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Tang Bo
Neurology
About me
Studied for a master's degree at the Second Affiliated Hospital of Harbin Medical University and currently works at Nanshan District People's Hospital in Shenzhen.
Proficient in diseases
Specializes in neurology diseases related to cerebral infarction, myasthenia gravis, Guillain-Barré syndrome, epilepsy, Parkinson's disease, dizziness, migraines, and neurosis.
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Myasthenia Gravis Best Treatment
The treatment of myasthenia gravis should also be individualized, specifically based on the actual condition of the patient. First and foremost, a clear diagnosis is essential. Once the diagnosis is confirmed, cholinesterase inhibitors can be used, but the dosage and frequency must be decided based on the patient's individual condition. Additionally, if the patient has a thymoma or thymic hyperplasia, a surgeon should determine whether surgical treatment is necessary. It is also necessary to consider whether to use steroids or plasmapheresis. In the event of a myasthenic crisis, symptomatic treatment should be provided according to the situation to maintain the patient's vital signs, and it is crucial to diagnose and treat early.
How is lacunar infarction treated?
Lacunar stroke is a type of cerebral stroke characterized by lesions smaller than 1.5 cm in diameter. Often, these can be discovered incidentally on a CT or MRI scan in asymptomatic patients. In such cases, it's important to evaluate whether the patient has risk factors such as hypertension or diabetes, and consider the patient's age, smoking, and drinking habits. Further assessments with cranial MRI angiography or other vascular imaging are recommended to clarify the state of the blood vessels and guide treatment. Additionally, some patients may experience an acute onset with symptoms like slurred speech or limb weakness. Although these symptoms might be mild, it is crucial to seek prompt medical attention to assess the blood vessels and guide further treatment based on the physician's physical examination of the patient.
The difference between stroke and cerebral infarction
Stroke includes ischemic stroke and hemorrhagic stroke. Ischemic stroke refers to cerebral infarction, while hemorrhagic stroke refers to cerebral hemorrhage. Symptoms such as limb weakness, slurred speech, or other neurological deficits should initially suggest the possibility of a stroke. Whether it is an ischemic or hemorrhagic stroke may be related to the symptoms, but a CT scan is essential. If a CT scan rules out cerebral hemorrhage, then cerebral infarction is more likely. The treatment varies with time; within 4.5 hours, if the conditions for thrombolytic therapy are met and there are no contraindications, and the relatives have signed an informed consent, thrombolytic treatment can be administered. If this time window is exceeded, this opportunity is lost, so it is crucial to seek medical attention immediately upon symptom onset.
Do you need to take medication for a long time for cerebral infarction?
Brain infarction generally requires long-term medication, and the specific medications to be taken can vary from person to person. Moreover, the choice of medication should be determined by a doctor based on the patient's condition and past risk factors. Brain infarction is a disease caused by multiple factors, with common causes including hypertension. In the case of hypertension, the choice of antihypertensive medication and the duration of treatment should be based on the patient's blood pressure to maintain it within a normal range. There is also a possibility that the condition is due to diabetes, as some diabetic patients are also prone to brain infarction. Such patients may need to use long-term antidiabetic drugs or insulin to control blood sugar. Additionally, antiplatelet medications might be necessary for brain infarction, but whether to use them should also be determined by the doctor based on the patient's specific circumstances. Since medications can have side effects, a comprehensive decision must be made on what drugs to use. (Note: The use of medications should be carried out under the guidance of a professional doctor.)
Can moxibustion be used for lacunar infarction (a type of stroke)?
Lacunar stroke is when small blood vessels in the deep parts of our brain's hemispheres or brainstem, under the long-term influence of high blood pressure, diabetes, or other risk factors, cause the supplying arteries to undergo ischemic necrosis. The affected areas typically have a diameter of less than 1.5 to 2 centimeters, leading to an acute syndrome of neurological function impairment. Treatment of this disease first depends on the patient's age and risk factors to decide whether to use medication. Also, the prognosis is generally good; there is no need for moxibustion, as moxibustion has neither benefits nor harms for lacunar stroke.
What medicine to take for a stroke?
Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The medications used for these two diseases differ, so it is essential to identify which type of disease it is. When symptoms occur, such as slurred speech, limb weakness, or other symptoms, it is crucial to seek medical attention immediately. Perform a cranial CT scan first to rule out bleeding, and then consider cerebral infarction. If it is a cerebral infarction, thrombolytic therapy can be administered within 4.5 hours of the acute phase, followed by hospital treatment. During the acute phase of a cerebral hemorrhage, the decision on whether to proceed with surgery depends on the amount of bleeding. Regardless of the situation, these conditions are often underpinned by several underlying diseases, such as hypertension, diabetes, or hyperlipidemia, along with other risk factors. Therefore, medication needs to be personalized, and it is also necessary to check for any contraindications to determine what medication to use. (Medication use should be guided by a professional doctor.)
CT manifestations of cerebral infarction
Brain infarction has different manifestations on CT scans at different stages. Generally, within 24 hours, the CT scan may not show any imaging of the cerebral infarction lesion. However, some patients, especially those with thrombosis in the middle cerebral artery, might exhibit a high density sign in the middle cerebral artery. In cases of large-scale cerebral infarction, some sulci on the side affected by the infarction may appear shallower, indicating possible brain swelling. Generally, within 24 hours, a CT scan can reveal a low-density image, which appears relatively darker. This condition is typically considered a brain infarction, and as time progresses, this dark, or low-density image, tends to become even darker. In some patients during the acute phase, although the infarction may not be apparent, a CT scan is performed to rule out bleeding, as CT is very sensitive to bleeding.
myasthenia gravis-related antibodies
Most cases of myasthenia gravis are mediated by acetylcholine receptor antibodies, involving cell-mediated immunity with complement, generally affecting the neuromuscular junction and causing a neuromuscular transmission disorder. This results in an acquired autoimmune disease of muscle weakness. However, a small number of patients with myasthenia gravis are mediated by muscle-specific kinase antibodies or low-density lipoprotein receptor-related protein 4 antibodies. Its main clinical manifestations include skeletal muscle weakness, fatigue, worsening with activity, and significant alleviation or reduction of symptoms after rest and the use of acetylcholinesterase inhibitors. Additionally, the disease can occur at any age, with females being more affected than males before the age of 40. Between 40 and 50 years old, the incidence rates between males and females are comparable, but after 50 years of age, the incidence rate in males is higher than in females.
What foods should not be eaten in the case of a cerebral infarction?
Stroke refers to the necrosis of brain tissue, causing a series of neurological functional deficit symptoms. The dietary requirements for stroke must be determined comprehensively based on the patient's own condition and underlying diseases. For instance, common risk factors for stroke include hypertension, diabetes, hyperlipidemia, and elevated homocysteine levels, along with unhealthy habits such as smoking and drinking. If the patient has hypertension, a light diet should be emphasized. If they have hyperlipidemia, fatty foods should be avoided in favor of a low-fat diet. In cases of high homocysteine levels, it is advisable to consume foods rich in vitamins. Additionally, if the patient has diabetes, they must adhere to a diabetic and low-sugar diet. Therefore, what food can be consumed depends on the patient's underlying diseases and the symptoms of the stroke. If the patient has swallowing difficulties, care must be taken to avoid hard foods as this could lead to choking and potentially cause a lung infection. Thus, the patient's individual condition must be taken into account when deciding their diet.
Key Points in the Treatment of Different Recovery Stages of Stroke
Stroke includes ischemic stroke and hemorrhagic stroke, namely cerebral infarction and cerebral hemorrhage. Their treatments are generally opposite. If it is a cerebral infarction, thrombolytic therapy is needed within 4.5 hours of the acute phase. It is necessary to consider whether there are indications and contraindications, and whether the patient and family members agree to undergo thrombolytic therapy. Regardless of whether thrombolytic therapy is administered, it is essential to subsequently check the condition of the cranial vessels to determine if surgical treatment is needed. If surgery is not required, hospitalization for conservative treatment might be necessary. Typically, about 7 to 14 days after the acute phase, rehabilitation treatment may be needed once the patient's condition stabilizes. The duration of rehabilitation treatment usually depends on the patient's recovery progress. Afterwards, it is important to consider the patient's underlying diseases, such as hypertension, diabetes, and other risk factors, to perform secondary prevention, which involves medication and control of risk factors. In the case of cerebral hemorrhage, the treatment during the acute phase depends on the amount and location of the bleeding and whether there are indications for surgery to determine if surgical treatment is necessary. If conservative treatment is chosen, it also involves hospital treatment, followed by possible rehabilitation treatment once stabilized.