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What are the best medications to use for Epilepsy, Parkinson’s disease & Migraine? What other changes need to be made?

We spent some time with Dr. Siddharth Kharkar, the best neurologist in Thane, to understand the best treatment for Epilepsy, Parkinson’s disease, and migraines. Here is what Dr. Siddharth Kharkar told us about the best treatment for neurological conditions:

1. Best treatment for Epilepsy:

A seizure is an attack of uncontrolled electricity in the brain. The tendency of having seizures, again and again, is called Epilepsy. So, Epilepsy is an illness, and the event that happens is called a Seizure.

  1. Proper diagnosis of Epilepsy: It is very important that the kind of Epilepsy you are having should be properly characterized. For example, seizures are of two different types: Focal and Generalized. Depending on your other characteristics, a diagnosis of Epilepsy syndromes such as Lennox Gastaut or Mesial Temporal Sclerosis (MTS) may be made. This diagnosis is very important for proper treatment.
  2. MRI & EEG are not absolute: MRI and EEG are extremely useful for the diagnosis of Epilepsy. However, in about 50% of the cases, the MRI can be normal. The situation with EEG is even worse. In about 70% of the cases, the EEG can be normal, even if you have Epilepsy. When they are abnormal they help a lot with treatment. However, when they are normal, the best neurologist in Mumbai, Thane or any other city depends a lot on your reliable information to treat you well.

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  1. Fewer number of medications: In general, it is better to take a higher dosage of one anti-epileptic medication, rather than take low doses of 2-3 different anti-epileptic medications.
  2. Monitoring for side-effects of Antiepileptic Medications: Some anti-epileptic medications may affect the liver or blood cells, and therefore you must monitor these closely.
  3. Surgery when needed: If 2 or more antiseizure medications don’t work, then you must consider seizure surgery for your problem. Many kinds of seizure surgery are available. The best seizure surgery is one in which the problematic part of the brain is removed. In some cases, Vagus Nerve Stimulation (VNS) surgery can help reduce seizures.
  4. Treatment of other conditions: Frequently, patients with epilepsy also have different conditions. Depression is very common in Epilepsy patients. Some patients may have attention deficit disorder. The best neurologist in Thane, Mumbai, or any other city should detect these problems and treat them in time for an optimum outcome.
  5. Don’t lose your self-confidence: If you have Epilepsy, it is very important for you not to lose your self-confidence. Many spectacularly successful people had Epilepsy. These famous people include Theodore Roosevelt (President of the United States) and Alexander the Great had Epilepsy.

2. Best treatment for Parkinson’s Disease:

Parkinson’s disease is a condition in which there is slowness in all body movements. There can also be uncontrolled shaking (tremor) of the hand and stiffness of body parts.

Parkinson’s disease happens because the brain does not produce enough of a chemical called Dopamine.

  1. Proper diagnosis of Parkinson’s disease: Many neurological disorders can produce symptoms similar to Parkinson’s disease. For example, hypothyroidism may produce slowing similar to Parkinson’s disease, although this is not true slowing (Bradykinesia). If needed, an f-DOPA scan may help in making the diagnosis of Parkinson’s disease.

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  1. Best Medications for Parkinson’s disease: The best medication for Parkinson’s disease in most cases is Levodopa. This is by far the most effective medication. However, it may cause nausea in some patients. If this happens, then treatment with certain medications to prevent nausea may be needed. Medications called Dopamine agonists may be the best medications for Parkinson’s disease in young patients.
  2. Take Levodopa on an empty stomach: Taking levodopa on an empty stomach increases its absorption. Up to 30% more levodopa is absorbed, just by taking it on an empty stomach.
  3. Avoid certain medications: In general, medications such as trihexyphenidyl may be avoided for treatment. Even though they are very effective in reducing symptoms, they also have multiple unwanted side effects.
  4. Some medications can worsen Parkinson’s disease: Avoid these medications completely! The best neurologists will avoid these medications because they can worsen your Parkinson’s disease.

 

DOPAMINE BLOCKERS: Medications that can produce symptoms like Parkinson’s disease

Many medications are used for psychiatric problems such as schizophrenia (these are also called “Neuroleptics”)

Haloperidol, Risperdal, Olanzapine, Aripiprazole, Trifluoperazine and many more. Clozapine and Quetiapine usually do not cause problems.

Some medications for mood and depression

Fluphenazine, Tranycypormine, and Lithium

Some anti-nausea medications

Metoclopramide, Levosulpuride, High doses of domperidone about 30-40 mg/day, Flunarazine, rarely cinnarizine

Some heart and blood pressure medications

Amiodarone, methyl-dopa

  1. Keep a proper Parkinson’s diary of your symptoms: Even the best neurologist in Thane, Mumbai or any other city cannot help you without having good feedback from you. Keeping a diary of your symptoms will enable your doctor to adjust your medications. You can download a Parkinson’s diary by clicking here [Parkinson’s Diary].
    While keeping your diary, remember the following things: ON = When you have the good effect of medications and can move freely. OFF = When the medication effect is gone, and you are not able to move properly. DYSKINESIAS = Disco-like movements that occur sometimes, as a mild side effect of medications.

3. Best treatment for Migraine:

Migraine is a condition in which patients get frequent headaches. These headaches are frequently on one side of the head. You may feel like avoiding bright light and loud sounds during this time. Very frequently, patients get nauseous when they have a migraine headache.

  1. Make sure you have a Migraine: It is a common error to label all headaches as “Migraine”. However, headaches can occur due to other reasons such as obstructive sleep apnea, hypothyroidism, etc. Some of these conditions can be serious such as a brain tumour or increased pressure inside the head (Idiopathic Intracranial Hypertension). Hence, you must ask the best neurologist to confirm your diagnosis. You can click here for the most common reasons (other than Migraine) that can cause a headache [Causes of Headache – NHS, UK].
  2. Understand that Pain is a signal: Migraine is your body’s way of telling you that you are doing something wrong. For example, if you run too much and have a stress fracture, your foot starts hurting. The pain is important so that you stop running. A migraine or headache is doing the same thing. If you keep running with a fracture, your foot will hurt. In the same way, the best neurologist in Thane or anywhere else in the world cannot stop your migraine if you sleep only for 4 hours in a day.
  3. Identify your migraine precipitants: The things that cause migraine to happen are called “Migraine Precipitants”. These are unique to every person. You should maintain a Migraine diary to identify your precipitants. You can download a migraine diary by clicking here [Migraine Diary]. Here is a list of common Migraine precipitants:

 

Most severe triggers for Migraine:

·           Too much / Too little sleep (Sleep for 8 hours/day)

·           Hunger (Eat properly, 4 /day. Don’t skip breakfast)

·       Stress (Do not shout. Control anxiety. Try Yoga.)

Less severe and less common triggers:

·           Strong tastes (too spicy, too sour. Cheese|Chocolate|Chinese|Alcohol)

·           Strong smells (too harsh e.g. Tar, Garbage or too sweet e.g. Perfume)

·           Excessive sunlight, Excessive dust/pollution

·           Long, winding roads

Triggers that occur only in some people

·           Bathing with very hot or very cold water

·           Tying hair too tightly

·           Menses

·       Fermented foods e.g. pickles

  1. Prophylactic medications: You should take prophylactic medication if you are getting more than 1 attack of migraine per week. Prophylactic medications are medications you take every day, to prevent an attack. Medications such as propranolol, amitriptyline, etc are used for prophylaxis. The best neurologist should be able to choose one that treats another problem also. For example, if you also have high blood pressure, beta blockers can be the best migraine treatment. This is because they would reduce BP also.
  2. Abortive Medications: Abortive medications such as triptans are the best treatment for migraine attacks. However, they can cause an increase in blood pressure, so you should not take them more than 2 times a week.

We hope that this discussion about the best treatments for Epilepsy, Parkinson’s disease, and migraines were useful to you. Please let us know.

We would be happy to have more discussions with Dr. Siddharth Kharkar, one of the best neurologists in Thane and Mumbai, about these topics and update you about them. Remember, you need to find a doctor that you are comfortable with. Whoever you are comfortable with and whoever gives attention to you and treats you with care is the best neurologist in Mumbai for you!

Disclaimer: The statements, opinions, and data contained in these publications are solely those of the individual authors and contributors and not of Credihealth and the editor(s). 

Call +91 8010-994-994 and talk to Credihealth Medical Experts for FREE. Get assistance in choosing the right specialist doctor and clinic, compare treatment cost from various centers and timely medical updates

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