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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
Can senile dementia be cured?
Dementia in the elderly is a clinical syndrome caused by the irreversible death of neurons. So far, the mechanism of the disease is not particularly clear, making it very difficult to cure dementia completely. However, there are some corresponding treatment methods that can delay the progression of the disease and improve the quality of life of patients as much as possible. These treatments mainly include exercise therapy, which involves getting patients to participate in appropriate physical activities that can promote cognitive development. In addition, letting patients listen to music more often, interact more with others, and continue learning can also delay the progression of aging. Furthermore, there are some medications that can improve the symptoms of dementia. Currently, the most commonly used worldwide are acetylcholinesterase inhibitors, which can increase the levels of acetylcholine and thereby improve cognitive function to some extent and slow the progression of the disease. Additionally, if elderly individuals exhibit some psychiatric symptoms, they can also be given some atypical antipsychotic medications to alleviate the condition.
Can a stroke be cured?
Stroke is mainly divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, also known as cerebral thrombosis, can benefit many patients if they can reach a hospital quickly and receive intravenous thrombolysis within the time window, such as within 4.5 hours, leaving them with only mild neurological deficits followed by proper rehabilitation training. Some patients can be cured. However, if the stroke is severe from the onset, resulting in complete paralysis or even consciousness disorders such as drowsiness, stupor, or coma, the treatment outcomes can be significantly less effective, potentially leaving some degree of disability. Generally speaking, whether a stroke can be cured depends closely on the initial severity of the stroke, the overall condition of the patient, and the timeliness of the treatment. Some conscious patients who receive timely treatment can be cured, whereas those with severe conditions typically suffer from long-term complications.
Can migraine be treated with hot compress?
Patients with migraines are not advised to use heat compresses, as the heat may promote the dilation of blood vessels both inside and outside the skull, possibly worsening the migraine or even triggering an attack. Some people may experience migraines when taking hot baths, which is based on the same principle. Migraines are primarily caused by a dysfunction in the constriction and dilation of blood vessels, resulting in severe pain that is typically moderate to severe in intensity. The pain may be accompanied by nausea, vomiting, a pulsing sensation in the blood vessels, and clinical symptoms such as photophobia (sensitivity to light) and phonophobia (sensitivity to sound). In terms of treatment, it is important to rest and provide the patient with a quiet environment, free from loud noises and bright lights. Appropriate pain relief medications should be taken, and if nausea and vomiting occur, antiemetic medications should be administered as well. Most symptoms will quickly subside, but it is important to focus on prevention.
Myasthenia gravis should not use what medicine?
Myasthenia gravis is a neuromuscular junction disease in neurology, primarily due to some synaptic dysfunction, leading to pathological fatigue and general weakness in patients. Patients with myasthenia gravis often experience exacerbation of the disease due to fatigue or infection, and certain medications can severely affect synaptic function, worsening the condition, and are therefore not to be used. The medications to avoid mainly include the following types: The first type is aminoglycoside antibiotics, which can exacerbate the transmission at the neuromuscular junction. Second, quinolone antibiotics should also be avoided as much as possible. Third, some antiarrhythmic drugs can also decrease the excitability of the fascia and are not recommended. Additionally, some drugs like morphine, benzodiazepines, and receptor blockers should also be contraindicated or used with caution.
How long is the recovery period for optic neuritis?
Optic neuritis is a demyelinating disease of the central nervous system. Besides affecting the optic nerve and causing a decrease in vision, it also impacts the brain's white matter and the spinal cord, leading to symptoms such as limb paralysis, numbness, and bladder and bowel dysfunction. Generally, the recovery period for optic neuritis is about six months, with the first three months being the most critical for recovery. If recovery has not occurred by six months, it is then considered a chronic phase, and further recovery becomes very challenging. It is crucial to diagnose and treat the condition promptly. Treatment primarily involves the use of corticosteroids, immunoglobulins, and potentially B-group vitamins to nourish the nerves. Overall, most patients with optic neuritis can recover substantially; however, the condition is prone to relapse, and the prognosis is poor if it reoccurs.
How is myasthenia gravis diagnosed?
Myasthenia gravis is essentially an immunoreactive disease in neurology, primarily caused by immune dysfunction in the body, leading to the production of autoantibodies. These antibodies attack the acetylcholine receptors on the postsynaptic membrane, resulting in corresponding clinical symptoms such as ptosis, diplopia, and general fatigue. The examination of myasthenia gravis mainly includes the following aspects: first, the completion of the Tensilon test, and if the test is positive, myasthenia gravis should be considered; second, the examination should include repetitive nerve stimulation electromyography, and if there is a significant decrement in wave amplitude, this disease should be considered; third, relevant blood tests should be conducted, mainly to check for acetylcholine receptor antibodies, as positive results for these antibodies are important in supporting this diagnosis.
Differences between Viral Meningitis and Tuberculous Meningitis
Virial meningitis and tuberculous meningitis sometimes require additional differentiation in clinical practice because their treatment plans are significantly different. Virial meningitis has a relatively abrupt onset and is caused by a viral infection, generally having a good prognosis. Patients with tuberculous meningitis usually exhibit symptoms of tuberculosis toxicity such as low fever, night sweats, and fatigue before the onset of the disease. Commonly, other forms of tuberculosis can be identified, such as pulmonary tuberculosis or intestinal tuberculosis. An important diagnostic tool for differentiation is the lumbar puncture. In viral meningitis, the lumbar puncture pressure is generally not particularly high, whereas in tuberculous meningitis, the lumbar puncture pressure is very high, reaching over 400 mm of water column. Additionally, the cerebrospinal fluid (CSF) in tuberculous meningitis is yellowish, and its protein levels are significantly elevated, as are its white blood cell counts, typically ranging from 50 to 500 × 10^6/L. In tuberculous meningitis, the levels of glucose and chloride in the cerebrospinal fluid are significantly decreased, especially chloride, which is a prominent indicator for diagnosing tuberculous meningitis. In contrast, such clear changes are not observed in the lumbar puncture for viral meningitis. Another aspect to consider is the treatment response; if antiviral treatment is ineffective, the possibility of tuberculous meningitis should be considered.
Is cerebral embolism the same as cerebral infarction?
Brain embolism is a form of cerebral infarction, so essentially, it is also a type of cerebral infarction. Cerebral infarction encompasses a wider range, including cerebral thrombosis, lacunar infarction, watershed infarction, and others. Brain embolism primarily refers to abnormal substances entering the bloodstream, which then enter the arteries of the brain, causing obstruction in these arteries and leading to ischemia and hypoxia of the brain tissue, thus presenting clinical symptoms of cerebral infarction. The onset of the condition in patients is quite severe, rapidly leading to paralysis of limbs and disorders of speech function. In cases of extensive brain embolism, patients may even experience coma and death as serious complications. Most patients with brain embolism have a history of atrial fibrillation. Atrial fibrillation can lead to the formation of mural thrombi, and when these thrombi dislodge, they can cause brain embolism.
Meningitis examination methods
The examination methods for meningitis mainly include several types. The first is the lumbar puncture examination, which is a very important diagnostic tool. Through lumbar puncture, one can observe the cerebrospinal fluid (CSF) pressure, its color, and perform laboratory tests on the CSF to examine biochemical properties and cell count changes. Additionally, it is possible to culture pathogens from the cerebrospinal fluid, which is of great auxiliary value in the diagnosis and differential diagnosis of meningitis. Secondly, patients with meningitis also need to undergo physical examinations. If signs of meningeal irritation are found during the physical examination, it also indicates meningitis. Thirdly, patients may need to undergo enhanced Magnetic Resonance Imaging (MRI) of the brain. If the meningitis lesions are severe, meningeal enhancement can be seen.
What to do about constipation in Parkinson's disease?
Among Parkinson's disease patients, constipation is a very common clinical symptom. In fact, many patients have experienced constipation for many years before the onset of Parkinson's disease symptoms, mainly due to the impact on some autonomic nerves in the intestines. For Parkinson's patients experiencing constipation, the main suggestions are: First, be sure to drink plenty of water. Drinking enough water can sufficiently lubricate the intestines and facilitate smoother bowel movements. Second, be sure to eat plenty of fresh vegetables and fruits. Vegetables and fruits are rich in vitamin C and can promote gastrointestinal motility. Additionally, it is recommended for patients to eat more bananas, as bananas have an evident laxative effect. Also, eat less of certain foods that can dry out the stool, such as sweet potatoes and chestnuts. If necessary, patients can be given laxative medications, and if bowel movements are extremely difficult, enemas can also be administered.