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Zhang Hui
Neurology
About me
Weifang People's Hospital, Department of Neurology, attending physician, has been engaged in clinical work in the field of neurology for many years, with rich clinical experience in common and prevalent neurological diseases.
Proficient in diseases
Cerebrovascular disease, Parkinson's disease, myelitis, etc.
Voices
What department is myasthenia gravis under?
Myasthenia gravis, this disease definitely requires registration with the Department of Neurology as it is a relatively common disease in neurology, and doctors in other departments are not particularly familiar with this disease, let alone diagnosis and treatment. Myasthenia gravis is an immune disease of the nervous system, and patients may experience generalized fatigue, which can be alleviated after rest. It is characterized by clinical symptoms that are lighter in the morning and more severe in the evening. Additionally, symptoms such as ptosis, double vision, and even some difficulties in swallowing and unclear speech, known as bulbar paralysis, may occur. This disease requires a thorough chest CT scan, as many patients have an associated thymoma. Furthermore, an electromyography examination is needed to check for antibodies related to myasthenia gravis, which is also important for guiding further treatment.
Is cerebellar atrophy serious?
Cerebellar atrophy is primarily a radiological finding, typically observed on cranial CT or MRI scans that show cerebellar shrinkage. The extent of cerebellar atrophy does not necessarily correlate with clinical manifestations; the severity of the atrophy may not align with the severity of clinical symptoms. If cerebellar atrophy occurs without any clinical symptoms and the patient remains agile and strong, then it is considered not severe. However, some diseases that cause cerebellar atrophy can be quite severe, such as multiple system atrophy, which has a subtype called olivopontocerebellar atrophy. This condition can lead to significant gait instability and limb ataxia, causing issues like inaccurate finger-to-nose testing and unstable object handling. The symptoms are definitely very severe, and the prognosis is very poor. Additionally, long-term alcohol consumption and alcohol poisoning can also cause cerebellar atrophy, which is also quite severe. In such cases, abstaining from alcohol and administering B vitamins are necessary for treatment, but the prognosis remains poor.
Can cerebral embolism be treated with thrombolysis?
Cerebral embolism is a relatively common ischemic cerebrovascular disease. If the area of cerebral embolism is very large and it exceeds the time window for thrombolysis, and if the patient is elderly with multiple underlying diseases, then thrombolysis is not recommended. Patients with large-area cerebral embolism have a higher probability of transitioning to cerebral hemorrhage, thus the risk of thrombolysis is very high. However, if it is within the time window for arterial thrombectomy, it is advocated to undergo arterial thrombectomy treatment. Family members can communicate more with the doctor to choose the appropriate treatment plan. If the symptoms of cerebral embolism are relatively mild, the affected area is considered small, and it is within three hours, then intravenous thrombolysis treatment could be considered. Patients undergoing intravenous thrombolysis must ensure that a cranial CT is rechecked within 24 hours to exclude any secondary bleeding.
Symptoms of facial neuritis
Facial neuritis, known as idiopathic facial paralysis, is a common disease in neurology. The main clinical manifestations and symptoms include acute onset, peaking within several hours to days. The primary manifestation is paralysis of the expression muscles on the affected side of the face, such as diminished forehead wrinkles, inability to open the eye, furrow the brow, or weak eyelid closure. Some patients may experience pain behind the ear, and in the tympanic membrane and external ear canal. Additionally, some patients exhibit deviation of the mouth corner, air leakage when puffing or whistling, and difficulty retaining food residues while eating or leaking water while drinking. Other patients may experience loss of taste in the anterior two-thirds of the tongue, along with secretion disorders of the salivary and lacrimal glands. Overall, the diagnosis of facial neuritis is relatively straightforward, and its clinical presentation is not particularly complex. Once the diagnosis is confirmed, timely treatment is essential, and most patients can recover.
Early symptoms of amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis (ALS) refers to motor neuron disease, with patients initially showing mainly reduced hand strength and clumsy fine motor activities, such as difficulty and lack of agility when using a screwdriver. There may also be atrophy of small muscles, such as the interosseous muscles of the hand and the hypothenar muscles, which are commonly seen in clinical settings. Some patients may initially exhibit symptoms like unclear speech, articulation disorders, and coughing or choking while drinking, which are important to recognize. As the disease progresses, the patient's generalized weakness becomes more apparent, with noticeable fasciculations and significant muscle atrophy developing clinically.
How to treat migraines
The incidence of migraines is still very high, and the pain can be quite severe, affecting patients' work and daily life, preventing them from resting well. The main treatments include the following: First, maintain the patient's emotional stability and keep the patient calm, avoiding strong lights and loud noises as much as possible to create a quiet environment. Second, administer oral non-steroidal analgesics for pain relief, or take ergot preparations for pain relief. Third, patients sometimes exhibit obvious anxiety and can take benzodiazepines for related treatment, as well as certain anti-anxiety medications. Fourth, if the patient experiences nausea and vomiting, symptomatic treatment should be given, including antiemetic medications. If the patient has frequent episodes, prophylactic treatment with receptor blockers can be used.
Is Parkinson's disease scary?
Parkinson's disease is not a terrifying disease, as its onset is relatively hidden and slow, with gradual progression. Many patients can significantly improve their symptoms, prolong their lives, and enhance their quality of life through rehabilitation training and medication. However, there is no effective cure for Parkinson's disease at this time; current treatments only relieve symptoms and improve quality of life. Patients with Parkinson's should not be afraid and must regularly visit neurology outpatient clinics for follow-up. Neurologists will provide appropriate medications for Parkinson’s and guide the daily life of patients. Moreover, patients must prevent falls. Parkinson's is not a terrifying disease; what is dangerous is arbitrarily stopping or reducing medication without listening to the doctor's advice. (Note: This answer is for reference only, medication should be taken under the guidance of a professional physician, and medications should not be taken blindly.)
What tea to drink for migraines?
Patients with migraines should avoid drinking strong tea. Research has confirmed that some stronger teas and coffee could potentially trigger migraines. This is because teas and other beverages containing theophylline can disrupt the contraction and relaxation functions of cerebral blood vessels. If you choose to drink tea, opt for lighter teas such as green tea, black tea, white tea, or floral teas. Additionally, it is crucial for migraine patients to rest adequately, ensure sufficient sleep, avoid staying up late, and minimize psychological stress, as these factors can easily trigger migraine attacks. If symptoms such as unilateral pulsating nausea and vomiting occur, it is necessary to promptly administer non-steroidal anti-inflammatory painkillers for treatment.
Symptoms and manifestations of cerebral embolism
The so-called cerebral embolism primarily refers to the presence of abnormal substances in the arteries, which block the smaller arteries leading to arterial occlusion, causing severe cerebral ischemia and hypoxia, and resulting in the necrosis of brain tissue. It generally occurs in patients with atrial fibrillation, where atrial fibrillation can form larger emboli that detach from the heart and can easily cause cerebral embolism. The symptoms of the onset are very sudden and rapidly reach their peak. Patients may experience coma and consciousness disorders, fixed staring of the eyes, paralysis of limbs, numbness of limbs, and an inability to sense pain and temperature in the limbs. Additionally, some may experience epileptic seizures and urinary and fecal incontinence. Cerebral embolism is a very dangerous disease, and once these symptoms appear, it is crucial to seek hospital treatment as soon as possible.
Causes of cerebral embolism
Any abnormal substance entering the cerebral arteries causing ischemia, hypoxia, and necrosis of brain tissue is called cerebral embolism. The causes of cerebral embolism mainly include the following types: The first type is cardiogenic cerebral embolism, which is caused by heart diseases. For example, the most common atrial fibrillation is the most common cause of cerebral embolism. Atrial fibrillation can lead to the formation of some mural thrombi. These thrombi form, detach, and enter the cerebral arteries causing embolism. Additionally, myocardial infarction is also an important cause, and patients with myocardial infarction can also form some abnormal thrombi in the heart. Second, other causes, such as air embolism. In patients with fractures, a large amount of fatty tissue enters the cerebral arteries, which can also cause cerebral arterial embolism. Moreover, some venous thrombi from the lower limbs can also form cerebral embolism. During childbirth, the entry of amniotic fluid into the brain can also cause cerebral embolism.