shoulders, neck, scalp or jaw. These headaches tend to form on both sides of the head, often starting at the back and spreading forward, with a dull or squeezing pain like a tight band.
  • Migraine headaches are typically more severe and are usually accompanied by other symptoms like nausea or changes in vision. The pain is usually limited to one side (although it can spread to both sides) and may be throbbing, pounding or pulsating. Migraines are typically recurrent and can be a life-long condition, beginning around puberty.  Three times as many women suffer from migraines than men.
  • Sinus headaches are due to swelling in the sinus passages behind the cheeks, nose and eyes and are typically caused by an infection. The pain is often in the front of the head and face. It’s usually is worse in the morning and is exacerbated by bending forward.  Sinus headaches are much less common than we think, and a lot of them are actually migraines.
  • Cluster headaches, while not very common, are extremely painful and tend to occur several times a day before eventually temporarily disappearing. They affect six times as many men as women.
  • Rebound or medication overuse headaches are usually thought of as headaches that keep returning, but not in any set pattern. They’re often caused by an overuse of painkillers or similar medications for more than a few days.

Treatment Options

  • Over-the-counter medications such as aspirin, acetaminophen, ibuprofen or naproxen sodium are usually effective in treating tension headaches.
  • Relieving stress by closing your eyes, taking a few deep breaths or doing anything relaxing can help ease any type of headache.
  • For migraines, drink water and rest in a quiet, dark place; placing a cool cloth on the head can also help. Prescription medications called triptans may also help provide relief.
  • For recurrent headaches, try keeping a diary to help find the trigger for your symptoms. Try to record the date and time symptoms began, how long the headache lasted, what you ate or drank in the past 24 hours, whether you’re experiencing any stressful emotions and what treatments worked. This information can help you and your doctor determine if there are any set patterns to your headache pain.

Ask Your Doctor

Most headaches are not the sign of a serious illness, but significant symptoms could be a sign of something that needs more immediate medical attention. See your doctor immediately if your headache comes on suddenly and is severe; is the worst headache you’ve ever felt; if you’ve developed slurred speech, changes in vision, problems moving your arms or legs, or a loss of balance, confusion or memory; if the pain gets worse over a 24-hour period; is accompanied by fever, stiff neck, nausea and vomiting; if it occurs with a head injury; or if it is severe and occurs near one eye that has turned red.

Parkinson’s Disease And Other Movement Disorders

Generally defined, movement disorders are neurological disease that manifest with tremor, rigidity, and other involuntary movements, such as tics, chorea, and dystonia. Some common movement disorders include Parkinson’s disease, Tourette’s syndrome, cervical dystonia, and essential tremor.

Parkinson’s disease

Parkinson’s disease (PD) occurs when nerve cells in an area of the brain that produce a brain chemical called dopamine become impaired and/or die. This shortage of dopamine causes the movement problems common among Parkinson’s patients. The primary symptoms include tremors or trembling in the hands, arms, legs, jaw and face; rigidity or stiffness in the limbs and trunk; slowness of movement and impaired balance and coordination. Early symptoms are subtle and occur gradually, but in some cases the disease will progress more quickly, and the tremor may begin to interfere with daily activities. PD usually affects people over the age of 50. At present, there is no known cure for PD, although a variety of medications can provide dramatic relief from the symptoms.

As many as one million Americans today are living with Parkinson’s disease, and approximately 60,000 Americans are diagnosed with PD each year. Men are one and a half times more likely to have Parkinson’s than women. The likelihood of developing Parkinson’s increases with age, but an estimated four percent of people with PD are diagnosed before the age of 50.

Other Movement Disorders

  • Atypical Parkinsonian syndrome is considered a catchall for many relatively uncommon disorders with similar symptoms to Parkinson’s.
  • Dystonia  is a movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
  • Essential tremor, the most common movement disorder, primarily affects the hands, but can also affect arms, feet, legs, trunk and vocal cords.
  • Tremor is a movement disorder characterized by rhythmic, involuntary muscular contraction of a part of the body and is mostly in the hands.
  • Tourette’s syndrome is a neurological movement disorder characterized by repetitive, stereotyped, semi-involuntary movements and vocalizations called tics.
  • Hemifacial spasm is a neuromuscular movement disorder characterized by frequent involuntary contractions of the muscles on one side of the face.
  • Ataxia is a group of neurological disorders that affects balance, coordination, and speech.
  • Huntington’s disease is a genetic disease that causes degeneration of neurons (brain cells) which, in turn, leads to uncontrolled movement disorders, loss of intellectual faculties and emotional disturbances.

For more information on diagnosis and treatment of neurological diseases, visit the Cushing Neuroscience Institute, part of North Shore-LIJ Health System. The Institute uses a multidisciplinary approach to the entire spectrum of neurological diseases.

Multiple Sclerosis

Multiple sclerosis is a disease of the nervous system, affecting the brain and spinal cord. It happens when there is damage to the myelin sheath, or the material that surrounds and protects nerve cells. When this tissue is damaged, messages between the brain and the body are slowed or blocked, which can create such symptoms as visual disturbances, muscle weakness, trouble with coordination and balance, thinking and memory problems, and feelings of numbness or tingling. The average age when MS symptoms first appear is between 30 and 35 years old. About 400,000 people in the U.S. are living with MS, with about 10,000 new cases diagnosed each year. MS is much more common in women than men.

The cause of MS is still unknown, but scientists think it may be an autoimmune disease, where the body attacks its own cells. Scientists do not know what triggers the onset of this disease, but environmental factors, or viruses may be involved and certain individuals may be genetically predisposed.  There is no cure for MS, but disease modifying therapies can help to decrease the relapses and slow the progression.  There are many medical options available to treat symptoms.  Physical and Occupational therapy are used to treat various issues that arise that may affect gait or mobility.

Ask Your Doctor

Early symptoms of MS may be vague and may occur sporadically over a long period of time. There is no single test used to diagnose MS. Instead, doctors use a series of criteria to help confirm a diagnosis, which usually includes using an MRI scan to show lesions in the brain.  Treatment options can help to relieve symptoms and reduce relapses, as well as improve daily function.

Dementia

Dementia itself is not a disease­—it’s a group of symptoms caused by a disorder affecting the brain. One of the most common symptoms is memory loss, but dementia also means there must be a serious problem with two or more brain functions (such as memory and language issues). Other signs of dementia include an inability to solve problems or control emotions, problems with normal activities such as eating or getting dressed, getting easily agitated, or seeing things that are not really there. Although dementia is most common among elderly people, it’s not considered a normal part of aging.  More than 35 million people worldwide are estimated to be living with dementia. This number is expected to double by 2030 and more than triple by 2050, according to the World Health Organization.

Ask Your Doctor

There are a variety of diseases that can lead to dementia, including Alzheimer’s disease, stroke, Huntington’s disease, and vascular dementia, among others. Other conditions can also cause dementia-like symptoms, including reactions to certain medications, nutritional deficiencies, infections, brain tumors, metabolic problems, endocrine abnormalities, or hypoxia (loss of oxygen to the brain). Early diagnosis can help improve the quality of life for people with dementia and their families. While there is no known cure or ability to stop dementia or reverse existing damage, certain medications may be able to improve symptoms or slow the progression of dementia, and to improve quality of life.

Epilepsy

Epilepsy is a general term for conditions with recurring seizures. These seizures are triggered when clusters of nerve cells in the brain send out mixed-up signals. Other symptoms can include strange sensations and emotions, or strange behavior, as well as violent muscle spasms or a loss of consciousness. Epilepsy can be caused by many things, including illness, brain injury or abnormal brain development. In some cases doctors simply don’t know what may be setting off the condition. Epilepsies can range in severity from being a relatively benign disorder to a life-threatening or disabling problem. There are two main types of seizures: primary generalized seizures (involving both sides of the brain) and partial seizures (those involving a smaller area of the brain). Both involve abnormal electrical activity in the brain that causes these involuntary changes in body movement, function, sensation, awareness and behavior. About 2.3 million adults and 467,711 children in the U.S. have epilepsy, according to the CDC, and nearly 150,000 American develop the condition each year.

Ask Your Doctor

Doctors use brain imaging studies such as an MRI or CT scan to evaluate any abnormalities in brain structures.  The most important test for the evaluation of epilepsy is the electroencephalogram, which evaluates brain electrical activity. Medications usually control seizures, as can surgically implanted devices to target key nerves, like the vagus nerve stimulator. For many patients, seizures can be cured by surgical removal of the seizure-causing part of the brain, which is performed by a neurosurgeon.  Once epilepsy is diagnosed, treatment should begin as soon as possible. Other treatment options include antiepileptic drugs and surgery.

How North Shore-LIJ Can Help

Part of the North Shore-LIJ Health System, one of the largest healthcare systems in the country, and the Hofstra North Shore-LIJ School of Medicine, the Cushing Neuroscience Institute specializes in the diagnosis and treatment of all neurosurgical and neurological diseases and serves thousands of patients from around the country and the world.

Our physicians combine experience with compassion and caring for each patient, and we are best known for our multidisciplinary approach to the entire spectrum of neurological disorders including benign and malignant brain tumors, brain aneurysms, stroke, AVMs and other neurovascular conditions, spinal disorders resulting in back and neck pain, traumatic brain injury, Parkinson’s disease and other movement disorders, epilepsy and seizure disorders, headaches and migraine, chronic pain, neuromuscular conditions, Alzheimer’s disease, dementia and other memory disorders.