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Double Vision : Causes, Symptoms & Treatments

What is double vision?

Double vision is the perception of two images of a single object seen adjacent to each other (horizontally, vertically, or obliquely) or overlapping. Double vision is medically termed diplopia. Polyplopia is the perception of three or more images of a single object overlapping each other.

What causes double vision?

There are dozens of causes of double vision ranging from benign to life-threatening. Therefore, it is important for the doctor to carefully review the history and the examination to determine the cause and initiate appropriate treatment when necessary. Sometimes, emergency treatment is needed.

Most causes of monocular diplopia stem from poor focusing of light by the eye. Refractive errors (myopia, hyperopia, astigmatism) are common. Dry eye (from a variety of causes such as meibomitis, Sjögren’s syndrome, and decreased tear production following refractive surgery) can produce diplopia that varies with blinking. Cataracts (clouding of the natural lens) and posterior capsule opacification (after cataract surgery) are common in people over 60 years of age. Other conditions that interfere with proper focusing of light include corneal irregularity from swelling or scars and retinal conditions, such as epiretinal membranes. Rarely is the underlying cause a medical emergency in cases of monocular diplopia.

Binocular diplopia on the other hand is produced by a misalignment of the eyes, which can be caused by life-threatening conditions. For example, aneurysms, strokes, trauma (head injury), and brain swelling (such as from brain cancer) can interfere with the nerves that control the extraocular muscles. The extraocular muscles move the eyes in different direction of gaze, much like the strings on a marionette, and when one or more muscle is weakened or paralyzed, it is referred to as cranial nerve palsy. In multiple sclerosis, lesions in regions of the brain that control eye alignment may result in diplopia that varies over time. Guillain-Barré syndrome can produce diplopia from restricted eye movement due to nerve damage. Migraineheadaches can cause a sudden but temporary eye misalignment. Diseases such as myasthenia gravis can interfere with the communication between the nerves and the eye muscles to cause diplopia. And the eye muscles themselves can be damaged or compressed by conditions such as Graves’ disease (often associated with thyroid disease), orbital inflammations, vascular disease (as seen with diabetes and high blood pressure), and others. Following traumatic fracture of the orbital bones, muscles and orbital tissue may be trapped in the fracture, leading to restriction of eye movement in certain directions of gaze. Sometimes the cause is relatively harmless, such as when the eye muscles or neurologic signals to the muscles weaken with fatigue or illness. Inability to align the eyes when focusing on a near object (convergence insufficiency) is a common benign cause of intermittent binocular diplopia that can often be treated with prism glasses.

 

What are the symptoms and signs of double vision?

Images may appear to overlap each other or may appear adjacent to each other. Diplopia may vary depending on the direction of gaze or with tilting or turning of the head.

One of the most critical features to determine is whether the diplopia is monocular or binocular. In monocular diplopia, the double vision is caused by a condition within one or both eyes and does not resolve when one eye is covered. In binocular diplopia, the eyes are misaligned. Each eye sees a single image when working alone, as when one eye is covered, but when both eyes are open the brain perceives two adjacent images.

How do health-care professionals diagnose the cause of double vision?

A thorough evaluation of double vision begins with a detailed history of the diplopia, including onset (gradual or sudden), duration, frequency (intermittent or constant), and variability with head position or eye gaze, noting any associated symptoms (pain, headache, nausea, and weight loss among others), and a complete history of past and current medical conditions. The physical examination includes measuring the visual acuity in each eye and assessing whether the diplopia is monocular or binocular. Careful examination of the eyes’ alignment in various head positions is performed if the diplopia is binocular. A complete eye examination, which may include dilating the eyes, is performed to look for any ocular or orbital abnormalities. Particular attention is paid to the pupils and eyelid position if a neurologic cause is suspected. In some instances, specialized imaging (topography, CT, MRI, etc.) and other tests are needed to further investigate possible causes. When a life- or vision-threatening cause is suspected, time may is of the essence.

What is the treatment for double vision?

Once the underlying cause has been determined, treatment is tailored to the underlying condition.

Diplopia stemming from refractive errors (myopia, hyperopia, astigmatism) can be corrected with glasses or contact lenses. Dry eyes are treated with artificial tears, punctal plugs, warm compresses, and a variety of other treatments. Cataracts are removed with surgery, and posterior capsule opacification (after cataract surgery) is treated with laser. It is uncommon for the cause of monocular diplopia to be a medical emergency.

Binocular diplopia on the other hand can be caused by life-threatening conditions, and emergency treatment may be necessary. This is particularly the case with aneurysms, head trauma, stroke, and other neurologic conditions. Any onset of diplopia with accompanying neurologic symptoms such as headache, nausea, dizziness, loss of balance, etc., should be evaluated immediately.

Diplopia produced by chronic diseases (see causes above) may subside with treatment of the underlying disease. If eye muscles are engorged (such as from Graves’ disease) or entrapped (as after traumatic orbital fracture), surgery of the muscles or surrounding tissue may correct the problem.

Convergence insufficiency, or inability to align the eyes when focusing on a near object, is a common benign cause of intermittent binocular diplopia when reading. It can improve with eye exercises (“pencil pushups” prescribed by the eye doctor).

Often glasses with prisms can be worn to correct binocular diplopia. If the diplopia is expected to resolve, temporary prisms (Fresnel prisms) can be added to glasses and later removed when the eyes realign.

Different types of fibroids and it’s treatments

What are the different types of fibroids?

There are many different types of fibroids. Depending on their size and location, fibroids can present with a wide range of symptoms.

Fibroids can be divided into submucosal, intramural or subserosal:

  • Submucosal fibroids: These fibroids are located just underneath the endometrium, or lining of the uterus, and protrude into the uterine cavity.  Submucosal fibroids can vary in how much of the fibroid protrudes into the uterine cavity and how much is in the muscle of the uterus. They often cause heavy bleeding and long periods, but they can also cause irregular bleeding.

  • Intramural fibroids:  These fibroids are found predominantly in the myometrium, or muscle of the uterus. Depending on their size and location, these fibroids can also extend toward and distort the uterine cavity or protrude outside the uterus.  Intramural fibroids can be asymptomatic (causing no symptoms), cause bleeding abnormalities, or cause pressure and bulk symptoms.
  • Subserosal fibroids: These fibroids are located near the outside of the uterus.  They can be partially in the myometrium (muscle of the uterus) or hanging off the outside of the uterus. They can cause bulk symptoms such as bladder or rectal pressure.

What symptoms do fibroids cause?

Most fibroids cause no symptoms at all. Depending on their size, location and number, fibroids can become significantly problematic.

Some common symptoms associated with fibroids include:

  • Abnormal uterine bleeding, heavy or long periods
  • Bulk and pressure symptoms
  • Bladder pressure, frequent urination
  • Rectal pressure, constipation
  • Infertility or recurrent miscarriages/pregnancy loss
  • Pregnancy complications
  • Pain
  • Anemia

What are the treatment options for fibroids?

There is a wide range of treatment options for fibroids.  Many factors influence treatment choice.  These include symptoms, fibroid location, size and number, age, reproductive plans and a woman’s preferences.

There is medical management:

  • Gonadotropin-releasing hormone agonists (GnRH agnosits):This medication is given as an injection (shot), either every month or every three months, and puts you in a temporary state of menopause. While on the medication the fibroids shrink. Once the medication is stopped, the fibroids usually re-grow and symptoms return. GnRH agonists are usually used to prepare women for surgery or to bridge women close to their natural menopause. GnRH agonists are not usually used for long-term treatment.

Other hormone treatments, including:

  • Progestins (oral, by injection or intra-uterine device [IUD]), oral contraceptive pills, androgenic agents (such as danazol) and anti-estrogens (such as raloxifene) have been used to try to control heavy bleeding in women with fibroids. However, these medications do not consistently decrease the size of the fibroids or uterus and are usually ineffective in reducing the amount of bleeding.

There is surgical management:

  • The surgical procedures provided at the MIGS Center combine current technology, and medical and surgical expertise to treat fibroids on an outpatient basis.
  • Myomectomy is a surgical procedure in which only the fibroids are removed, preserving the uterus. As an alternative to hysterectomy, one advantage of a myomectomy is that with the uterus in place, childbearing remains an option. A disadvantage of a myomectomy is that when the uterus remains in place, fibroids can recur, sometimes requiring additional surgery.

 

Fibroids can be removed by hysteroscopic myomectomy, laparoscopic myomectomy or an open abdominal myomectomy.

  • Hysteroscopic myomectomy is a technique used to remove fibroids that are submucosal. A hysteroscope, a thin tube containing a video camera, is passed through the cervix and into the uterus. The fibroid is then removed by shaving it out. There are no incisions with a hysteroscopic myomectomy. It is a day surgery procedure (you typically leave the hospital 1 hour after the completion of the procedure) with a 1-day recovery period.
  • Laparoscopic myomectomy is a technique used to remove fibroids that are intramural (deep in the muscle of the uterine wall), subserosal or pedunculated(on the outside of the uterus).  This minimally invasive technique uses a laparoscopic technique to remove the fibroids through very small incisions. It is a day surgery procedure (you typically leave the hospital 1-2 hours after the completion of the procedure) with a 1-2 week recovery period.
  • Open myomectomy uses a traditional large abdominal incision to remove the fibroids. Most fibroids can be removed by minimally invasive techniques; the use of the open method is limited to women with specific situations where laparoscopic or hysteroscopic removal of fibroids is not appropriate.
  • Uterine Artery Embolization/Uterine Fibroid Embolization (UAE/UFE) is performed by an interventional radiologist.  The blood flow to the uterus and/or fibroid is blocked, leading to necrosis and a gradual shrinkage of the fibroid.
  • MR-Guided Focused Ultrasound uses ultrasound energy to heat and destroy the fibroid causing gradual shrinkage of the fibroid.
  • Fibroids can be treated with a hysterectomy, which involves removing the uterus with the fibroids. The hysterectomy can typically be done in a minimally invasive way.

Intestinal Failure: Causes, Symptoms and Treatments

If you have intestinal failure, you may receive all or most of your nutrients and calories intravenously through total parenteral nutrition (TPN). TPN is given through a catheter placed in the arm, groin, neck or chest. Patients on TPN may live for many years, but long-term use of TPN can result in serious complications, such as bone disorders, central venous catheter infections and liver disease. Our goal is to restore intestinal function to minimize and ultimately eliminate the need for TPN. Unfortunately, not every patient can be weaned from TPN. In these cases, we work to optimize the use of TPN and decrease the risk of complications.

Conditions

Patients who may benefit from being treated at the Intestinal Rehabilitation and Transplantation Program include:

Adults with intestinal failure caused by:

  • Desmoid tumor, a benign growth of tissue that can develop in the abdomen
  • Fistulae or an abnormal duct that connects an abscess, cavity or hollow organ to the body surface or to another hollow organ
  • Inflammatory bowel disease, such as Crohn’s disease where chronic inflammation occurs in the intestines
  • Multiple intestinal surgeries resulting in adhesions, motility problems that may lead to abnormal intestinal contractions and spasms
  • Pseudoobstruction that impairs gastrointestinal motility despite the absence of an actual obstruction
  • Radiation enteritis, a disorder of the large and small bowel that occurs during or after a course of radiation therapy to the abdomen, pelvis or rectum
  • Refractory celiac disease, also known as sprue, a digestive disease that damages the small intestine and interferes with absorption of nutrients from food
  • Superior mesenteric artery/vein thrombosis
  • Trauma
  • Tumor resection
  • Volvulus or an abnormal rotation of the intestine

Treatments:

The Intestinal Rehabilitation and Transplantation Program offers a wide range services for adults and children. The type and length of treatment differs for each patient, depending on the needs and goals.

Services include:

  • Counseling and education about intestinal rehabilitation
  • Drug and diet modification to train the small intestine to absorb more nutrients
  • Consultations to help assess and correct nutrient deficiencies and prevent damage to kidneys, bones and liver
  • Management of TPN to avoid complications
  • Placement and management of catheters in veins called central venous lines
  • Surgery, such as bowel lengthening and tapering that can help increase bowel length and nutrient absorption
  • Intestinal transplants
  • Consultations with doctors caring for patients with intestinal failure

For patients dependent on TPN, the program provides services to help patients:

  • Reduce or eliminate the need for TPN
  • Reduce complications associated with TPN
  • Decrease diarrhea and/or vomiting
  • Gain weight
  • Decrease the need for intestinal transplantation

 

Acne: Causes and Treatments

Acne, medically known as Acne Vulgaris, is a skin disease that involves the oil glands at the base of hair follicles. It commonly occurs during puberty when the sebaceous (oil) glands come to life – the glands are stimulated by male hormones produced by the adrenal glands of both males and females.

Acne is not dangerous, but can leave skin scars. Human skin has pores (tiny holes) which connect to oil glands located under the skin. The glands are connected to the pores via follicles – small canals. These glands produce Sebum, an oily liquid. The sebum carries dead skin cells through the follicles to the surface of the skin. A small hair grows through the follicle out of the skin. Pimples grow when these follicles get blocked, resulting in an accumulation of oil under the skin.

Causes of acne

Nobody is completely sure what causes acne. Experts believe the primary cause is a rise in androgen levels – androgen is a type of hormone. Androgen levels rise when a human becomes an adolescent. Rising androgen levels make the oil glands under your skin grow; the enlarged gland produces more oil. Excessive sebum can break down cellular walls in your pores, causing bacteria to grow.

Some studies indicate that a susceptibility to acne could also be genetic. Some medications that contain androgen and lithium may cause acne. Greasy cosmetics may cause acne in some susceptible people. Hormone changes during pregnancy may cause acne either to develop for the first time, or to recur.

The types of acne pimples

Hair follicle with acne
Human skin has pores (tiny holes) which connect to oil glands located under the skin. The glands are connected to the pores via follicles – small canals. These glands produce Sebum, an oily liquid. The sebum carries dead skin cells through the follicles to the surface of the skin.
  • Whiteheads – remain under the skin and are very small
  • Blackheads – clearly visible, they are black and appear on the surface of the skin. Remember that a blackhead is not caused by dirt. Scrubbing your face vigorously when you see blackheads will not help
  • Papules – visible on the surface of the skin. They are small bumps, usually pink
  • Pustules – clearly visible on the surface of the skin. They are red at their base and have pus at the top
  • Nobules – clearly visible on the surface of the skin. They are large, solid pimples. They are painful and are embedded deep in the skin
  • Cysts – clearly visible on the surface of the skin. They are painful, and are filled with pus. Cysts can easily cause scars

 

How common is acne?

Dermatologists (skin specialists) say that approximately three-quarters of 11 to 30 year-olds will get acne at some time. Acne can affect people of all races and all ages. It most commonly affects adolescents and young adults, although there are people in their fifties who still get acne. According to Brown University, USA, approximately 17 million Americans are estimated to have acne at any one time.

Although acne affects both men and women, young men suffer from acne for longer – probably because testosterone, which is present in higher quantities in young men, can make acne worse.

Treating mild acne :

The majority of people who get acne will develop mild acne. This can usually be treated with OTC (over-the-counter) medications. OTC medications can be bought at a pharmacy without a doctor’s prescription. They are usually applied to the skin – topical medicines.

Most acne OTC products may contain the following active ingredients:

  • ResorcinolResorcinol helps break down blackheads and whiteheads. It is a crystalline phenol and comes from various resins. Resorcinol is also used for treating dandruff, eczema and psoriasis.
  • Benzoyl PeroxideBenzoyl Peroxide kills bacteria and slows down your glands’ production of oil. Benzoyl peroxide is a white crystalline peroxide used in bleaching (flour or oils or fats) and as a catalyst for free radical reactions. It works as a peeling agent, accelerating skin turnover and clearing pores, which in turn reduces the bacterial count in the affected area.
  • Salicylic AcidSalicylic Acid helps break down blackheads and whiteheads, also reduces shedding of cells which line the follicles of the oil glands, effective in treating inflammation and swelling. Salicylic acid is a white crystalline substance which is also used as a fungicide, or in making aspirin or dyes or perfumes. It causes the epidermis to shed skin more easily, prevents pores from becoming blocked while at the same time allowing room for new cells to grow. It is commonly added to shampoos used for treating dandruff.
  • SulfurSulfur helps break down blackheads and whiteheads. Sulfur, in its native form, is a yellow crystalline solid. Sulfur has been used for centuries for treating acne, psoriasis and eczema. Scientists are not sure how sulfur works to help skin diseases. We do know that elemental sulfur does oxidize slowly to sulfurous acid, which is a mild reducing and antibacterial agent.
  • Retin-ARetin-A helps unplug blocked pores. Retin-A contains Tretinoin, an acid from of vitamin A, also known as all-trans retinoic acid (ATRA). Tretinoin is also used for the treatment of acute promyelocytic leukemia. Retin-A has been used widely to combat aging of the skin, and it also acts as a chemical peel.
  • Azelaic AcidAzelaic Acid strengthens cells that line the follicles, stops oil eruptions, reduces bacteria growth. It is a saturated dicarboxylic acid found naturally in wheat, rye, and barley. Azelaic acid also mops up free radicals, which reduces inflammation. It is useful for patients with darker skin who have dark patches on their face (melasma), or whose acne spots leave persistent brown marks.

 

Mesenchymal stem Cells: what it’s usage

Mesenchymal stem cells (MSCs) can make several types of cells belonging to our skeletal tissues, such as cartilage, bone and fat. Scientists are investigating how MSCs might be used to treat bone and cartilage diseases. Some MSC research is also exploring therapies for other diseases, but the scientific basis for these applications has not yet been established or widely accepted.

Did you know?

Mesenchymal stem cells make up about 0.001-0.01% of all the cells in your bone marrow

Human mesenchymal stem cells grown in a single layer on the bottom of a flask; 4x magnification

Human mesenchymal stem cells grown in a single layer on the bottom of a flask; 4x magnification

Human mesenchymal stem cells grown in a single layer on the bottom of a flask; 10x magnification

Human mesenchymal stem cells grown in a single layer on the bottom of a flask; 10x magnification

Bone cells made from MSCs; the colour is from a stain used to mark the bone cells (von Kossa stain)

Bone cells made from MSCs; the colour is from a stain used to mark the bone cells (von Kossa stain)

Fat cells made from MSCs; the colour is from a stain called Nile red O that marks fat cells red

Fat cells made from MSCs; the colour is from a stain called Nile red O that marks fat cells red

Cartilage cells made from MSCs; cartilage cells are stained red using the dye Safranin O

Cartilage cells made from MSCs; cartilage cells are stained red using the dye Safranin O

Cartilage cells made from MSCs; the cartilage cells are marked brown by a process called immunostaining

Cartilage cells made from MSCs; the cartilage cells are marked brown by a process called immunostaining

What can mesenchymal stem cells do?

Mesenchymal stem cells (MSCs) are an example of tissue or ‘adult’ stem cells. They are ‘multipotent’, meaning they can produce more than one type of specialized cell of the body, but not all types. MSCs make the different specialized cells found in the skeletal tissues. For example, they can differentiate − or specialize  −  into cartilage cells (chondrocytes), bone cells (osteoblasts) and fat cells (adipocytes). These specialized cells each have their own characteristic shapes, structures and functions, and each belongs in a particular tissue.

Some early research suggested that MSCs might also differentiate into many different types of cells that do not belong to the skeletal tissues, such as nerve cells, heart muscle cells, liver cells and endothelial cells, which form the inner layer of blood vessels. These results were not confirmed in later studies. In some cases, it appears that the MSCs might have fused together with existing specialized cells, leading to false conclusions about the ability of MSCs to produce certain cell types. In other cases, the results were an artificial effect caused by chemicals used to grow the cells in the lab.

Mesenchymal stem cell differentiation: MSCs can make fat, cartilage and bone cells. They have not been proven to make other types of cells of the body.

Mesenchymal stem cell differentiation: MSCs can make fat, cartilage and bone cells. They have not been proven to make other types of cells of the body.

Where are mesenchymal stem cells found?

MSCs were originally found in the bone marrow. There have since been many claims that they also exist in a wide variety of other tissues, such as umbilical cord blood, adipose (fat) tissue and muscle. It has not yet been established whether the cells taken from these other tissues are really the same as, or similar to, the mesenchymal stem cells of the bone marrow.

The bone marrow contains many different types of cells. Among them are blood stem cells(also called hematopoietic stem cells; HSCs) and a variety of different types of cells belonging to a group called ‘mesenchymal’ cells. Only about 0.001-0.01% of the cells in the bone marrow are mesenchymal stem cells.

It is fairly easy to obtain a mixture of different mesenchymal cell types from adult bone marrow for research. But isolating the tiny fraction of cells that are mesenchymal stem cells is more complicated. Some of the cells in the mixture may be able to form bone or fat tissues, for example, but still do not have all the properties of mesenchymal stem cells. The challenge is to identify and pick out the cells that can both self-renew (produce more of themselves) and can differentiate into three cell types – bone, cartilage and fat. Significant advances have now been made in this direction. Interestingly, studies in humans have for once paved the way to similar studies in the mouse. Both types of studies have converged in identifying the non-hematopoietic (blood) stem cells in the bone marrow (widely called “mesenchymal” stem cells) as “skeletal” stem cells. This is a better term, because all the cell types that these cells can generate are indeed found in the tissues that together make the skeleton (bone, cartilage, fat in the bone marrow cavity of the bones). One very intriguing development reads that the “skeletal” stem cells seem to to provide a “niche” or home for the other type of stem cell, the hematopoietic (blood) stem cells. Both would live together in contact with each other close to the blood vessels of the bone marrow.

Developing new treatments using mesenchymal stem cells:

No treatments using MSCs are yet available. However, several possibilities for their use in the clinic are currently being explored.

Bone and cartilage repair
The ability of MSCs to differentiate into bone cells called osteoblasts has led to their use in early clinical trials investigating the safety of potential bone repair methods. These studies are looking at possible treatments for localized skeletal defects (damage at a particular place in the bone).

Other research is focussed on using MSCs to repair cartilage. Cartilage covers the ends of bones and allows one bone to slide over another at the joints. It can be damaged by a sudden injury like a fall, or over a long period by a condition like osteoarthritis, a very painful disease of the joints. Cartilage does not repair itself well after damage. The best treatment available for severe cartilage damage is surgery to replace the damaged joint with an artificial one. Because MSCs can differentiate into cartilage cells called chondrocytes, scientists hope MSCs could be injected into patients to repair and maintain the cartilage in their joints. Researchers are also investigating the possibility that transplanted MSCs may release substances that will tell the patient’s own cells to repair the damage.

Many hurdles remain before this kind of treatment can become a reality. For example, when MSCs are transplanted, most of them are rapidly removed from the body. Researchers are working on new techniques for transplanting the cells, such as developing three-dimensional structures or scaffolds that mimic the conditions in the part of the body where the cells are needed. These scaffolds will hold the cells and encourage them to differentiate into the desired cell type.

Heart and blood vessel repair:
Some studies in mice suggest that MSCs can promote formation of new blood vessels in a process called neovascularisation. MSCs do not make new blood vessel cells themselves, but they may help with neovascularisation in a number of ways. For example, they may release proteins that stimulate the growth of other cells called endothelial precursors – cells that will develop to form the inner layer of blood vessels. They may also “guide” the assembly of new blood vessels from preexisting endothelial cells (those that line the blood vessel). Such studies on animals have led researchers to hope that MSCs may provide a way to repair the blood vessel damage linked to heart attacks or diseases such as critical limb ischaemia. A number of early stage clinical trials using MSCs in patients are currently underway but it is not yet clear whether the treatments will be effective.

Inflammatory and autoimmune diseases:

Several claims have been made that MSCs are able to avoid detection by the immune system and can be transplanted from one patient to another without risk of immune rejection by the body. However, these claims have not been confirmed by other studies. MSCs are rejected like any other “non-self” cell type. It has also been suggested that MSCs may be able to slow down the multiplication of immune cells in the body to reduce inflammation and help treat transplant rejection or autoimmune diseases. Again, this has yet to be proven and much more evidence is needed to establish whether MSCs could really be used for this kind of application.

Fibromyalgia: Causes, Symptoms and Treatments

What Are the Symptoms of Fibromyalgia?

Symptoms of fibromyalgia include:

  • Chronic muscle pain, muscle spasms, or tightness
  • Moderate or severe fatigue and decreased energy
  • Insomnia or waking up feeling just as tired as when you went to sleep
  • Stiffness upon waking or after staying in one position for too long
  • Difficulty remembering, concentrating, and performing simple mental tasks (“fibro fog”)
  • Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
  • Tension or migraine headaches
  • Jaw and facial tenderness
  • Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
  • Feeling anxious or depressed
  • Numbness or tingling in the face, arms, hands, legs, or feet
  • Increase in urinary urgency or frequency (irritable bladder)
  • Reduced tolerance for exercise and muscle pain after exercise
  • A feeling of swelling (without actual swelling) in the hands and feet

There are several theories about the causes of fibromyalgia, from hormonal disturbances to stress to genetics. While there is no clear consensus about what causes fibromyalgia, most researchers believe fibromyalgia results not from a single event but from a combination of many physical and emotional stressors.

Other Theories About Causes of Fibromyalgia

Some have speculated that lower levels of a brain neurotransmitter called serotonin leads to lowered pain thresholds or an increased sensitivity to pain. Serotonin is associated with a calming, anxiety-reducing reaction. The lowered pain thresholds in fibromyalgia patients may be caused by the reduced effectiveness of the body’s natural endorphin painkillers and the increased presence of a chemical called “substance P.” Substance P amplifies pain signals.

There have been some studies that link fibromyalgia to sudden trauma to the brain and spinal cord. Keep in mind, though, theories about what causes fibromyalgia are merely speculative.

Who Gets Fibromyalgia?

Fibromyalgia is far more common in women than in men. Some interesting studies show that men make serotonin at a much faster rate than women — about 50% faster. That may help explain why fibromyalgia syndrome, or FMS, is more common in women.

Another theory states that fibromyalgia is caused by biochemical changes in the body and may be related to hormonal changes or menopause. In addition, some (but not all) people with fibromyalgia have low levels of human growth hormone, which may contribute to the muscle pain.

Does Stress Cause Fibromyalgia?

Some researchers theorize that stress or poor physical conditioning are factors in the cause of fibromyalgia. Another theory suggests that muscle “microtrauma” (very slight damage) leads to an ongoing cycle of pain and fatigue. These mechanisms, like all the others, are still unproven for fibromyalgia.

Do Insomnia or Sleep Disorders Cause Fibromyalgia?

Most people with fibromyalgia experience insomnia or non-restorative sleep — sleep that is light and not refreshing. Disordered sleep might lead to lower levels of serotonin, which results in increased pain sensitivity. Researchers have created a lower pain threshold in women by depriving them of sleep, possibly simulating fibromyalgia.

How Is Fibromyalgia Fatigue Treated?

Along with deep muscle pain and painful tender points, fatigue is a key symptom of fibromyalgia and it can be debilitating. Not only do you feel exhausted and weak, but bed rest does not seem to help. Many people with fibromyalgia report sleeping eight to 10 hours at night and feeling as if they haven’t slept at all.

Some drugs may help ease the fatigue associated with fibromyalgia. In addition, aerobic exercise can help ease fatigue, minimize pain, improve quality of sleep, and improve mood.

How Does Exercise Help Fibromyalgia Symptoms?

Numerous studies show that exercise is one of the most important treatments for fibromyalgia. Many people with fibromyalgia are are not physically fit. They avoid exercise because they fear increased pain. Yet aerobic or conditioning exercise can actually help relieve pain and depression.

Regular exercise increases the body’s production of endorphins, natural painkillers that also boost mood. Starting slowly and gradually increasing the duration and intensity of exercise can help you enjoy the benefits of exercise without feeling more pain.

Paraplegia : Causes, Symptoms & Treatments

Definition

Paraplegia is a spinal cord injury that paralyses the lower limbs. It is a result of severe damage to the spinal cord and the nervous system. Paraplegia mainly affects the trunk, legs, and the pelvic region, resulting in loss of movement.

Causes of Paraplegia :

  • Accidents
  • Severe spinal cord injury
  • Motor neuron disease
  • Cancerous cell growth, tumors or blood clots within spinal cord
  • Spina bifida
  • Prolonged diseases
  • Alcohol addiction

Categorization

There are two main categories – complete and incomplete. Complete paraplegia is witnessed when the injury affects the patient at the neurological level and it hinders the movement of limbs, whereas in case of incomplete paraplegia, some of the limbs are still moving.

Symptoms of Paraplegia

  • Loss of ability to feel and move
  • No control over bowel and bladder activities
  • Intense pain or tingling sensation in the trunk, legs, and the pelvic region
  • Problems in breathing and coughing
  • Sexual function and fertility can be affected

There are no apparent symptoms that could be seen. Moreover, there may be delayed symptoms like numbness and paralyses.

Diagnosis of Paraplegia :

The doctors may diagnose paraplegia with the help of one of the following tests:

  • Computerized CT Scan for a better understanding of the severity of the injury
  • X-rays to examine any tumors or fractures in the spine
  • Magnetic Resonance Imaging (MRI) to test for blood clots or any mass formation that may compress the spinal cord

 

Treatment of Paraplegia:

In the early stage, treatment is possible through medication and traction for immobilization. Surgery or experimental treatments can also be conducted.

While the patient is undergoing a treatment, doctors focus on preventing secondary problems like bowel and bladder issues, blood clots, pressure ulcers and respiratory infections. Any hospitalization will depend on the patient’s condition.

In the case of complete paraplegia, there are new technologies that may restore movement.

Recovery may start from the first week or it may take up to six months to experience improvement. However, there may be no permanent treatment for this condition.

Strawberry Nevus: Causes, symptoms & Treatments

What Are the Symptoms of Strawberry Nevus?

A strawberry nevus, or hemangioma, is named for its color. This red tinge to your skin comes from a collection of blood vessels close to your skin’s surface. While the hemangioma can be anywhere, the most common locations are the face, scalp, back, and chest. If you look closely at the area, you may see small blood vessels closely packed together.

 

What Causes Strawberry Nevus?

Physicians do not know the cause of strawberry nevus. According to What to Expect, one in 10 babies are born with the marking. Most develop while your baby is in the uterus, when small veins and capillaries collect under the skin, creating a red patch.

What Are the Effects of Strawberry Nevus?

A strawberry nevus is rarely harmful, but it can affect a child’s self-esteem if the mark is in a highly visible place and does not fade as the child ages. Also, some strawberry nevi can leave behind a gray or white scar as they fade, leaving the area noticeably different from the surrounding skin.

In the severest cases, a large hemangioma can be life threatening. A large nevus pulls blood platelets in from your bloodstream, which can lead to heart failure. A physician can evaluate the size of the marking and perform tests to determine its depth, if necessary.

How Is Strawberry Nevus Diagnosed?

Physicians diagnose most strawberry marks by physical examination. In some instances, your child’s physician may recommend testing to ensure that the strawberry mark does not go deep into the skin. If your doctor suspects that the strawberry mark is deep, a cavernous hemangioma, or close to a major organ, he or she may need to remove it.

Tests to determine the birth mark’s depth may include a:

  • biopsy, or tissue removal
  • computed tomography (CT) scan
  • magnetic resonance imaging (MRI) scan

How Is Strawberry Nevus Treated?

Because most strawberry marks are not harmful and will fade with time, treatment is not necessarily recommended. However, if the mark is in a very visible area, such as the face, it can be a source of anxiety for a child. You can first try pressing on and kneading the mark to fade it more quickly.

If this doesn’t work, your physician can use steroid injections, laser removal, or cryotherapy—using liquid nitrogen to freeze the tissue—to fade the abnormal areas of skin. However, these procedures are not without their side effects. Side effects can include scarring and pain as the removed tissue heals.

In severe cases, a plastic surgeon may be able to remove the entire red patch of skin. This is typically recommended only when the birthmark extends deep into the skin.

Hyperhidrosis: Causes, symptoms & Treatments

Causes

Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.

Excessive sweating occurs without such triggers. Persons with hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional.

When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis. In most cases, no cause can be found. It seems to run in families.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body or it may be in one area. Conditions that cause second hyperhidrosis include:

  • Acromegaly
  • Anxiety conditions
  • Cancer
  • Carcinoid syndrome
  • Certain medications and substances of abuse
  • Glucose control disorders
  • Heart disease
  • Hyperthyroidism
  • Lung disease
  • Menopause
  • Parkinson disease
  • Pheochromocytoma
  • Spinal cord injury
  • Stroke
  • Tuberculosis or other infections

Symptoms

The primary symptom of hyperhidrosis is wetness.

Treatment

Treatments may include:

  • Antiperspirants: Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 20% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some patients may be be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odor.
  • Medication: Medicines may prevent stimulation of sweat glands. These are prescribed for certain types pf hyperhidrosis such as excessive sweating of the face. Medicines have side effects and are not right for everyone.
  • Iontophoresis: This procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10 to 20 minutes and requires several sessions. Side effects include skin cracking and blisters, although rare.
  • Botox: Botulinum toxin type A (Botox) is used to treat severe underarm sweating. This condition is called primary axillary hyperhidrosis. Botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. Botox used for sweating of the palms can cause mild, but temporary weakness and intense pain.
  • Endoscopic thoracic sympathectomy (ETS) : In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments do not work. The procedure cuts a nerve, turning off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.
  • Underarm surgery: This is surgery to remove the sweat glands in the armpits. Methods used include laser, curettage (scraping), excision (cutting), or liposuction. These procedures are done using local anesthesia.

 

 

Cerebral Palsy: Symptoms, Causes & Treatments

What Are the Symptoms of Cerebral Palsy?

The symptoms of CP range from mild to severe. They also vary depending on the part of the brain that was affected. Some of the more common symptoms include:
  • delays in reaching motor skill milestones, such as rolling over, sitting up alone, or crawling
  • delays in speech development and difficulty speaking
  • stiff muscles
  • abnormal muscle tone
  • a lack of muscle coordination
  • tremors or involuntary movements
  • excessive drooling and problems with swallowing
  • difficulty walking
  • favoring one side of the body, such as reaching with one hand
  • neurological problems, such as seizures, intellectual disabilities, and blindness

Call your doctor immediately if you suspect your child has CP. Early diagnosis and treatment is very important

What Causes Cerebral Palsy?

CP is caused by an abnormality in brain development or by damage to the developing brain. The brain damage usually occurs before birth, but it can also happen during birth or the first years of life. In most cases, the exact cause of CP isn’t known. Some of the possible causes include:
  • a lack of oxygen to the brain during labor and delivery
  • severe jaundice in the infant
  • maternal infections, such German measles and herpes simplex
  • brain infections, such as encephalitis and meningitis
  • bleeding into the brain
  • head injuries as a result of a car accident, a fall, or child abuse

How Is Cerebral Palsy Treated?

The goal of treatment is to improve limitations and prevent complications. Treatment may include assistive aids, medications, and surgery.

Assistive Aids

Assistive aids include:

  • eyeglasses
  • hearing aids
  • walking aids
  • body braces
  • wheelchairs

Medications

Anticonvulsants and muscle relaxants, such as diazepam and dantrolene, are often used to treat CP. These medications can help reduce spasticity and drooling.

Surgery

Surgery may be used to relieve pain and improve mobility. It may also be needed to release tight muscles or to correct bone abnormalities caused by spasticity.

Other Treatment

Other types of treatment for CP include:

  • speech therapy
  • physical therapy
  • occupational therapy
  • counseling or psychotherapy
  • social services consultations

How Can Cerebral Palsy Be Prevented?

The majority of problems that cause CP can’t always be prevented. However, if you’re pregnant or planning on becoming pregnant, you can take certain preventive measures to minimize complications. It’s important to get vaccinated against diseases that can cause fetal brain damage, such as rubella. It’s also crucial to receive adequate prenatal care. Attending regular appointments with your doctor during pregnancy can help prevent premature birth, low birth weight, and infections.

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